Materiały źródłowe

• #1 Evaluation and Management of Orthostatic Hypotension | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p527.html

  Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic response to postural changes in blood pressure. […] Orthostatic hypotension is often found in older patients and in those who are frail. It is present in up to 20 percent of patients older than 65 years. In one study, the prevalence of orthostatic hypotension was 18 percent in patients older than 65 years, but only 2 percent of these patients were symptomatic. […] Orthostatic hypotension may be acute or chronic, as well as symptomatic or asymptomatic. Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, and headache.

• #2 Mechanisms, causes, and evaluation of orthostatic hypotension – UpToDate

  https://www.uptodate.com/contents/mechanisms-causes-and-evaluation-of-orthostatic-hypotension

  Orthostatic hypotension is a condition described by a significant reduction in blood pressure that typically occurs upon standing or assuming an upright posture. It may be asymptomatic or symptomatic and can be due to impaired autonomic reflexes or intravascular volume depletion. Symptoms can include dizziness, lightheadedness, syncope, muscle ache in the neck and shoulders, and even angina. […] Orthostatic hypotension is common with an overall prevalence of up to 20 percent. Many disorders can cause orthostatic hypotension, as can acute or chronic volume depletion and a side effect of medications (particularly antihypertensive agents). […] This topic will review the etiologies, clinical features, and diagnosis of orthostatic and postprandial hypotension.

• #3 Orthostatic Hypotension : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/orthostatic-hypotension/

  Orthostatic Hypotension is the second most common etiology of syncope, occurring in approximately 15% of syncope presentations. Often unrecognized or overlooked factor associated with increased cardiovascular morbidity and all-cause mortality. […] Orthostatic hypotension: decrease in systolic blood pressure of 20 mmHg or decrease in diastolic blood pressure of 10 mmHg within 3 minutes of standing compared with blood pressure from the sitting or supine position. […] In hypertensive subjects, a cut-off of 30 mmHg fall in sBP may be more appropriate. […] Initial orthostatic hypotension: decrease in systolic blood pressure of at least 40 mmHg or diastolic blood pressure of at least 20 mmHg within 15 seconds of standing. […] Delayed orthostatic hypotension: gradual impairment of adaptive mechanisms during orthostasis, resulting in slow decrease in sBP ≥20 mmHg or diastolic ≥10 mmHg, between 3 and 45 minutes. […] Orthostatic Hypotension-Epidemiology, Prognosis, and Treatment. Ricci F, Caterina RD, Fedorowski A. J Am Coll Cardio. 2015; 66(7): 848-60. -PubMed

• #4 Orthostatic Hypotension – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448192/

  Orthostatic hypotension, also known as postural hypotension, is defined as a sudden drop in blood pressure that occurs upon standing from a sitting or supine position. This condition significantly impacts quality of life and increases the risk of falls, cardiovascular disease, dementia, depression, and mortality. […] The prevalence of orthostatic hypotension increases with age, particularly in individuals aged 65 or older, due to impaired baroreceptor sensitivity. A systematic review and meta-analysis found that 1 in 5 adults aged 60 or older living in the community experience orthostatic hypotension, with rates being even higher among those residing in long-term care facilities. […] Orthostatic hypotension is more likely to be prevalent among geriatric inpatients. Factors such as clinical settings, frequency of testing, and encouragement to mobilize can influence its prevalence in hospitals. A study reported that 25% of patients presenting to the emergency department with syncope were diagnosed with orthostatic hypotension.

• #5 Orthostatic hypotension – wikidoc

  https://www.wikidoc.org/index.php/Orthostatic_hypotension

  Incidence: The approximation of orthostatic hypotension associated hospitalization is 36 per 100,000 adults, and the rate can be as high as 233 per 100,000 patients 75 years of age. […] Prevalence: The overall prevalence of orthostatic hypotension depends on age as it increases with age in the general population. The prevalence ranges from 5% in patients 50 years of age to 30% in those 70 years of age. It is ~20% in 65-year-old patients. […] Age: Orthostatic Hypotension is commonly seen in individuals older than 50 years of age. […] Gender: Orthostatic hypotension affects men and women equally. […] Common risk factors in the development of orthostatic hypotension include: Age (65), Medications, Autonomic neuropathies, such as Parkinson’s disease, diabetes, Volume depletion, Postpartum period, Prolong bedrest.

• #6 Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/26271068/

  Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients 50 years of age to 30% in those 70 years of age. […] Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. […] In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.

• #7 Orthostatic Hypotension

  https://fpnotebook.com/CV/Exam/OrthstcHyptnsn.htm

  Orthostatic Hypotension Prevalence increases with age and debility Middle Age: 5% Age 60 years: 20% Nursing Home: 50% Geriatric medical ward: 68% […] Orthostatic Hypotension related hospital admissions (U.S., 2007) All adults: 36 per 100,000 Adults75 years: 233 per 100,000.

• #8 Evaluation and Management of Orthostatic Hypotension | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p527.html

  Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic response to postural changes in blood pressure. […] Orthostatic hypotension is often found in older patients and in those who are frail. It is present in up to 20 percent of patients older than 65 years. In one study, the prevalence of orthostatic hypotension was 18 percent in patients older than 65 years, but only 2 percent of these patients were symptomatic. […] Orthostatic hypotension may be acute or chronic, as well as symptomatic or asymptomatic. Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, and headache.

• #9 Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/26271068/

  Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients 50 years of age to 30% in those 70 years of age. […] Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. […] In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.

• #10 Orthostatic hypotension in elderly: Do you measure orthostatic and clinostatic blood pressure?

  https://www.hvt-journal.com/articles/art349

  Orthostatic hypotension (OH) is defined as a reduction in systolic BP of at least 20 mmHg or in diastolic BP of at least 10 mmHg within three minutes of standing. It is a common condition in older adults, with prevalence ranging from 5% in individuals 50 years old to 30% in patients 70 of age. It is responsible for adverse events (i.e., falls, hospitalization, institutionalization), morbidity and mortality. […] A large study conducted in the United Kingdom showcased lower incidence of OH reported among general practitioners than outlined by previous works. Authors hypothesize this result may be due to an underestimation cause by a lack of time during routine clinical examination or poorly standardized methods of measurement. […] OH is a frequent but often overlooked condition in older adults. Elderly patients present several risk factors for autonomic dysfunction, furthermore drugs administered should be carefully gauged in detail keeping only those strictly essential. In addition, screening and properly training the patient in the management of autonomic dysfunction may have a positive impact on falls, fear of falling and other consequences of OH in terms of quality of life, morbidity and mortality.

