Related Experiment Video
Updated: Aug 4, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
[Prevalence of orthostatic hypotension in elderly hypertensive patients in primary care]
L Vara González1, R Domínguez Rollán, M Fernández Ruiz
1Centro de Salud La Marina y Gerencia de Atención Primaria. Médico de Familia. Centro de Salud La Marina. Santander. Cantabria. lvara@iedatos.es
Objective:
To find the prevalence of orthostatic hypotension (OH) and associated factors in elderly hypertensive patients in a primary care setting.
Design:
Descriptive cross-sectional study.
Setting:
La Marina Health Centre (an urban centre in Santander).
Patients:
A random sample of 295 patients aged 65 years or older regularly assisted from hypertension.
Measurements And Main Results:
Measurements of sitting and standing blood pressure were obtained. Orthostatic hypotension was defined as 20 mmHg or greater decrease in systolic or 10 mmHg or greater decrease in diastolic blood pressure after 1-minute or 5-minute standing. Associated diseases, symptoms upon standing, medication use, habits and other clinical assessments were also recorded. The prevalence of OH was 14.6%. The prevalence of systolic OH after 1-minute (OH-S1) and after 5-minute (OH-S5) standing was 5.8% in both, and the diastolic OH was 5.1% after 1-minute (OH-D1) and 4.1% after 5-minute (OH-D5) standing. By logistic regression analysis, association between higher level of systolic blood pressure and global OH was found, also with the presence of orthostatic intolerance symptoms (although only 25.6% of the patients with OH showed symptoms) and smoking. Beta-blockers and calcium channel blockers (different from dihydropyridines) use was associated with OH after 1-minute standing and smoking with OH after 5-minute standing.
Conclusions:
The detected prevalence is high and justifies the case finding of OH in elderly hypertensive patients in primary care. The symptoms of orthostatic intolerance are correlated with OH, but only 1 out of 4 patients showed symptoms. Smoking could be related with OH, so beta-blockers and calcium channel blockers (different from dihydropyridines) use.
Related Concept Videos
Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Hypertension and Regulation of Blood Pressure
Drug Dosing: Geriatric Patients
Hypertension I: Introduction
Hypertension III: Clinical Manifestations and Diagnostic Studies

