Orthostatic hypotension: Difference between revisions
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==Causes== | ==Causes== | ||
Baroreflex failure may cause labile hypertension with hypotension.<ref name="pmid8413455">{{cite journal| author=Robertson D, Hollister AS, Biaggioni I, Netterville JL, Mosqueda-Garcia R, Robertson RM| title=The diagnosis and treatment of baroreflex failure. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 20 | pages= 1449-55 | pmid=8413455 | Baroreflex failure may cause labile hypertension with hypotension.<ref name="pmid8413455">{{cite journal| author=Robertson D, Hollister AS, Biaggioni I, Netterville JL, Mosqueda-Garcia R, Robertson RM| title=The diagnosis and treatment of baroreflex failure. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 20 | pages= 1449-55 | pmid=8413455 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=8413455 }} | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=8413455 }}</ref> | ||
[[Carotid endarterectomy]] of the [[internal carotid artery]] may be a cause.<ref name="pmid15874927">{{cite journal |author=Nouraei SA, Al-Rawi PG, Sigaudo-Roussel D, Giussani DA, Gaunt ME |title=Carotid endarterectomy impairs blood pressure homeostasis by reducing the physiologic baroreflex reserve |journal=J. Vasc. Surg. |volume=41 |issue=4 |pages=631–7 |year=2005 |month=April |pmid=15874927 |doi=10.1016/j.jvs.2005.01.009 |url=http://linkinghub.elsevier.com/retrieve/pii/S0741521405000315 |issn=}}</ref><ref name="pmid18095499">{{cite journal |author=Azuma Y, Imai K, Oda K, Niwa F, Makino M, Oshima F |title=[Case of baroreflex failure after bilateral revascularization of the cervical carotid artery] |language=Japanese |journal=Rinsho Shinkeigaku |volume=47 |issue=10 |pages=657–61 |year=2007 |month=October |pmid=18095499 |doi= |url= |issn=}}</ref> | [[Carotid endarterectomy]] of the [[internal carotid artery]] may be a cause.<ref name="pmid15874927">{{cite journal |author=Nouraei SA, Al-Rawi PG, Sigaudo-Roussel D, Giussani DA, Gaunt ME |title=Carotid endarterectomy impairs blood pressure homeostasis by reducing the physiologic baroreflex reserve |journal=J. Vasc. Surg. |volume=41 |issue=4 |pages=631–7 |year=2005 |month=April |pmid=15874927 |doi=10.1016/j.jvs.2005.01.009 |url=http://linkinghub.elsevier.com/retrieve/pii/S0741521405000315 |issn=}}</ref><ref name="pmid18095499">{{cite journal |author=Azuma Y, Imai K, Oda K, Niwa F, Makino M, Oshima F |title=[Case of baroreflex failure after bilateral revascularization of the cervical carotid artery] |language=Japanese |journal=Rinsho Shinkeigaku |volume=47 |issue=10 |pages=657–61 |year=2007 |month=October |pmid=18095499 |doi= |url= |issn=}}</ref> | ||
However, orthostasis may be improved by [[endarterectomy]]<ref name="pmid8685922">{{cite journal |author=Hirschl M, Kundi M, Blazek G |title=Five-year follow-up of patients after thromboendarterectomy of the internal carotid artery: Relevance of baroreceptor sensitivity |journal=Stroke |volume=27 |issue=7 |pages=1167–72 |year=1996 |month=July |pmid=8685922 |doi= |url=http://stroke.ahajournals.org/cgi/pmidlookup?view=long&pmid=8685922 |issn=}}</ref> if there is "vasodepressor-type carotid sinus syndrome caused by compression of the carotid baroreceptors by atherosclerotic plaques."<ref name="pmid10193149">{{cite journal |author=Akiyama Y, Hashimoto N, Morimoto M |title=Orthostatic hypotension improved after bilateral carotid endarterectomy--case report |journal=Neurol. Med. Chir. (Tokyo) |volume=39 |issue=2 |pages=153–6 |year=1999 |month=February |pmid=10193149 |doi= |url=http://joi.jlc.jst.go.jp/JST.Journalarchive/nmc1959/39.153?from=PubMed |issn=}}</ref> | However, orthostasis may be improved by [[endarterectomy]]<ref name="pmid8685922">{{cite journal |author=Hirschl M, Kundi M, Blazek G |title=Five-year follow-up of patients after thromboendarterectomy of the internal carotid artery: Relevance of baroreceptor sensitivity |journal=Stroke |volume=27 |issue=7 |pages=1167–72 |year=1996 |month=July |pmid=8685922 |doi= |url=http://stroke.ahajournals.org/cgi/pmidlookup?view=long&pmid=8685922 |issn=}}</ref> if there is "vasodepressor-type carotid sinus syndrome caused by compression of the carotid baroreceptors by atherosclerotic plaques."