What is the lowest orthostatic hypotension?

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Orthostatic hypotension, a medical term, will undoubtedly affect their normal work and study. It is a common clinical manifestation of internal environment stability damage, which generally occurs in the elderly. When the systolic blood pressure was the highest in the basal decubitus position, the systolic blood pressure of postural hypotension decreased the most, and the systolic blood pressure of orthostatic hypotension decreased 320mmhg (2.7kPa). Let me share with you how much is the lowest orthostatic hypotension?.

What is the lowest orthostatic hypotension?

First, orthostatic hypotension is a common clinical manifestation of impaired internal environment stability, which occurs in 15% - 20% of the general elderly. The prevalence increased with age, cardiovascular disease and basal blood pressure. Many elderly people's blood pressure has a wide range of changes when their body position changes, and it is closely related to the systolic blood pressure of the basic supine position. That is, when the systolic blood pressure is the highest in the basal decubitus position, the systolic blood pressure of postural hypotension decreases the most, and the systolic blood pressure of orthostatic hypotension decreases 320mmhg (2.7kPa). Orthostatic hypotension is an important risk factor for syncope and fainting in the elderly, even in the absence of other evidence of autonomic nervous system dysfunction.

Second: if the elderly complain of postural dizziness and mild mental confusion, clinicians can not think that he is suffering from orthostatic hypotension. Blood pressure and pulse rate should be measured after the patient lies on his back for at least 5 minutes, then blood pressure and pulse rate should be measured after standing for 1 minute, and blood pressure and pulse rate should be measured after standing for 3 minutes. Hypotension may occur immediately or delayed after standing. In order to find the hypotension reaction of the performance, it may be necessary to extend the standing time or do tilt test. Blood pressure should be measured several times before treatment to confirm the persistence of orthostatic hypotension.

Third: Patients with symptoms should not take antihypertensive drugs before meals, and should lie flat after meals. It may also be helpful to reduce the dosage of antihypertensive drugs and eat more with less. Recent data suggest that in some patients walking after meals can help to restore normal circulation, but this therapy should only be performed under close monitoring. Studies on patients with autonomic nervous insufficiency have shown that indomethacin 50 mg once every 6 hours, caffeine 250 mg with or without dioxygergotamine 6-10 mg / kg subcutaneous injection or somatostatin 12-16 mg subcutaneous injection may improve postprandial hypotension. Caffeine should only be given in the morning to make its effect disappear in the evening, so as not to affect the patient's sleep and avoid drug tolerance.

matters needing attention

The most common cause of orthostatic hypotension may be the use of drugs, such as phenothiazine, tricyclic antidepressants, anxiolytics and antihypertensive drugs. The latter includes preparations with central effects (e.g. methyldopa and clonidine) and peripheral effects (e.g. pazosin, hydralazine and guanidine). The elderly depend on adequate venous return to provide normal cardiac output due to impaired ventricular diastolic filling. Therefore, drugs, especially nitrates and diuretics, which can reduce the reflux in Nanjing, often cause orthostatic hypotension. Many drugs can also cause orthostatic hypotension in the elderly even with conventional dosage.