SOURCE: Gorelik O, Cohen N. Seated postural hypotension. J Am Soc Hypertens 2015;9:985-992.
Traditionally, orthostatic hypotension (OH) is defined as a drop in systolic blood pressure > 20 mmHg or diastolic blood pressure > 10 mmHg (or both) within 3 minutes of standing from a supine position. The consequences of OH include adverse symptoms, such as dizziness or “coat-hanger” headache, as well as serious or even fatal events consequent to falls. Studies on OH measured when patients transfer from supine to the seated position are infrequent; Gorelik and Cohen reviewed the data from 17 different studies to elucidate the literature on seated postural hypotension (SOH).
Similar to OH, the prevalence of SOH increases with age and is more frequent among patients ingesting antihypertensive medications. Probably because of the lack of a firmly established definition of SOH, measurement methods varied among studies, such that changes in blood pressure were measured within as little as 1 minute to as long as 5 minutes or even longer after changing from the supine to seated posture; most data employed the standard blood pressure change (> 20/10 mmHg) to define SOH. Symptoms evoked among patients with SOH were essentially the same as those observed in patients with “typical” OH.
Some experts have advised routinely measuring orthostatic blood pressure in patients with underlying neurologic disorders, such as Parkinson’s disease, in which OH prevalence is distinctly higher. Measurement of postural changes in blood pressure from supine to seated may be helpful to sort out symptoms such as dizziness or falls, especially in older patients.
Measurement of postural changes in blood pressure from supine to seated may be helpful to sort out symptoms such as dizziness or falls, especially in older patients.
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