Orthostatic Hypotension

i. Orthostatic hypotension is defined as a drop in blood pressure of over 20 mmHg within three minutes of standing up.

ii. It should always be considered in elderly patients, particularly if they’re taking multiple medications and complaining of dizziness.

iii. Symptoms may include dizziness or a sudden blackout after standing up from a seated position, with symptoms resolving within minutes.

iv. Dehydration is one of the most common causes of orthostatic hypotension. Therefore, an evaluation of urea and electrolytes (U&E) should be requested.

v. Orthostatic hypotension is frequently observed in older adults, particularly those on multiple medications – a condition referred to as polypharmacy – and in those diagnosed with high blood pressure.

Diagnosis

i. Diagnosis is typically made by comparing blood pressure readings taken while the patient is lying down and standing up.

Further Reading: Orthostatic Hypotension