• #11 Recent advances in orthostatic hypotension – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/recent-advances-in-orthostatic-hypotension/

  Orthostatic hypotension also called postural hypotension is a form of low blood pressure that happens when you stand up from sitting or lying down. This article reviews current advances in the area. […] Orthostatic hypotension or postural hypotension is a relatively common condition in the elderly population. It is an important cause of preventable falls in the elderly and this article summarises the most recent advances in this field from epidemiology, clinical presentation and management. […] A number of studies have reviewed the prevalence of OH in recent years. The Irish TILDA study analysed data from 4,475 persons after an active standing test. […] The total prevalence of OH was 6.9%, increasing to 18% for persons over the age of 80 years. […] In the Swedish Good Aging in Skane study (GAS-SNAC), 1,400 individuals were randomly selected from a database on ageing. The study concluded that OH was a risk factor for mild cognitive dysfunction.

• #12 Orthostatic Hypotension – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448192/

  Orthostatic hypotension, also known as postural hypotension, is defined as a sudden drop in blood pressure that occurs upon standing from a sitting or supine position. This condition significantly impacts quality of life and increases the risk of falls, cardiovascular disease, dementia, depression, and mortality. […] The prevalence of orthostatic hypotension increases with age, particularly in individuals aged 65 or older, due to impaired baroreceptor sensitivity. A systematic review and meta-analysis found that 1 in 5 adults aged 60 or older living in the community experience orthostatic hypotension, with rates being even higher among those residing in long-term care facilities. […] Orthostatic hypotension is more likely to be prevalent among geriatric inpatients. Factors such as clinical settings, frequency of testing, and encouragement to mobilize can influence its prevalence in hospitals. A study reported that 25% of patients presenting to the emergency department with syncope were diagnosed with orthostatic hypotension.

• #13 What Is Orthostatic Hypotension (Postural Hypotension)?

  https://www.webmd.com/heart/what-is-orthostatic-hypotension-dizzy-standing

  Orthostatic hypotension (also called postural hypotension) is a sudden dip in blood pressure that happens when you stand up after you’ve been sitting or lying down. […] You’re more likely to be affected when you’re older. As you age, the cells in your heart and arteries that keep your blood pressure steady respond more slowly. […] A study of elderly women found that most with congestive heart failure had a significant drop in their blood pressure when they were tilted back, then moved to an upright position. […] Some researchers say orthostatic hypertension is common both in people who have high blood pressure and in those who don’t, but there aren’t a lot of studies on it. […] Some researchers say orthostatic hypertension becomes more common with advancing age, a higher body mass index, and chronic high blood pressure (also called primary or essential hypertension). […] Your doctor may need to test you for orthostatic hypertension more than once to confirm the diagnosis.

• #14 Orthostatic Hypotension – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448192/

  Orthostatic hypotension, also known as postural hypotension, is defined as a sudden drop in blood pressure that occurs upon standing from a sitting or supine position. This condition significantly impacts quality of life and increases the risk of falls, cardiovascular disease, dementia, depression, and mortality. […] The prevalence of orthostatic hypotension increases with age, particularly in individuals aged 65 or older, due to impaired baroreceptor sensitivity. A systematic review and meta-analysis found that 1 in 5 adults aged 60 or older living in the community experience orthostatic hypotension, with rates being even higher among those residing in long-term care facilities. […] Orthostatic hypotension is more likely to be prevalent among geriatric inpatients. Factors such as clinical settings, frequency of testing, and encouragement to mobilize can influence its prevalence in hospitals. A study reported that 25% of patients presenting to the emergency department with syncope were diagnosed with orthostatic hypotension.

• #15 Orthostatic Hypotension

  https://fpnotebook.com/CV/Exam/OrthstcHyptnsn.htm

  Orthostatic Hypotension Prevalence increases with age and debility Middle Age: 5% Age 60 years: 20% Nursing Home: 50% Geriatric medical ward: 68% […] Orthostatic Hypotension related hospital admissions (U.S., 2007) All adults: 36 per 100,000 Adults75 years: 233 per 100,000.

• #16 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  To the authors knowledge, this is the first study to quantify incident recorded postural hypotension in general practice. The rate is lower than expected compared with studies in screened older populations. […] Postural (orthostatic) hypotension is a common, yet frequently overlooked, condition associated with serious adverse outcomes in later life. It is estimated to affect around 20% of community-dwelling older adults and between 20% and 31% of those living in long-term care. […] In the UK, the reported prevalence of postural hypotension has ranged from 28% in older females, up to 81% of older adults screened using continuous blood pressure (BP) monitoring. […] Early detection in patients who are symptomatic or in those with certain risk factors may prevent some of these complications. General practice plays an important role in identification; however, current guidelines for detecting postural hypotension are varied and based on limited evidence.

• #17 Orthostatic Hypotension

  https://fpnotebook.com/CV/Exam/OrthstcHyptnsn.htm

  Orthostatic Hypotension Prevalence increases with age and debility Middle Age: 5% Age 60 years: 20% Nursing Home: 50% Geriatric medical ward: 68% […] Orthostatic Hypotension related hospital admissions (U.S., 2007) All adults: 36 per 100,000 Adults75 years: 233 per 100,000.

• #18 Orthostatic Hypotension – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448192/

  Orthostatic hypotension, also known as postural hypotension, is defined as a sudden drop in blood pressure that occurs upon standing from a sitting or supine position. This condition significantly impacts quality of life and increases the risk of falls, cardiovascular disease, dementia, depression, and mortality. […] The prevalence of orthostatic hypotension increases with age, particularly in individuals aged 65 or older, due to impaired baroreceptor sensitivity. A systematic review and meta-analysis found that 1 in 5 adults aged 60 or older living in the community experience orthostatic hypotension, with rates being even higher among those residing in long-term care facilities. […] Orthostatic hypotension is more likely to be prevalent among geriatric inpatients. Factors such as clinical settings, frequency of testing, and encouragement to mobilize can influence its prevalence in hospitals. A study reported that 25% of patients presenting to the emergency department with syncope were diagnosed with orthostatic hypotension.

