Orthostatic hypotension is a common, treatable cause of falls in older adults, and it is often missed because blood pressure is checked sitting then standing straight away. The standard approach is to measure after about five minutes lying down, then again at one and three minutes after standing.
A fall of 20 mmHg systolic or 10 mmHg diastolic, or symptoms on standing, is significant. Review antihypertensives, diuretics, alpha-blockers and other culprit drugs when it is found.
- Measure after about five minutes lying down.
- Repeat at one and three minutes after standing.
- A fall of 20 systolic or 10 diastolic, or symptoms, is significant.
- Review blood pressure-lowering and other culprit medicines.
Why it matters
A sitting-to-standing check done at once misses many cases.
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