Postural hypotension Flashcards
1
Q
What is the definition of postural hypotension?
A
When someones blood pressures falls by more than 20/10mmHg within 3 mins of standing compared to when they sit/lie down
2
Q
What is the pathology of postural hypotension?
A
- Normally the blood pressure of a person rises if someones stands up due to ↑ venous return/venoconstriction
- Loss of extracellular fluid prevents this = ↓ BP
- Baroreflex mechanism that controls heart rate and vascular resistance declines with age
3
Q
What are the risk factors/aetiology of postural hypotension?
A
- Elderly
- Diabetes = hypovolaemia
- Systemic amyloidosis = hypovolaemia
- Age = hypovolaemia
- Parkinson’s disease
- Tricyclic antidepressents – interference with autonomic function
- Nitrates – interference with peripheral vasoconstriction
- Ca channel blockers – interference with peripheral vasoconstriction
- Diuretics = hypovolemia
- Prolonged bed rest
4
Q
What are the signs/symptoms of postural hypotension?
A
- JVP – when lying flat
- Cold skin
- Empty peripheral veins
- Tachycardia
- Dizziness
- Headache
- Blurred vision
- Fatigue
- Syncope
- Nausea
5
Q
What investigations are carried out for suspected postural hypotension?
A
• Lying and standing BP
6
Q
What is the pharmacological treatment for postural hypotension?
A
• Midodrine
7
Q
What is the non pharmacological treatment for postural hypotension?
A
- Manage underlying cause
- Drink more water
- Compression stockings
- Physical counterpressure manoeuvres
- Sit up and then change position slowly
