Orthostatic hypotension: pathophysiology, assessment, treatment and the paradox of supine hypertension

Abstract

Both hypertension and orthostatic hypotension (OH) are strongly age-associated and are common management problems in older people. However, unlike hypertension, management of OH has unique challenges with few well-established treatments. Not infrequently, they both coexist, further compounding the management. This review provides comprehensive information on OH, including pathophysiology, diagnostic workup and treatment, with a view to provide a practical guide to its management. Special references are made to patients with supine hypertension and postprandial hypotension and older hypertensive patients.

Keywords: nocturnal hypertension; orthostatic hypotension; orthostatic intolerance; supine hypertension; syncope.