• #19 Evaluation and Management of Orthostatic Hypotension | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p527.html/amp/

  Orthostatic hypotension is often found in older patients and in those who are frail. It is present in up to 20 percent of patients older than 65 years. In one study, the prevalence of orthostatic hypotension was 18 percent in patients older than 65 years, but only 2 percent of these patients were symptomatic. […] In acute care settings, syncope may be the initial presentation of orthostatic hypotension. A prospective study of 611 patients presenting to an emergency department following a syncopal episode found that 24 percent had orthostatic hypotension.

• #20 Orthostatic Hypotension – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448192/

  Orthostatic hypotension, also known as postural hypotension, is defined as a sudden drop in blood pressure that occurs upon standing from a sitting or supine position. This condition significantly impacts quality of life and increases the risk of falls, cardiovascular disease, dementia, depression, and mortality. […] The prevalence of orthostatic hypotension increases with age, particularly in individuals aged 65 or older, due to impaired baroreceptor sensitivity. A systematic review and meta-analysis found that 1 in 5 adults aged 60 or older living in the community experience orthostatic hypotension, with rates being even higher among those residing in long-term care facilities. […] Orthostatic hypotension is more likely to be prevalent among geriatric inpatients. Factors such as clinical settings, frequency of testing, and encouragement to mobilize can influence its prevalence in hospitals. A study reported that 25% of patients presenting to the emergency department with syncope were diagnosed with orthostatic hypotension.

• #21 Orthostatic Hypotension

  https://fpnotebook.com/CV/Exam/OrthstcHyptnsn.htm

  Orthostatic Hypotension Prevalence increases with age and debility Middle Age: 5% Age 60 years: 20% Nursing Home: 50% Geriatric medical ward: 68% […] Orthostatic Hypotension related hospital admissions (U.S., 2007) All adults: 36 per 100,000 Adults75 years: 233 per 100,000.

• #22 Neurogenic Orthostatic Hypotension: Pathophysiology and Diagnosis

  https://www.ajmc.com/view/ace0034_oct15_noh_low

  In 2004, the rate of hospitalization associated with OH was 36 per 100,000 adults in the United States. […] In contrast to extensive data about the prognosis of OH in elderly patients, few studies describe the prognosis in NOH. […] The death rate was higher in patients with comorbid cardiovascular disease (53% vs 31%, P = .04). […] Patients with NOH had a 3-fold higher risk of death than the general population in that geographic area.

• #23 Orthostatic hypotension – wikidoc

  https://www.wikidoc.org/index.php/Orthostatic_hypotension

  Incidence: The approximation of orthostatic hypotension associated hospitalization is 36 per 100,000 adults, and the rate can be as high as 233 per 100,000 patients 75 years of age. […] Prevalence: The overall prevalence of orthostatic hypotension depends on age as it increases with age in the general population. The prevalence ranges from 5% in patients 50 years of age to 30% in those 70 years of age. It is ~20% in 65-year-old patients. […] Age: Orthostatic Hypotension is commonly seen in individuals older than 50 years of age. […] Gender: Orthostatic hypotension affects men and women equally. […] Common risk factors in the development of orthostatic hypotension include: Age (65), Medications, Autonomic neuropathies, such as Parkinson’s disease, diabetes, Volume depletion, Postpartum period, Prolong bedrest.

• #24 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  Postural hypotension is a common condition associated with adverse outcomes in older adults. General practice plays an important role in identification of the condition. […] To examine the incidence of postural hypotension between 2008 and 2018 in general practice and how trends vary by age, sex, year, and social deprivation. […] Of 2 911 260 patients, 24 973 had an electronic record indicating a new diagnosis of postural hypotension between 2008 and 2018. This was equivalent to 17.9 cases per 10 000 PYAR in males (95% confidence interval [CI] = 17.6 to 18.2) and 16.2 cases per 10 000 PYAR in females (95% CI = 15.9 to 16.5). A significant age-sex interaction was identified. Recorded postural hypotension rate increased with age and social deprivation, and reduced between 2008 and 2018. The rate was higher in males compared with females, particularly in older age groups (80 years).

• #25 Orthostatic Hypotension and other Autonomic Failure Syndromes: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1154266-overview

  Autonomic failure syndromes are relatively uncommon. The prevalence of multiple system atrophy (MSA) is 1.94.9 cases per 100,000 population, as reported in several series. No accurate data on the frequency of autoimmune autonomic neuropathy (AAN), pure autonomic failure (PAF), or postural orthostatic tachycardia syndrome (POTS) are available. […] AAN and MSA have no clear sex predilection. In the literature about PAF, men were affected more often than women. POTS affects women 5 times more often than men. […] Autonomic dysfunction may cause clinically significant functional impairment. POTS is usually a benign, sometimes self-limiting condition, though rare patients have severe limitation in their activities. […] Severe autonomic dysfunction may directly cause death. More often, chronic disability increases the patient’s susceptibility to other potentially fatal complications, such as infection.

• #26 Orthostatic hypotension – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/972

  Orthostatic hypotension (OH) is an independent predictor of mortality and the cause of significant morbidity associated with falls. […] A common problem in frail older people. OH-related hospitalizations increase markedly with age. […] OH is increasingly recognized as a common comorbidity of hypertension, both because of the pathophysiology of hypertension itself, and also because the measurement of OH is derived from the difference between two blood pressures (lying or sitting, and standing), the absolute value of which will be greater with a higher starting blood pressure. […] OH is associated with increased risk of dementia and cardiovascular disease, and is an independent risk factor for all-cause mortality. […] This topic concentrates on OH caused by autonomic problems.

• #27 Orthostatic Hypotension in Adults With Hypertension – Professional Heart Daily | American Heart Association

  https://professional.heart.org/en/science-news/orthostatic-hypotension-in-adults-with-hypertension

  Orthostatic hypotension (OH) has been understood as a manifestation of autonomic dysfunction, but OH is a common comorbidity of hypertension (HTN). […] Orthostatic hypotension (OH) is defined as a sustained reduction in systolic blood pressure of at least 20mmHg or diastolic blood pressure of 10mmHg within 3 minutes of standing. […] This scientific statement focuses on the most current epidemiology and the complexities of the pathophysiology between OH and HTN.

