Postural Hypotension Flashcards
1
Q
Postural Hypotension Diagnosis
A
- Reduction in systolic blood pressure of at least 20mmHg within 3 minutes of standing
- If resolves rapidly, suggests benign cause such as dehydration
2
Q
Postural Hypotension Aetiology
A
- Neurogenic and non-neurogenic causes
- Neurogenic due to neuropathy (diabetes, autoimmune) or central lesions (Parkinson’s)
- Non-neurogenic due to cardiac impairment, reduced intravascular volume, vasodilation
- Drugs e.g. diuretics, alpha-adrenoreceptor blockers, anti-hypertensives
- Also idiopathic (Bradbury-Eggleston syndrome)
3
Q
Postural Hypotension Prognosis
A
- Depends on cause
- Earlier and more severe the involvement of the autonomic nervous system, the poorer the prognosis
4
Q
Postural Hypotension Management
A
- Goal is to raise standing blood pressure without raising supine blood pressure
- Aim is to reduce symptoms
- No specific treatment available
- Identify and reduce drugs exacerbating
- Education
- Physical measures e.g. raising head of bed, moving to upright gradually, abdominal compression
- Increased salt and water ingestion
- Pharmacological treatment with fludrocortisone
