Hypotension, Orthostatic

Jonathan M. Tisdell, MD and Patricia L. Seymour, MD Reviewed 06/2019

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

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

Ricci F, De Caterina R, Fedoro...

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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