• #28

  https://journals.lww.com/md-journal/fulltext/2017/09080/prevalence,_risk_factors,_and_prognosis_of.43.aspx

  Orthostatic hypotension (OH) is a major clinical sign of cardiovascular autonomic dysfunction in diabetic patients. Our aim was to quantitatively evaluate the prevalence and risk factors of OH in patients with diabetes mellitus (DM) and assess its prognosis. […] The pooled prevalence of OH in DM was 24% (95% confidence interval [CI]: 19%–28%). Potential risk factors, that is, glycosylated hemoglobin A (HbA1c) (odds ratio [OR], 1.13, 95% CI, 1.07–1.20), hypertension (OR, 1.02, 95% CI, 1.01–1.02), and diabetic nephropathy (OR, 2.37, 95% CI, 1.76–3.19), were significantly associated with OH in DM. In addition, the prognosis of OH in DM was associated with higher risk of total mortality and cardiovascular events. […] The pooled prevalence of OH in DM appears high. HbA1c, hypertension, and diabetic nephropathy are risk factors for OH in DM. OH indicates poor prognosis in diabetic patients. Attention should be focused on diabetic patients with the stated risk factors to prevent OH.

• #29 Orthostatic Hypotension and Parkinson’s Disease: A Review about Epidemiology, Pathophysiology and Clinical Management

  https://www.gavinpublishers.com/article/view/orthostatic-hypotension-and-parkinsons-disease–a-review-about-epidemiology-pathophysiology-and-clinical-management

  Orthostatic Hypotension (OH) may cause unexplained falls, syncope, blurry vision, dizziness, fatigue, shoulder and neck pain and is confronted daily by colleges in internal medicine. […] Dysautonomia is an important non-motor feature of PD and the most common cardiovascular autonomic dysfunctions is Orthostatic Hypotension (OH) with or without clinical symptoms. […] In a meta-analysis study from 2011, which included 25 studies and 5,070 patients with PD, the estimated prevalence of OH in PD was 30.1%. […] In a study conducted in 2015 on a cohort of 210 patients with PD, although the prevalence of classically defined OH, was relatively high (i.e. 50%) only a third of patients (~16%) had symptoms. […] There are findings from cardiac sympathetic neuroimaging that support that OH belongs to the prodromal non-motor signs of PD and could be easily distinguished from other synucleinopathies such as Multiple system atrophy (MSA).

• #30 Prognostic value of postural hypotension in hospitalized patients with heart failure | Scientific Reports

  https://www.nature.com/articles/s41598-022-06760-0

  To the best of our knowledge, this is the first study to prospectively investigate the prognostic value of PH in patients with heart failure. We demonstrated that (1) 22% of the study population was affected by PH; (2) PH was associated with male sex, high NYHA classification, and not taking ACE-Is; and (3) patients with PH had a lower risk of heart failure readmission after discharge and PH was not associated with all-cause death. […] Our finding of the lack of association between PH and unfavorable prognosis including mortality is relevant given that the drugs recognized as GDMT for heart failure exert blood pressure-lowering effects and may cause hypotension. This may prompt clinicians to withdraw or down-titrate GDMT. However, previous studies have clearly demonstrated that down-titration of GDMT is associated with poor prognosis. Therefore, we believe that dose reduction or withdrawal of GDMT in patients with heart failure based on the consideration of PH alone is not justified, and prospective large-scale randomized clinical studies should aim to address this issue in the future.

• #31 Orthostatic Hypotension in SCI | PM&R KnowledgeNow

  https://now.aapmr.org/orthostatic-hypotension-in-sci/

  Orthostatic hypotension (OH) is defined as a reduction in systolic blood pressure (BP) of at least 20 mm Hg or a reduction in diastolic BP of at least 10 mm Hg within 3 minutes of standing or head-up tilting to 60 degrees. […] OH following spinal cord injury (SCI) is common and well-documented, most often seen with complete lesions above neurological level T6 and most severe during the acute phase. […] OH has been reported to be more common after traumatic than nontraumatic SCI. Prevalence in acute SCI has been reported to be as high as 74% and occurs more frequently with tetraplegia than paraplegia. […] Symptoms are less likely to occur in SCI below the origin of the major splanchnic outflow at T6 and with incomplete injuries. […] The major underlying abnormality in SCI-related OH is due to sympathetic interruption.

• #32 Prevalence of orthostatic hypotension and associated factors among older people with hypertension in Northern Ethiopia | BMC Geriatrics | Full Text

  https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-024-05519-8

  The prevalence of hypertension increases with age, and older people with this condition are at increased risk of developing orthostatic hypotension (OH) due to age-related changes in blood pressure regulation mechanisms as well as prescribed medications. […] The prevalence and characteristics of OH in older people with hypertension in Low-Income Countries have not been well characterized. This study aims to determine the prevalence of OH and associated factors among older people with hypertension in northern Ethiopia. […] The prevalence of OH was 23.8% (CI: 21.5%, 26.1%). […] The use of CCBs was identified as an independent risk factor for OH. […] Given the frequent association with adverse effects, it is important to estimate the prevalence of OH among the aging population, especially as there has been little research into the phenomenon in LICs. […] Our study indicates that among older people (60+) with hypertension in Ethiopia, a low-income country, there was a high prevalence of measured OH, with one out of four individuals affected.

• #33 Evaluation and Management of Orthostatic Hypotension | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p527.html

  Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic response to postural changes in blood pressure. […] Orthostatic hypotension is often found in older patients and in those who are frail. It is present in up to 20 percent of patients older than 65 years. In one study, the prevalence of orthostatic hypotension was 18 percent in patients older than 65 years, but only 2 percent of these patients were symptomatic. […] Orthostatic hypotension may be acute or chronic, as well as symptomatic or asymptomatic. Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, and headache.

• #34 Evaluation and Management of Orthostatic Hypotension | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0901/p527.html/amp/

  Orthostatic hypotension is often found in older patients and in those who are frail. It is present in up to 20 percent of patients older than 65 years. In one study, the prevalence of orthostatic hypotension was 18 percent in patients older than 65 years, but only 2 percent of these patients were symptomatic. […] In acute care settings, syncope may be the initial presentation of orthostatic hypotension. A prospective study of 611 patients presenting to an emergency department following a syncopal episode found that 24 percent had orthostatic hypotension.

