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Orthostatic hypotension, also known as postural hypotension, [2] is a medical condition wherein a person's blood pressure drops when they are standing up (orthostasis) or sitting down. Primary orthostatic hypotension is also often referred to as neurogenic orthostatic hypotension. [ 3 ]
Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
Causes range from non-serious to potentially fatal. [1] There are three broad categories of causes: heart or blood vessel related; reflex, also known as neurally mediated; and orthostatic hypotension. [1] Issues with the heart and blood vessels are the cause in about 10% and typically the most serious while neurally mediated is the most common. [1]
Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining. [1] There are many types of orthostatic intolerance. OI can be a subcategory of dysautonomia, a disorder of the autonomic nervous system [2] occurring when an individual stands up. [3]
Baroreflex and autonomic pathways normally ensure that blood pressure is maintained despite various stimuli, including postural change. The precise mechanism of orthostatic hypertension remains unclear, but alpha-adrenergic activity may be the predominant pathophysiologic mechanism of orthostatic hypertension in elderly hypertensive patients. [5]
This decreases the venous return, and so there will be decreased cardiac output, which ultimately causes systolic blood pressure to fall (hypotension). This hypotension may lead the subject to faint or to have other symptoms of hypotension. Standing requires about 10% more energy than sitting. [2] [better source needed]
Camptocormia, also known as bent spine syndrome (BSS), is a symptom of a multitude of diseases that is most commonly seen in the elderly. It is identified by an abnormal thoracolumbar spinal flexion, which is a forward bending of the lower joints of the spine, occurring in a standing position.
[2] [3] [4] Used to identify orthostatic hypotension, [5] orthostatic vital signs are commonly taken in triage medicine when a patient presents with vomiting, diarrhea or abdominal pain; with fever; with bleeding; or with syncope, dizziness or weakness. [2]