Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?

DSpace/Manakin Repository

Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?

Citable link to this page

 

 
Title: Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?
Author: Fedorowski, Artur; Hamrefors, Viktor; Sutton, Richard; van Dijk, J. Gert; Freeman, Roy; Lenders, Jacques WM; Wieling, Wouter

Note: Order does not necessarily reflect citation order of authors.

Citation: Fedorowski, Artur, Viktor Hamrefors, Richard Sutton, J. Gert van Dijk, Roy Freeman, Jacques WM Lenders, and Wouter Wieling. 2017. “Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?” Clinical Autonomic Research 27 (3): 167-173. doi:10.1007/s10286-017-0409-7. http://dx.doi.org/10.1007/s10286-017-0409-7.
Full Text & Related Files:
Abstract: Purpose The contribution of diastolic blood pressure measurement to the diagnosis of classical orthostatic hypotension is not known. We aimed to explore the prevalence of isolated systolic and diastolic orthostatic hypotension components in patients with syncope and orthostatic intolerance. Methods: A total of 1520 patients aged >15 years with suspected syncope and/or symptoms of orthostatic intolerance were investigated in a tertiary center using tilt-table testing and continuous non-invasive blood pressure monitoring. Classical orthostatic hypotension was defined as a decline in systolic blood pressure ≥20 mmHg and/or diastolic blood pressure ≥10 mmHg at 3 min of tilt test. The prevalence of upright systolic blood pressure <90 mmHg and its overlap with isolated diastolic orthostatic hypotension was also assessed. Results: One hundred eighty-six patients (12.2%) met current diagnostic criteria for classical orthostatic hypotension. Of these, 176 patients (94.6%) met the systolic criterion and 102 patients (54.8%) met the diastolic criterion. Ninety-two patients (49.5%) met both systolic and diastolic criteria, whereas ten patients (5.4%) met the diastolic criterion alone. Of these, three had systolic blood pressure <90 mmHg during tilt test and were diagnosed with orthostatic hypotension on the grounds of low standing blood pressure. Based on patient history and ancillary test results, causes of orthostatic intolerance and syncope other than orthostatic hypotension were present in the remaining seven patients. Conclusions: An abnormal orthostatic fall in diastolic blood pressure without an abnormal fall in systolic blood pressure is rare among patients with syncope and orthostatic intolerance. Approximately 95% of patients with classical orthostatic hypotension can be identified by systolic criterion alone.
Published Version: doi:10.1007/s10286-017-0409-7
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440543/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:33490844
Downloads of this work:

Show full Dublin Core record

This item appears in the following Collection(s)

 
 

Search DASH


Advanced Search
 
 

Submitters