• #35 Orthostatic Hypotension and Parkinson’s Disease: A Review about Epidemiology, Pathophysiology and Clinical Management

  https://www.gavinpublishers.com/article/view/orthostatic-hypotension-and-parkinsons-disease–a-review-about-epidemiology-pathophysiology-and-clinical-management

  Orthostatic Hypotension (OH) may cause unexplained falls, syncope, blurry vision, dizziness, fatigue, shoulder and neck pain and is confronted daily by colleges in internal medicine. […] Dysautonomia is an important non-motor feature of PD and the most common cardiovascular autonomic dysfunctions is Orthostatic Hypotension (OH) with or without clinical symptoms. […] In a meta-analysis study from 2011, which included 25 studies and 5,070 patients with PD, the estimated prevalence of OH in PD was 30.1%. […] In a study conducted in 2015 on a cohort of 210 patients with PD, although the prevalence of classically defined OH, was relatively high (i.e. 50%) only a third of patients (~16%) had symptoms. […] There are findings from cardiac sympathetic neuroimaging that support that OH belongs to the prodromal non-motor signs of PD and could be easily distinguished from other synucleinopathies such as Multiple system atrophy (MSA).

• #36 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  A large proportion of people with postural hypotension are asymptomatic, and are therefore likely to remain undetected unless screened because they are in high-risk groups. […] The study found rising rates of recorded postural hypotension in groups with greater social deprivation. This may be because of a greater prevalence of polypharmacy, comorbidity, and CVD among this population, as previously described in the literature. […] The finding in the current study that the rate of recorded postural hypotension followed a slight downward trend from 2008 to 2018 may reflect evidenced changes in rising GP workload during this period and reducing priority of postural hypotension detection among other chronic disease management and GP work.

• #37 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  A large proportion of people with postural hypotension are asymptomatic, and are therefore likely to remain undetected unless screened because they are in high-risk groups. […] The study found rising rates of recorded postural hypotension in groups with greater social deprivation. This may be because of a greater prevalence of polypharmacy, comorbidity, and CVD among this population, as previously described in the literature. […] The finding in the current study that the rate of recorded postural hypotension followed a slight downward trend from 2008 to 2018 may reflect evidenced changes in rising GP workload during this period and reducing priority of postural hypotension detection among other chronic disease management and GP work.

• #38 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  A large proportion of people with postural hypotension are asymptomatic, and are therefore likely to remain undetected unless screened because they are in high-risk groups. […] The study found rising rates of recorded postural hypotension in groups with greater social deprivation. This may be because of a greater prevalence of polypharmacy, comorbidity, and CVD among this population, as previously described in the literature. […] The finding in the current study that the rate of recorded postural hypotension followed a slight downward trend from 2008 to 2018 may reflect evidenced changes in rising GP workload during this period and reducing priority of postural hypotension detection among other chronic disease management and GP work.

• #39 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  A large proportion of people with postural hypotension are asymptomatic, and are therefore likely to remain undetected unless screened because they are in high-risk groups. […] The study found rising rates of recorded postural hypotension in groups with greater social deprivation. This may be because of a greater prevalence of polypharmacy, comorbidity, and CVD among this population, as previously described in the literature. […] The finding in the current study that the rate of recorded postural hypotension followed a slight downward trend from 2008 to 2018 may reflect evidenced changes in rising GP workload during this period and reducing priority of postural hypotension detection among other chronic disease management and GP work.

• #40 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  A large proportion of people with postural hypotension are asymptomatic, and are therefore likely to remain undetected unless screened because they are in high-risk groups. […] The study found rising rates of recorded postural hypotension in groups with greater social deprivation. This may be because of a greater prevalence of polypharmacy, comorbidity, and CVD among this population, as previously described in the literature. […] The finding in the current study that the rate of recorded postural hypotension followed a slight downward trend from 2008 to 2018 may reflect evidenced changes in rising GP workload during this period and reducing priority of postural hypotension detection among other chronic disease management and GP work.

• #41 Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/26271068/

  Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients 50 years of age to 30% in those 70 years of age. […] Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. […] In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.

• #42 Orthostatic hypotension – Wikipedia

  https://en.wikipedia.org/wiki/Orthostatic_hypotension

  Orthostatic hypotension may cause accidental falls. […] It is also linked to an increased risk of cardiovascular disease, heart failure, and stroke. […] Also, observational data suggest that orthostatic hypotension in middle age increases the risk of eventual dementia and reduced cognitive function.

• #43 Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/26271068/

  Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients 50 years of age to 30% in those 70 years of age. […] Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. […] In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.

• #44 Orthostatic hypotension – wikidoc

  https://www.wikidoc.org/index.php/Orthostatic_hypotension

  Orthostatic hypotension screening consists of blood pressure measurements in supine (or sitting) and standing position during clinical consultations. […] The symptoms of orthostatic hypotension mainly develop in the elderly, and start with generalized symptoms of dizziness, lightheadedness, or syncope and less frequently with headache, leg buckling, or chest pain. […] Common complications of orthostatic hypotension include: Symptomatic orthostatic hypotension may cause falling. The risk of recurrent falls is particularly higher in frail, older adults. […] According to various studies, orthostatic hypotension may be a risk factor for: Cardiovascular and all-cause mortality, Cardiovascular events, Congestive heart failure, Atrial fibrillation, Cognitive decline or dementia, Anxiety, depression, and impaired quality of life. […] Depending on the underlying cause of orthostatic hypotension, the prognosis may vary.

• #45 Neurogenic Orthostatic Hypotension: Pathophysiology and Diagnosis

  https://www.ajmc.com/view/ace0034_oct15_noh_low

  Orthostatic hypotension (OH) occurs when the body is unable to maintain the same blood pressure when standing. […] OH is common in elderly patients and increases with age. In the longitudinal Cardiovascular Health Study, the prevalence of symptomatic OH increased from 14.8% in patients aged 65 to 69 years to 26% in patients 85 years or older. […] In contrast to OH in elderly patients, neurogenic orthostatic hypotension (NOH) is rare enough to be classified as an orphan disease in the United States. […] Symptomatic NOH is estimated to affect approximately 80,000 patients with PD, MSA, or PAF. […] The reported prevalence of NOH in PD varies widely, with estimates ranging from 18% to 58%. […] Epidemiologic studies suggest that OH in elderly patients increases the risk of frequent falling, syncope, chronic kidney disease, stroke, HF, coronary events, and all-cause mortality.

• #46 Orthostatic hypotension – Wikipedia

  https://en.wikipedia.org/wiki/Orthostatic_hypotension

  Orthostatic hypotension, also known as postural hypotension, is a medical condition wherein a person’s blood pressure drops when they are standing up (orthostasis) or sitting down. […] Very mild occasional orthostatic hypotension is common and can occur briefly in anyone, although it is prevalent in particular among the elderly and those with known low blood pressure. […] Chronic orthostatic hypotension is associated with cerebral hypoperfusion that may accelerate the pathophysiology of dementia. […] The numerous possible causes for orthostatic hypotension include certain medications (e.g. alpha blockers), autonomic neuropathy, decreased blood volume, multiple system atrophy, and age-related blood-vessel stiffness. […] Orthostatic hypotension can be confirmed by measuring a person’s blood pressure after lying flat for 5 minutes, then 1 minute after standing, and 3 minutes after standing.

