Download A4Medicine Mobile App
Empower Your RCGP AKT Journey: Master the MCQs with Us! 🚀
This table summarizes the key points about orthostatic hypotension based on NICE recommendations
| Topic | Key Information |
|---|---|
| Definition | - Sustained reduction of systolic blood pressure by ≥20 mmHg or diastolic blood pressure by ≥10 mmHg within 3 minutes of standing. |
| - Or upon tilting the body to a 60° angle on a tilt table. | |
| Causes | - Idiopathic (Bradbury–Eggleston syndrome). |
| - Disorders affecting the autonomic nervous system (e.g., Parkinson's disease, multiple system atrophy, diabetic autonomic neuropathy). | |
| - Loss of blood volume or dehydration. | |
| - Certain medications, notably antihypertensives. | |
| Prevalence | - 5-30% in people aged >65 years. |
| - Up to 60% in those with Parkinson's disease. | |
| - Up to 70% in care home residents. | |
| - Approximately 0.2% of people aged >75 years are hospitalized due to orthostatic hypotension-related issues. | |
| Diagnostic Advice (NICE) | - Measure blood pressure in lying and standing positions. If orthostatic hypotension is suspected, monitor for 3 minutes. |
| - If confirmed, identify potential causes and manage accordingly. | |
| Management Recommendations (European Federation) | - Education: Inform patients about factors that can influence blood pressure (e.g., sudden posture changes, alcohol, large meals). |
| - Physical Measures: Elevate bed head, slow postural changes, leg crossing, leg bending/squatting, use of elastic stockings and abdominal compression... |
Try our Free Plan to get the full article.
