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Updated: May 27, 2026
Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Orthostatic hypotension among outpatients with ischemic stroke
Michael S Phipps1, Arlene A Schmid, John R Kapoor
1Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT, USA. michael.phipps@yale.edu
Background:
The treatment of hypertension is an essential component of stroke prevention; however, the clinical management of patients with cerebrovascular disease is complicated by orthostatic hypotension (OH). The primary objectives were to: determine the prevalence of OH in a stroke outpatient clinic; describe categories of OH; and identify factors independently associated with the presence of OH.
Methods:
Veterans with stroke, cared for in a multidisciplinary stroke clinic, were included. OH was defined as a ≥20 mmHg fall in systolic blood pressure (BP), a ≥10 mmHg fall in diastolic BP, or a ≥10 mmHg fall in systolic BP with symptoms. Multivariable logistic regression was used to identify factors associated with OH including demographics, comorbidites, stroke severity, and baseline BP.
Results:
Among 60 patients with stroke, 16 (27%) patients had OH. Among those with OH, half were hypertensive, seven were normotensive, and one was hypotensive. A history of coronary artery disease was independently associated with the presence of OH.
Conclusions:
Orthostatic hypotension is present in about one quarter of outpatients with stroke, and coronary artery disease appears to be a risk factor. Stroke patients should be screened for OH given that the presence of positional BP changes may alter clinical management.
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