• #47 Orthostatic hypotension – Wikipedia

  https://en.wikipedia.org/wiki/Orthostatic_hypotension

  Orthostatic hypotension may cause accidental falls. […] It is also linked to an increased risk of cardiovascular disease, heart failure, and stroke. […] Also, observational data suggest that orthostatic hypotension in middle age increases the risk of eventual dementia and reduced cognitive function.

• #48 Recent advances in orthostatic hypotension – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/recent-advances-in-orthostatic-hypotension/

  Orthostatic hypotension also called postural hypotension is a form of low blood pressure that happens when you stand up from sitting or lying down. This article reviews current advances in the area. […] Orthostatic hypotension or postural hypotension is a relatively common condition in the elderly population. It is an important cause of preventable falls in the elderly and this article summarises the most recent advances in this field from epidemiology, clinical presentation and management. […] A number of studies have reviewed the prevalence of OH in recent years. The Irish TILDA study analysed data from 4,475 persons after an active standing test. […] The total prevalence of OH was 6.9%, increasing to 18% for persons over the age of 80 years. […] In the Swedish Good Aging in Skane study (GAS-SNAC), 1,400 individuals were randomly selected from a database on ageing. The study concluded that OH was a risk factor for mild cognitive dysfunction.

• #49 Primary Care and Orthostatic Hypotension – SCIRE Professional

  https://scireproject.com/primary-care/orthostatic-hypotension/

  Orthostatic hypotension (OH) is defined as a decrease in systolic blood pressure of at least 20mmHg, or a reduction in diastolic blood pressure of at least 10mmHg, upon the change in body position from a supine (lying) to an upright position. […] Multiple large cohort studies have shown that delayed BP recovery and classic OH are associated with future risk of falls, fractures, fainting, stroke, CVD, and even earlier death (10-year mortality rate of 50-64%). […] People with OH will most often have an injury level of T6 or above, but it is also more likely to occur in your patients that are older (50). […] OH also frequently occurs without symptoms, so measuring your patients usual (normal) blood pressure while standing, sitting, and lying down (supine) will be helpful. […] If treatment options such as education, diet management, compression socks, exercise, and/or medication review are insufficient to resolve your patients OH, you may need to refer them to a specialist (e.g., a physiatrist or a cardiologist) for further examination.

• #50 Recent advances in orthostatic hypotension – Pavilion Health Today

  https://pavilionhealthtoday.com/gm/recent-advances-in-orthostatic-hypotension/

  Freud et al conducted a retrospective analysis of 571 patients over 90 years to examine the prevalence of systolic and diastolic OH. They found that the prevalence of systolic OH is more common than diastolic OH. […] The mortality rate was higher in patients with OH at 30% than in those that did not have OH at 22%. […] Delayed OH is supposed to happen after three minutes of testing. […] The prevalence of orthostatic intolerance and its significance was found by OConnell et al, who studied 5,692 community dwelling adults aged over 50 years in the Irish Longitudinal Study on Ageing. The authors found OI in 6.7% of participants. […] It seems that most of the research is carried out in patients with neurogenic OH. […] Droxidopa, which is a prodrug for norepinephrine, has limited use in the treatment of OH.

• #51 Neurogenic Orthostatic Hypotension: Pathophysiology and Diagnosis

  https://www.ajmc.com/view/ace0034_oct15_noh_low

  In 2004, the rate of hospitalization associated with OH was 36 per 100,000 adults in the United States. […] In contrast to extensive data about the prognosis of OH in elderly patients, few studies describe the prognosis in NOH. […] The death rate was higher in patients with comorbid cardiovascular disease (53% vs 31%, P = .04). […] Patients with NOH had a 3-fold higher risk of death than the general population in that geographic area.

• #52 Orthostatic hypotension in elderly: Do you measure orthostatic and clinostatic blood pressure?

  https://www.hvt-journal.com/articles/art349

  Orthostatic hypotension (OH) is defined as a reduction in systolic BP of at least 20 mmHg or in diastolic BP of at least 10 mmHg within three minutes of standing. It is a common condition in older adults, with prevalence ranging from 5% in individuals 50 years old to 30% in patients 70 of age. It is responsible for adverse events (i.e., falls, hospitalization, institutionalization), morbidity and mortality. […] A large study conducted in the United Kingdom showcased lower incidence of OH reported among general practitioners than outlined by previous works. Authors hypothesize this result may be due to an underestimation cause by a lack of time during routine clinical examination or poorly standardized methods of measurement. […] OH is a frequent but often overlooked condition in older adults. Elderly patients present several risk factors for autonomic dysfunction, furthermore drugs administered should be carefully gauged in detail keeping only those strictly essential. In addition, screening and properly training the patient in the management of autonomic dysfunction may have a positive impact on falls, fear of falling and other consequences of OH in terms of quality of life, morbidity and mortality.

• #53 Orthostatic hypotension in elderly: Do you measure orthostatic and clinostatic blood pressure?

  https://www.hvt-journal.com/articles/art349

  Orthostatic hypotension (OH) is defined as a reduction in systolic BP of at least 20 mmHg or in diastolic BP of at least 10 mmHg within three minutes of standing. It is a common condition in older adults, with prevalence ranging from 5% in individuals 50 years old to 30% in patients 70 of age. It is responsible for adverse events (i.e., falls, hospitalization, institutionalization), morbidity and mortality. […] A large study conducted in the United Kingdom showcased lower incidence of OH reported among general practitioners than outlined by previous works. Authors hypothesize this result may be due to an underestimation cause by a lack of time during routine clinical examination or poorly standardized methods of measurement. […] OH is a frequent but often overlooked condition in older adults. Elderly patients present several risk factors for autonomic dysfunction, furthermore drugs administered should be carefully gauged in detail keeping only those strictly essential. In addition, screening and properly training the patient in the management of autonomic dysfunction may have a positive impact on falls, fear of falling and other consequences of OH in terms of quality of life, morbidity and mortality.

