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Updated: Jun 6, 2026
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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
[Arterial hypertension with orthostatic hypotension]
1II. interná klinika Lekárskej fakulty UK a UN Bratislava, Slovenská republika. boris.krahulec@faneba.sk
Vnitrni Lekarstvi
|December 9, 2010
Summary
Arterial hypertension with orthostatic hypotension is a common issue in older adults, often linked to autonomic nervous system failure. Management involves lifestyle changes and targeted medications for blood pressure regulation.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Context:
- Arterial hypertension (AH) co-occurring with orthostatic hypotension (OH) presents a significant clinical challenge, particularly in the elderly and those with autonomic nervous system (ANS) dysfunction.
- ANS damage can be primary or secondary, frequently associated with conditions like diabetes mellitus.
- OH affects approximately 30% of older individuals, with postprandial hypotension also being a concern.
Purpose:
- To outline the clinical significance, diagnostic approaches, and therapeutic strategies for managing arterial hypertension with orthostatic hypotension.
Summary:
- Various medications, including antihypertensives, tricyclic antidepressants, alpha1-adrenergic antagonists, and diuretics, can precipitate OH.
- Diagnosis relies on simple bedside orthostatic tests, head-up tilt table tests, and cardiovascular reflex assessments.
- Non-pharmacological treatments include adequate fluid intake, leg compression, and elevating the head of the bed.
- Pharmacological options for AH with OH involve short-acting antihypertensives or transdermal nitroglycerin.
- OH can be managed with clonidine, midodrine, fludrocortisone, or beta1-blockers.
Impact:
- Provides a comprehensive overview for clinicians managing complex blood pressure disorders in aging populations.
- Highlights the importance of considering ANS function in patients with both hypertension and hypotension.
- Informs therapeutic decisions by detailing both non-medicamentous and pharmacological interventions.
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