Orthostatic hypotension

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In medicine, orthostatic hypotension is "a significant drop in blood pressure after assuming a standing position. Orthostatic hypotension is a finding, and defined as a 20-mm hg decrease in systolic pressure or a 10-mm hg decrease in diastolic pressure 3 minutes after the person has risen from supine to standing. Symptoms generally include dizziness, blurred vision, and syncope."[1]

Orthostatic hypotension is an orthostatic intolerance along with postural orthostatic tachycardia syndrome (POTS)[2][3] and vasovagal syncope.

Causes

Baroreflex failure may cause labile hypertension with hypotension.[4]

Carotid endarterectomy of the internal carotid artery may be a cause.[5][6]

However, orthostasis may be improved by endarterectomy[7] if there is "vasodepressor-type carotid sinus syndrome caused by compression of the carotid baroreceptors by atherosclerotic plaques."[8]

Complications

Orthostatic hypotension may cause accidental falls.[9]

References

  1. Anonymous (2024), Orthostatic hypotension (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Grubb BP, Karabin B (July 2008). "Cardiology patient page. Postural tachycardia syndrome: perspectives for patients". Circulation 118 (3): e61–2. DOI:10.1161/CIRCULATIONAHA.107.761650. PMID 18625897. Research Blogging.
  3. Low PA, Sandroni P, Joyner M, Shen WK (January 2009). "Postural Tachycardia Syndrome (POTS)". J. Cardiovasc. Electrophysiol.. DOI:10.1111/j.1540-8167.2008.01407.x. PMID 19207771. Research Blogging.
  4. Robertson D, Hollister AS, Biaggioni I, Netterville JL, Mosqueda-Garcia R, Robertson RM (1993). "The diagnosis and treatment of baroreflex failure.". N Engl J Med 329 (20): 1449-55. PMID 8413455.
  5. Nouraei SA, Al-Rawi PG, Sigaudo-Roussel D, Giussani DA, Gaunt ME (April 2005). "Carotid endarterectomy impairs blood pressure homeostasis by reducing the physiologic baroreflex reserve". J. Vasc. Surg. 41 (4): 631–7. DOI:10.1016/j.jvs.2005.01.009. PMID 15874927. Research Blogging.
  6. Azuma Y, Imai K, Oda K, Niwa F, Makino M, Oshima F (October 2007). "[Case of baroreflex failure after bilateral revascularization of the cervical carotid artery]" (in Japanese). Rinsho Shinkeigaku 47 (10): 657–61. PMID 18095499[e]
  7. Hirschl M, Kundi M, Blazek G (July 1996). "Five-year follow-up of patients after thromboendarterectomy of the internal carotid artery: Relevance of baroreceptor sensitivity". Stroke 27 (7): 1167–72. PMID 8685922[e]
  8. Akiyama Y, Hashimoto N, Morimoto M (February 1999). "Orthostatic hypotension improved after bilateral carotid endarterectomy--case report". Neurol. Med. Chir. (Tokyo) 39 (2): 153–6. PMID 10193149[e]
  9. Romero-Ortuno R, Cogan L, Foran T, Kenny RA, Fan CW (2011). "Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people.". J Am Geriatr Soc 59 (4): 655-65. DOI:10.1111/j.1532-5415.2011.03352.x. PMID 21438868. Research Blogging.