<ref name="pmid10193149">{{cite journal |author=Akiyama Y, Hashimoto N, Morimoto M |title=Orthostatic hypotension improved after bilateral carotid endarterectomy--case report |journal=Neurol. Med. Chir. (Tokyo) |volume=39 |issue=2 |pages=153–6 |year=1999 |month=February |pmid=10193149 |doi= |url=http://joi.jlc.jst.go.jp/JST.Journalarchive/nmc1959/39.153?from=PubMed |issn=}}</ref> | ||
==Complications== | |||
Orthostatic hypotension may cause [[accidental fall]]s.<ref name="pmid21438868">{{cite journal| author=Romero-Ortuno R, Cogan L, Foran T, Kenny RA, Fan CW| title=Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people. | journal=J Am Geriatr Soc | year= 2011 | volume= 59 | issue= 4 | pages= 655-65 | pmid=21438868 | doi=10.1111/j.1532-5415.2011.03352.x | pmc= | url= }} </ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 07:52, 29 April 2011
In medicine, orthostatic hypotension is "a significant drop in blood pressure after assuming a standing position. Orthostatic hypotension is a finding, and defined as a 20-mm hg decrease in systolic pressure or a 10-mm hg decrease in diastolic pressure 3 minutes after the person has risen from supine to standing. Symptoms generally include dizziness, blurred vision, and syncope."[1]
Orthostatic hypotension is an orthostatic intolerance along with postural orthostatic tachycardia syndrome (POTS)[2][3] and vasovagal syncope.
Causes
Baroreflex failure may cause labile hypertension with hypotension.[4]
Carotid endarterectomy of the internal carotid artery may be a cause.[5][6]
However, orthostasis may be improved by endarterectomy[7] if there is "vasodepressor-type carotid sinus syndrome caused by compression of the carotid baroreceptors by atherosclerotic plaques."[8]
Complications
Orthostatic hypotension may cause accidental falls.[9]
References
- ↑ Anonymous (2024), Orthostatic hypotension (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Grubb BP, Karabin B (July 2008). "Cardiology patient page. Postural tachycardia syndrome: perspectives for patients". Circulation 118 (3): e61–2. DOI:10.1161/CIRCULATIONAHA.107.761650. PMID 18625897. Research Blogging.
- ↑ Low PA, Sandroni P, Joyner M, Shen WK (January 2009). "Postural Tachycardia Syndrome (POTS)". J. Cardiovasc. Electrophysiol.. DOI:10.1111/j.1540-8167.2008.01407.x. PMID 19207771. Research Blogging.
- ↑ Robertson D, Hollister AS, Biaggioni I, Netterville JL, Mosqueda-Garcia R, Robertson RM (1993). "The diagnosis and treatment of baroreflex failure.". N Engl J Med 329 (20): 1449-55. PMID 8413455.
- ↑ Nouraei SA, Al-Rawi PG, Sigaudo-Roussel D, Giussani DA, Gaunt ME (April 2005). "Carotid endarterectomy impairs blood pressure homeostasis by reducing the physiologic baroreflex reserve". J. Vasc. Surg. 41 (4): 631–7. DOI:10.1016/j.jvs.2005.01.009. PMID 15874927. Research Blogging.
- ↑ Azuma Y, Imai K, Oda K, Niwa F, Makino M, Oshima F (October 2007). "[Case of baroreflex failure after bilateral revascularization of the cervical carotid artery]" (in Japanese). Rinsho Shinkeigaku 47 (10): 657–61. PMID 18095499. [e]
- ↑ Hirschl M, Kundi M, Blazek G (July 1996). "Five-year follow-up of patients after thromboendarterectomy of the internal carotid artery: Relevance of baroreceptor sensitivity". Stroke 27 (7): 1167–72. PMID 8685922. [e]
- ↑ Akiyama Y, Hashimoto N, Morimoto M (February 1999). "Orthostatic hypotension improved after bilateral carotid endarterectomy--case report". Neurol. Med. Chir. (Tokyo) 39 (2): 153–6. PMID 10193149. [e]
- ↑ Romero-Ortuno R, Cogan L, Foran T, Kenny RA, Fan CW (2011). "Continuous noninvasive orthostatic blood pressure measurements and their relationship with orthostatic intolerance, falls, and frailty in older people.". J Am Geriatr Soc 59 (4): 655-65. DOI:10.1111/j.1532-5415.2011.03352.x. PMID 21438868. Research Blogging.