• #54 Orthostatic hypotension in elderly: Do you measure orthostatic and clinostatic blood pressure?

  https://www.hvt-journal.com/articles/art349

  Orthostatic hypotension (OH) is defined as a reduction in systolic BP of at least 20 mmHg or in diastolic BP of at least 10 mmHg within three minutes of standing. It is a common condition in older adults, with prevalence ranging from 5% in individuals 50 years old to 30% in patients 70 of age. It is responsible for adverse events (i.e., falls, hospitalization, institutionalization), morbidity and mortality. […] A large study conducted in the United Kingdom showcased lower incidence of OH reported among general practitioners than outlined by previous works. Authors hypothesize this result may be due to an underestimation cause by a lack of time during routine clinical examination or poorly standardized methods of measurement. […] OH is a frequent but often overlooked condition in older adults. Elderly patients present several risk factors for autonomic dysfunction, furthermore drugs administered should be carefully gauged in detail keeping only those strictly essential. In addition, screening and properly training the patient in the management of autonomic dysfunction may have a positive impact on falls, fear of falling and other consequences of OH in terms of quality of life, morbidity and mortality.

• #55 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  Postural hypotension is a common condition associated with adverse outcomes in older adults. General practice plays an important role in identification of the condition. […] To examine the incidence of postural hypotension between 2008 and 2018 in general practice and how trends vary by age, sex, year, and social deprivation. […] Of 2 911 260 patients, 24 973 had an electronic record indicating a new diagnosis of postural hypotension between 2008 and 2018. This was equivalent to 17.9 cases per 10 000 PYAR in males (95% confidence interval [CI] = 17.6 to 18.2) and 16.2 cases per 10 000 PYAR in females (95% CI = 15.9 to 16.5). A significant age-sex interaction was identified. Recorded postural hypotension rate increased with age and social deprivation, and reduced between 2008 and 2018. The rate was higher in males compared with females, particularly in older age groups (80 years).

• #56 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  To the authors knowledge, this is the first study to quantify incident recorded postural hypotension in general practice. The rate is lower than expected compared with studies in screened older populations. […] Postural (orthostatic) hypotension is a common, yet frequently overlooked, condition associated with serious adverse outcomes in later life. It is estimated to affect around 20% of community-dwelling older adults and between 20% and 31% of those living in long-term care. […] In the UK, the reported prevalence of postural hypotension has ranged from 28% in older females, up to 81% of older adults screened using continuous blood pressure (BP) monitoring. […] Early detection in patients who are symptomatic or in those with certain risk factors may prevent some of these complications. General practice plays an important role in identification; however, current guidelines for detecting postural hypotension are varied and based on limited evidence.

• #57 Orthostatic hypotension – wikidoc

  https://www.wikidoc.org/index.php/Orthostatic_hypotension

  Orthostatic hypotension screening consists of blood pressure measurements in supine (or sitting) and standing position during clinical consultations. […] The symptoms of orthostatic hypotension mainly develop in the elderly, and start with generalized symptoms of dizziness, lightheadedness, or syncope and less frequently with headache, leg buckling, or chest pain. […] Common complications of orthostatic hypotension include: Symptomatic orthostatic hypotension may cause falling. The risk of recurrent falls is particularly higher in frail, older adults. […] According to various studies, orthostatic hypotension may be a risk factor for: Cardiovascular and all-cause mortality, Cardiovascular events, Congestive heart failure, Atrial fibrillation, Cognitive decline or dementia, Anxiety, depression, and impaired quality of life. […] Depending on the underlying cause of orthostatic hypotension, the prognosis may vary.

• #58 Hypotension (Low Blood Pressure): Causes, Symptoms, and Treatment

  https://patient.info/doctor/hypotension

  The National Institute for Health and Care Excellence (NICE) has updated its guidance on assessment and referral for suspected postural hypotension within the above guideline. […] If the person’s systolic blood pressure falls by 20 mmHg or more, or their diastolic blood pressure falls by 10 mmHg or more, after the person has been standing for at least 1 minute, look for the likely causes such as current medication and manage them appropriately. […] The key to managing postural hypotension is individually tailored therapy.

• #59 Orthostatic hypotension (postural hypotension) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/diagnosis-treatment/drc-20352553

  A health care provider’s goal in evaluating orthostatic hypotension is to find the cause and determine treatment. The cause isn’t always known. […] A provider also might recommend one or more of the following: Blood pressure monitoring. This involves measuring blood pressure while sitting and standing. A drop of 20 millimeters of mercury (mm Hg) in the top number (systolic blood pressure) within 2 to 5 minutes of standing is a sign of orthostatic hypotension. A drop of 10 mm Hg in the bottom number (diastolic blood pressure) within 2 to 5 minutes of standing also indicates orthostatic hypotension. […] Treatment for orthostatic hypotension is directed at the cause rather than the low blood pressure itself. For example, if dehydration causes orthostatic hypotension, your health care provider may suggest lifestyle changes such as drinking more water.

• #60 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  To the authors knowledge, this is the first study to quantify incident recorded postural hypotension in general practice. The rate is lower than expected compared with studies in screened older populations. […] Postural (orthostatic) hypotension is a common, yet frequently overlooked, condition associated with serious adverse outcomes in later life. It is estimated to affect around 20% of community-dwelling older adults and between 20% and 31% of those living in long-term care. […] In the UK, the reported prevalence of postural hypotension has ranged from 28% in older females, up to 81% of older adults screened using continuous blood pressure (BP) monitoring. […] Early detection in patients who are symptomatic or in those with certain risk factors may prevent some of these complications. General practice plays an important role in identification; however, current guidelines for detecting postural hypotension are varied and based on limited evidence.

• #61 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  To the authors knowledge, this is the first study to quantify incident recorded postural hypotension in general practice. The rate is lower than expected compared with studies in screened older populations. […] Postural (orthostatic) hypotension is a common, yet frequently overlooked, condition associated with serious adverse outcomes in later life. It is estimated to affect around 20% of community-dwelling older adults and between 20% and 31% of those living in long-term care. […] In the UK, the reported prevalence of postural hypotension has ranged from 28% in older females, up to 81% of older adults screened using continuous blood pressure (BP) monitoring. […] Early detection in patients who are symptomatic or in those with certain risk factors may prevent some of these complications. General practice plays an important role in identification; however, current guidelines for detecting postural hypotension are varied and based on limited evidence.

