The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Orthostatic Hypotension Evaluation

Diagnosis and management of postural blood pressure drops.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Orthostatic Hypotension Evaluation?

Orthostatic hypotension (OH) is defined as a drop of >=20 mmHg in systolic and/or >=10 mmHg in diastolic blood pressure within 3 minutes of standing. Neurogenic OH (autonomic failure), drug-induced OH and postprandial hypotension are distinguished.

Multiple system atrophy (MSA), Parkinson's disease, pure autonomic failure, diabetic autonomic neuropathy and Lewy body dementia are common neurogenic causes. The drug list (alpha-blockers, diuretics, antidepressants, dopamine agonists) must be reviewed.

Symptoms

Dizziness on standing
Pre-syncope and syncope
Visual disturbances (greying out)
Generalised weakness and fatigue
Cervical pain (coathanger pain)
Cognitive impairment (cerebral hypoperfusion)

Risk Factors

Advanced age
Parkinson's disease and atypical parkinsonism
Diabetic autonomic neuropathy
Multiple drug use (polypharmacy)
Volume depletion (dehydration)
Adrenal insufficiency

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent dizziness/falls on standing
  • Syncope evaluation
  • Symptoms of new drug use
  • Parkinson disease + orthostatic complaints
  • Detection of unexplained falls

Treatment Methods

01
Tilt-table test (head-up tilt 60-70°)
02
Active stand test (sequential blood pressure measurement)
03
Drug review and reduction (offending drugs)
04
Volume expansion (salt 6-10 g/day, fluid 2-3 L)
05
Compression stockings (waist-level)
06
Physical countermanoeuvres (leg crossing, squatting)
07
Midodrine (5-10 mg 3x1 - alpha-1 agonist)
08
Fludrocortisone (0.1-0.3 mg/day - mineralocorticoid)
09
Droxidopa (refractory cases)
10
Pyridostigmine (autonomic neuropathy)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kardiyoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Hypertension (High Blood Pressure)

Kardiyoloji

Hypertension is a condition in which blood pressure readings remain above 140/90 mmHg; early treatment helps prevent serious complications.

Coronary Artery Disease

Kardiyoloji

Narrowing of the coronary arteries due to atherosclerosis can cause chest pain (angina) and heart attack.

Heart Failure

Kardiyoloji

Heart failure is a chronic cardiac condition characterized by shortness of breath, leg swelling, and fatigue.

Heart Attack (Myocardial Infarction)

Kardiyoloji

A heart attack is a medical emergency; because heart muscle is lost by the minute, immediate intervention saves lives.

Atrial Fibrillation

Kardiyoloji

Atrial fibrillation is a common arrhythmia characterized by an irregular heartbeat and increased risk of stroke.

Heart Palpitations

Kardiyoloji

Palpitations are usually due to benign causes, but underlying cardiac rhythm disorders must be ruled out.

Heart Valve Diseases

Kardiyoloji

Valve stenosis or regurgitation increases the workload of the heart and, over time, can lead to heart failure.

Aortic Aneurysm

Kardiyoloji

Aortic aneurysms are often silent; early diagnosis allows treatment before rupture (a life-threatening tear).

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.