Highlights
- •Orthostatic hypotension is associated with increased morbidity and mortality.
- •There are different forms of orthostatic hypotension, and mimics of orthostatic hypotension.
- •Understanding these can lead to more accurate diagnoses and better patient care.
Abstract
Orthostatic hypotension (OH) is a common clinical manifestation characterized by a
significant fall in blood pressure with postural change and is frequently accompanied
by debilitating symptoms of orthostatic intolerance. The reported prevalence of OH
ranges between 5 and 10% in middle-aged adults with a burden that increases concomitantly
with age; in those over 60 years of age, the prevalence is estimated to be over 20%.
Unfortunately, the clinical course of OH is not necessarily benign. OH patients are
at an increased risk of adverse clinical outcomes including death, falls, cardiovascular
and cerebrovascular events, syncope, and impaired quality of life.
The differential diagnosis of OH is broad and includes acute precipitants as well
as chronic underlying medical conditions, especially of neurological origin. Appropriate
diagnosis relies on a systematic history and physical examination with particular
attention to orthostatic vital signs, keeping in mind that ambient conditions during
diagnostic testing may affect OH detection due to factors such as diurnal variation.
Keywords
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Article info
Publication history
Published online: August 01, 2020
Accepted:
July 27,
2020
Received in revised form:
June 7,
2020
Received:
March 9,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
