Related Experiment Video
Updated: Aug 29, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Postural hypotension in hypertensive patients
Alfonso Lagi1, Antonio Rossi, Aurelio Comelli
1Department of Internal Medicine, Ospedale Santa Maria Nuova, Azienda Sanitaria 10, Firenze, Italy. alfonso.lagi@asf.toscana.it
Background:
The association between orthostatic hypotension and supine hypertension (Hypo-Hyper) has been reported in previous studies on selected populations. The present longitudinal study aimed to characterize the haemodynamic patterns, comorbidity, prognostic implications and eventual effect of therapy in patients with the Hypo-Hyper pattern.
Methods:
Ambulatory blood pressure monitoring (AMAP) and clinical evaluation were performed on 615 consecutive patients recruited from the Hypertension Clinics of five Italian Hospitals: 34 patents were identified as Hypo-Hyper, and underwent 10-month follow-up.
Results:
The incidence of the Hypo-Hyper pattern was 5.5% in the hypertensives studied. Hypo-Hyper was more frequent in the elderly (mean age 58 years), and the affected population exhibited different kinds of underlying pathologies. Multivariate analysis showed no association between antihypertensive treatment and Hypo-Hyper pattern. Patients with AMAP features of higher blood pressure values at night-time than at daytime displayed higher rates of myocardial hypertrophy and pacemaker implantation during the follow-up.
Conclusions:
Although the study design did not aim to identify any pathophysiological mechanism for Hypo-Hyper pattern, these first data show that the Hypo-Hyper association is the effect of a particular subtype of hypertension, with significantly different prognostic implications.
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 III: Clinical Manifestations and Diagnostic Studies
Hypertension V: Nursing Management
Hypertension I: Introduction
Hypertension and Regulation of Blood Pressure