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Orthostatic hypotension, also known as postural hypotension, [2] is a medical condition wherein a person's blood pressure drops when they are standing up (orthostasis) or sitting down. Primary orthostatic hypotension is also often referred to as neurogenic orthostatic hypotension. [ 3 ]
Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
A patient is considered to have orthostatic hypotension when the systolic blood pressure falls by more than 20 mm Hg, the diastolic blood pressure falls by more than 10 mm Hg, or the pulse rises by more than 20 beats per minute within 3 minutes of standing [5] [7]
For example, if a person’s actual blood pressure is 134, and blood pressure is measured on a dangling arm, the reading could end up over 140, which is considered to be stage 2 hypertension.
Before taking the test, the patient may be instructed to fast for a period before the test will take place and to stop taking any medications. On the day of the tilt table test, an intravenous line may be placed in case the patient needs to be given medications quickly; however, this may influence the results of the test and may only be indicated in particular circumstances.
Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining. [1] There are many types of orthostatic intolerance. OI can be a subcategory of dysautonomia, a disorder of the autonomic nervous system [2] occurring when an individual stands up. [3]
A large fall in blood pressure upon standing (typically a systolic/diastolic blood pressure decrease of >20/10 mmHg) is termed orthostatic hypotension (postural hypotension) and represents a failure of the body to compensate for the effect of gravity on the circulation.
Blood pressure numbers tend to have a natural rhythm, rising and falling throughout the day, and some people with hypertension, also known as high blood pressure, may be prone to morning peaks.