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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
Identification and management of orthostatic hypotension in older and medically complex patients
1Rehabilitation and Long-Term Care Division, Portland VA Medical Center, Oregon Health & Sciences University, PO Box 1035 (V-3-Dir), Portland, OR 97207, USA. scott.mader@va.gov
Abstract:
Orthostatic hypotension is defined as a drop in systolic blood pressure (BP) of at least 20 mmHg or of diastolic BP of at least 10 mmHg within 3 min of standing. It is uncommon in the healthy elderly. However, it occurs in 30-50% of elderly persons with known risk factors and is another example of a multifactorial geriatric syndrome similar to falls and delirium. Most patients with orthostatic hypotension either have no symptoms or atypical symptoms, and therefore, screening BPs should be taken in all patients with risk factors. The treatment approach is not standardized but a stepped-care algorithm is presented that is likely to be successful for many patients. Future studies need to focus on the potential benefits of screening and treating patients with this disorder.
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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)...