Management of chronic orthostatic hypotension.

Onrot J, Goldberg MR, Hollister AS, Biaggioni I, Robertson RM, Robertson D
Am J Med. 1986 80 (3): 454-64

PMID: 2937292 · DOI:10.1016/0002-9343(86)90720-5

Chronic orthostatic hypotension is characterized by recurrent symptoms of cerebral hypoperfusion due to low upright blood pressure levels. The initial approach should be to identify and correct reversible causes. Persistence of orthostatic hypotension suggests autonomic failure. The goal of management is to minimize symptoms and maximize functional capacity; therefore the magnitude of blood pressure fall is not as important as the advent of symptoms. Therapy is based upon the underlying pathophysiology and the risk/benefit ratio of interventions. Patient education and nondrug measures form the cornerstone of management. Drug therapy is often limited by unacceptable supine hypertension. Rational drug use can be governed by individualized trials of therapy. Patients with moderate or severe orthostatic hypotension are difficult to treat, but can be helped toward resumption of a normal life.

MeSH Terms (19)

Activities of Daily Living Atrial Natriuretic Factor Autonomic Nervous System Diseases Blood Pressure Blood Volume Carbon Dioxide Clothing Combined Modality Therapy Diagnosis, Differential Drug Therapy, Combination Fludrocortisone Hydrogen-Ion Concentration Hypotension, Orthostatic Nonprescription Drugs Patient Education as Topic Physical Exertion Posture Sodium Weather

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