Orthostatic hypotension

Orthostatic hypotension : Orthostatic hypotension is defined as a drop of 20 mmHg or more in TAS (systolic blood pressure) or a decrease in TAS below 90 mmHg and a drop of 10 mmHg or more in TAD (diastolic blood pressure ) or a decrease in TAD below 60 mmHg within the first 3 minutes after adopting the orthostatic position. It is one of the causes of syncope or fainting.

Summary

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  • 1 Description
  • 2 Risk factors
  • 3 Types of arterial hypotension
  • 4 Sources

Description

Orthostatic hypotension is a drop in blood pressure that comes as a result of a person standing for a long time, or when standing up after sitting or lying down. A large amount of blood accumulates in the legs, preventing the normal amount of blood from returning to the heart, which means that it is also not possible for an adequate amount of blood to leave the heart to circulate to the body, mainly to the brain. This causes a momentary decrease in blood flow to the brain, and the person may pass out.

Risk factor’s

  • Usually occurring when patients are standing or walking, loss of consciousness in dysautonomic syncope tends to be slow and progressive.
  • Primary autonomic deficit.
  • This is a problem that is often underdiagnosed or misdiagnosed.
  • Intake of some drugs such as: vasodilators, nitrates, calcium antagonists, ACE inhibitors, antiarrhythmics, antidepressants, anxiolytics, hypnotics, antidiabetics, clonidine (sympathetic agonist α²), methyldopa, metamizole, carbamazepine, terfenadine, α and β blockers (prazosin as a blocker α¹ and labetalol and carvedilol as α and β blockers).
  • Intake of alcohol.
  • Hypovolemia ( hemorrhage , diarrhea , heavy vomiting ).
  • Suprarrenal insufficiency.
  • Bradycardia and sweating are rare in these cases, unlike in patients with vasovagal syncope.
  • The pregnancy.
  • Very tall patients.
  • Sympathectomy

Types of arterial hypotension

  • Orthostatic hypotension: It is defined as the body’s inability to regulate blood pressure quickly. It is produced by sudden changes in body position (when going from lying down to standing). It usually lasts a few seconds or minutes and can cause fainting.
  • Postprandial Orthostatic Hypotension: If it occurs after eating, it is called postprandial orthostatic hypotension, which most often affects older adults, people with high blood pressure and Parkinson’s disease .
  • Neurally mediated hypotension: Occurs when standing for a long time, causing dizziness, fainting or stomach upset. This type of hypotension affects young adults and children to a greater extent.

Severe hypotension: It is caused by a sudden loss of blood that deprives the brain of oxygen

 

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