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Postural hypotension: causes, clinical features, investigation, and management
1Neurovascular Medicine Unit, Imperial College School of Medicine at St Mary's, London, United Kingdom. c.mathias@ic.ac.uk
Annual Review of Medicine
|March 12, 1999
Summary
Postural hypotension, a drop in blood pressure upon standing, has many causes and can lead to injury. Diagnosis involves history, clinical tests, and lab work for effective treatment.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Postural hypotension presents with diverse neurogenic and non-neurogenic origins.
- It is a hallmark of autonomic failure syndromes and complicates conditions like diabetes mellitus.
- Prevalence escalates with age, posing risks of syncope and injury.
Purpose of the Study:
- To outline the diagnostic approach to postural hypotension.
- To differentiate between neurogenic and non-neurogenic etiologies.
- To guide treatment strategies based on the underlying cause.
Main Methods:
- Clinical suspicion based on patient history.
- Ambulatory blood pressure monitoring (lying and standing).
- Laboratory investigations to determine etiology and functional deficit.
Main Results:
- History and clinical measurements are key initial diagnostic steps.
- Laboratory tests are crucial for confirming diagnosis and identifying causes.
- Treatment efficacy depends on distinguishing neurogenic from non-neurogenic origins.
Conclusions:
- Postural hypotension requires a multi-faceted diagnostic approach.
- Identifying the specific cause is essential for effective management.
- Treatment involves addressing the underlying disorder, with specific strategies for neurogenic forms.
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