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Blood pressure and heart rate should be measured in supine and standing positions. As described above, orthostatic hypotension diagnosis is when there is a drop of greater than or equal to 20 mmHg or greater or equal to 10 mmHg in systolic and diastolic blood pressures, respectively within 3 minutes of standing. [1]
A patient is considered to have orthostatic hypotension when the systolic blood pressure falls by more than 20 mm Hg, the diastolic blood pressure falls by more than 10 mm Hg, or the pulse rises by more than 20 beats per minute within 3 minutes of standing [5] [7]
The prevalence of this condition has been studied in various populations. In a study conducted in 1922, it was found that 4.2% of 2000 apparently healthy aviators aged 18 to 42 years had an increase in diastolic blood pressure from below 90 mmHg while in the supine position to above 90 mmHg in the upright posture. [24]
The most common symptoms of POTS are rapid heart rate within 10 minutes of standing or sitting up, lightheadedness and fainting, fatigue, brain fog, nausea, and shortness of breath.
A significant increase in heart rate from supine to standing may indicate a compensatory effort by the heart to maintain cardiac output. A related syndrome, postural orthostatic tachycardia syndrome (POTS), is diagnosed when at least a 30 bpm increase in heart rate occurs with little or no change in blood pressure.
The heart resumes beating normally upon being returned to a flat or head-down position. A drop in blood pressure during the tilt table test is indicative of orthostatic hypotension. A marked increase in heart rate in the absence of orthostatic hypotension is indicative of postural orthostatic tachycardia syndrome. [6]
Blood pressure is recorded as two readings: a higher systolic pressure, which occurs during the maximal contraction of the heart, and the lower diastolic or resting pressure. [11] In adults, a normal blood pressure is 120/80, with 120 being the systolic and 80 being the diastolic reading. [12] Usually, the blood pressure is read from the left ...
Supine hypertension is a paradoxical elevation in blood pressure upon assuming a supine position from a standing or sitting position. [1] [2] [3] It is assumed to be a manifestation of disorders of the autonomic nervous system [4] or due to side effects of medications such as midodrine and droxidopa. [5] [6]