Orthostatic hypotension in spinal cord injured patients

Abstract

Treatment of orthostatic hypotension is an important consideration for many patients with spinal cord injuries, especially those with an injury to the cervical cord. Delay in attainment of an upright sitting posture can cause a delay in the completion of rehabilitation. Although most trials of medications used in the treatment of orthostatic hypotension have been performed on non-spinal cord injured patients, this paper provides a review of both pharmacological and non-pharmacologic means of therapy. Normally, regulation of mean arterial pressure occurs through several different mechanisms; long-term control is via the renal system and short-term control is via the nervous system. These mechanisms will be discussed, as well as causes of orthostatic hypotension in spinal cord injured patients, and the normalization of blood pressure control which generally occurs to some degree following a spinal cord injury.