Orthostatic hypotension is a common, treatable cause of falls in older adults and is easy to miss on a seated reading. Measure blood pressure after five minutes lying, then at one and three minutes after standing.
A sustained fall of 20 mmHg systolic or 10 mmHg diastolic, or symptoms on standing, supports the diagnosis. Review antihypertensives, diuretics, alpha-blockers and other contributing drugs before adding treatment.
- Measure lying and standing blood pressure in every older adult who has fallen.
- Recheck at one and three minutes after standing.
- Review antihypertensives, diuretics and alpha-blockers first.
- Ask about dizziness on standing even when readings are borderline.
Why it matters
A seated reading cannot detect the drop that causes the fall.
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