• #62 Prevalence of orthostatic hypotension and associated factors among older people with hypertension in Northern Ethiopia | BMC Geriatrics | Full Text

  https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-024-05519-8

  The prevalence of hypertension increases with age, and older people with this condition are at increased risk of developing orthostatic hypotension (OH) due to age-related changes in blood pressure regulation mechanisms as well as prescribed medications. […] The prevalence and characteristics of OH in older people with hypertension in Low-Income Countries have not been well characterized. This study aims to determine the prevalence of OH and associated factors among older people with hypertension in northern Ethiopia. […] The prevalence of OH was 23.8% (CI: 21.5%, 26.1%). […] The use of CCBs was identified as an independent risk factor for OH. […] Given the frequent association with adverse effects, it is important to estimate the prevalence of OH among the aging population, especially as there has been little research into the phenomenon in LICs. […] Our study indicates that among older people (60+) with hypertension in Ethiopia, a low-income country, there was a high prevalence of measured OH, with one out of four individuals affected.

• #63 Orthostatic Hypotension: Epidemiology, Prognosis, and Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/26271068/

  Orthostatic hypotension (OH) is a common cardiovascular disorder, with or without signs of underlying neurodegenerative disease. OH is diagnosed on the basis of an orthostatic challenge and implies a persistent systolic/diastolic blood pressure decrease of at least 20/10 mm Hg upon standing. Its prevalence is age dependent, ranging from 5% in patients 50 years of age to 30% in those 70 years of age. […] Despite being largely asymptomatic or with minimal symptoms, the presence of OH independently increases mortality and the incidence of myocardial infarction, stroke, heart failure, and atrial fibrillation. […] In this review, we outline the etiology and prevalence of OH in the general population, summarize its relationship with morbidity and mortality, propose a diagnostic and therapeutic algorithm, and delineate current challenges and future perspectives.

• #64 Orthostatic hypotension – wikidoc

  https://www.wikidoc.org/index.php/Orthostatic_hypotension

  Incidence: The approximation of orthostatic hypotension associated hospitalization is 36 per 100,000 adults, and the rate can be as high as 233 per 100,000 patients 75 years of age. […] Prevalence: The overall prevalence of orthostatic hypotension depends on age as it increases with age in the general population. The prevalence ranges from 5% in patients 50 years of age to 30% in those 70 years of age. It is ~20% in 65-year-old patients. […] Age: Orthostatic Hypotension is commonly seen in individuals older than 50 years of age. […] Gender: Orthostatic hypotension affects men and women equally. […] Common risk factors in the development of orthostatic hypotension include: Age (65), Medications, Autonomic neuropathies, such as Parkinson’s disease, diabetes, Volume depletion, Postpartum period, Prolong bedrest.

• #65 Orthostatic Hypotension

  https://fpnotebook.com/CV/Exam/OrthstcHyptnsn.htm

  Orthostatic Hypotension Prevalence increases with age and debility Middle Age: 5% Age 60 years: 20% Nursing Home: 50% Geriatric medical ward: 68% […] Orthostatic Hypotension related hospital admissions (U.S., 2007) All adults: 36 per 100,000 Adults75 years: 233 per 100,000.

• #66 Incidence of postural hypotension recorded in UK general practice: an electronic health records study | British Journal of General Practice

  https://bjgp.org/content/73/726/e9

  To the authors knowledge, this is the first study to quantify incident recorded postural hypotension in general practice. The rate is lower than expected compared with studies in screened older populations. […] Postural (orthostatic) hypotension is a common, yet frequently overlooked, condition associated with serious adverse outcomes in later life. It is estimated to affect around 20% of community-dwelling older adults and between 20% and 31% of those living in long-term care. […] In the UK, the reported prevalence of postural hypotension has ranged from 28% in older females, up to 81% of older adults screened using continuous blood pressure (BP) monitoring. […] Early detection in patients who are symptomatic or in those with certain risk factors may prevent some of these complications. General practice plays an important role in identification; however, current guidelines for detecting postural hypotension are varied and based on limited evidence.

• #67 Orthostatic hypotension – Wikipedia

  https://en.wikipedia.org/wiki/Orthostatic_hypotension

  Orthostatic hypotension may cause accidental falls. […] It is also linked to an increased risk of cardiovascular disease, heart failure, and stroke. […] Also, observational data suggest that orthostatic hypotension in middle age increases the risk of eventual dementia and reduced cognitive function.

• #68 Primary Care and Orthostatic Hypotension – SCIRE Professional

  https://scireproject.com/primary-care/orthostatic-hypotension/

  Orthostatic hypotension (OH) is defined as a decrease in systolic blood pressure of at least 20mmHg, or a reduction in diastolic blood pressure of at least 10mmHg, upon the change in body position from a supine (lying) to an upright position. […] Multiple large cohort studies have shown that delayed BP recovery and classic OH are associated with future risk of falls, fractures, fainting, stroke, CVD, and even earlier death (10-year mortality rate of 50-64%). […] People with OH will most often have an injury level of T6 or above, but it is also more likely to occur in your patients that are older (50). […] OH also frequently occurs without symptoms, so measuring your patients usual (normal) blood pressure while standing, sitting, and lying down (supine) will be helpful. […] If treatment options such as education, diet management, compression socks, exercise, and/or medication review are insufficient to resolve your patients OH, you may need to refer them to a specialist (e.g., a physiatrist or a cardiologist) for further examination.

• #69 Orthostatic hypotension in elderly: Do you measure orthostatic and clinostatic blood pressure?

  https://www.hvt-journal.com/articles/art349

  Orthostatic hypotension (OH) is defined as a reduction in systolic BP of at least 20 mmHg or in diastolic BP of at least 10 mmHg within three minutes of standing. It is a common condition in older adults, with prevalence ranging from 5% in individuals 50 years old to 30% in patients 70 of age. It is responsible for adverse events (i.e., falls, hospitalization, institutionalization), morbidity and mortality. […] A large study conducted in the United Kingdom showcased lower incidence of OH reported among general practitioners than outlined by previous works. Authors hypothesize this result may be due to an underestimation cause by a lack of time during routine clinical examination or poorly standardized methods of measurement. […] OH is a frequent but often overlooked condition in older adults. Elderly patients present several risk factors for autonomic dysfunction, furthermore drugs administered should be carefully gauged in detail keeping only those strictly essential. In addition, screening and properly training the patient in the management of autonomic dysfunction may have a positive impact on falls, fear of falling and other consequences of OH in terms of quality of life, morbidity and mortality.

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