Orthostatic hypotension is common in older adults who fall and is often caused or worsened by medicines: antihypertensives, alpha-blockers, nitrates, antidepressants, antipsychotics and Parkinson's drugs.
Measure blood pressure after the patient has lain down for five minutes, then at one and three minutes after standing. A fall of 20 mmHg systolic or 10 mmHg diastolic, or symptoms on standing, confirms it. A seated reading alone misses most cases.
- Measure lying and standing blood pressure in every older person who has fallen
- Record readings at one and three minutes after standing
- Review antihypertensives, alpha-blockers and psychotropics when orthostatic hypotension is found
- Advise slow rising, hydration and sitting before standing
Why it matters
Orthostatic hypotension is a common, treatable and often drug-induced cause of falls.
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