Orthostatic hypotension is common in frail patients, often asymptomatic, and frequently caused or worsened by drugs. Without a lying and standing measurement, the review has no way to see it.
Measure after five minutes lying, then at one and three minutes standing. A drop of 20 systolic or 10 diastolic changes which drugs you prioritise — antihypertensives, alpha-blockers, anticholinergics, antidepressants.
- Lying for five minutes, then standing at one and three minutes.
- Record symptoms during standing.
- Repeat after any medication change.
Why it matters
It reveals the drug effect a seated blood pressure hides.
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