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Hypotension, Orthostatic

Reviewed 06/2018
 


BASICS

Postural or orthostatic hypotension (OH) represents the failure of cardiovascular reflexes to maintain adequate BP on standing from a supine or sitting position. 

DESCRIPTION

  • OH is defined as a s...

DIAGNOSIS

Initial approach: detailed history and physical examination with a focus on neurodegenerative disorders and neuropathy; thorough medication review; screening for reversible causes: 12-lead E...

TREATMENT

  • Abdominal binder or compression stockings (not thromboembolism deterrent [TED] hose), preferably waist high with 30 to 50 mm Hg for the legs and 20 to 30 mm Hg of pressure for the abdomen (w...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Monitor for significant supine HTN, fluid overload, electrolyte abnormalities, and HF in patients under medical treatment. In patients without an apparent cause o...

REFERENCES

1
Lanier JB, Mote MB, Clay EC. Evaluation and management of orthostatic hypotension. Am Fam Physician.  2011;84(5):527–536. [View Abstract on OvidMedline]
2
Ricci F, Caternina RD, Fedorow...

CODES

ICD10

I95.1 Orthostatic hypotension 

ICD9

458.0 Orthostatic hypotension 

SNOMED

  • 28651003 Orthostatic hypotension (disorder)

  • 371073003 postural orthostatic tachycardia syndrome (disorder)

CLINICAL PEARLS

  • OH is a clinical finding, not a disease. Treatment should be guided by symptoms rather than by absolute BP drop.

  • Always check the medication list and volume status. Drug-related OH may ...

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