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Orthostatic hypertension involving the systolic BP is known as systolic orthostatic hypertension. High diastolic blood pressure measured while standing in a person who stood up shortly after waking up. When it affects an individual's ability to remain upright, orthostatic hypertension is considered as a form of orthostatic intolerance.
For people with high blood pressure, higher heart rate variability (HRV) is a risk factor for atrial fibrillation. [ 51 ] Both high systolic pressure and high pulse pressure (the numerical difference between systolic and diastolic pressures) are risk factors. [ 49 ]
Initial orthostatic hypotension is frequently characterized by a systolic blood pressure decrease of ≥40 mmHg or diastolic blood pressure decrease of ≥20 mmHg within 15 seconds of standing. [32] Blood pressure then spontaneously and rapidly returns to normal, so the period of hypotension and symptoms is short (<30 s). [32]
For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
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