Postural Hypotension

What is Postural Hypotension (also known as Orthostatic Hypotension)?

According to Augn et al.(2012), Postural Hypotension (otherwise known as Orthostatic Hypotension) is defined as a reduction in systolic blood pressure of at least 20 mmHg and/or diastolic blood pressure of at least 10 mmHg within 3 minutes of standing from a lying position.

It is explained by Jarvis that postural hypotension occurs as a result of impaired autoregulatory mechanisms. Changes occur following abrupt peripheral vasodilation without a compensatory increase in cardiac output.

Augn et al.(2012) state that as a result of reduction in blood pressure, postural hypotension is often associated with episodes of syncope, falls, and related injuries. Furthermore, postural hypotension is most definitely considered a significant risk factor for cardiovascular morbidity and mortality.

Aung et al., 2012 are of the view that while postural hypotension is prevalent predominantly within the elderly hospitalised population particularly on medical and geriatric wards, it is also prevalent in acute surgical and trauma patients due to increased risk factors of hypovolemia, underlying medical conditions, post-surgery immobilisation and newly introduced medications.

Where postural hypotension is identified in patients, nursing staff must be vigilant in monitoring their patients’ blood pressure. Furthermore, nursing staff must taking into account the importance and relevance of taking observations both in lying and standing positions, documenting results and reporting findings accordingly. In addition, appropriate and sensible measures must be taken to reduce risks associated with postural hypotension such as falls, sycopal episodes and related injuries.

References:

Aung, A, Corcoran, S, Nagaligam, V, Paul, E & Newnham, H Prevalence, Associations, and Risk Factors for Orthostatic Hypotension in Medical, Surgical, and Trauma Inpatients: An Observational Cohort Study’, Oschner Journal 2012, vol. 12, no. 1, pp. 35-41.

Jarvis, C 2008, ‘Physical Examination & Health Assessment: Fifth Edition, General Survey, Measurement, Vital Signs, ch. 9, pp. 161, Sydney, Churchill Livingstone