Postural hypotension, also called orthostatic hypotension, is an abnormal drop in blood pressure on standing. It impairs quality of life and increases risk of falls, cardiovascular disease, depression, dementia, and death. 1 2 3 4 Early detection in patients with symptoms or certain risk factors may prevent some of these complications. Current guidelines for detecting and managing postural hypotension are varied and based on limited evidence. Primary care providers play an important role in screening and detection of postural hypotension and in helping patients make shared treatment decisions to improve symptoms and reduce risk.
We searched Embase, Medline, the Cochrane Central Register of Controlled Trials, and Web of Science using the terms “orthostatic hypotension,” “postural hypotension,” “orthostatic intolerance,” and “postural intolerance.” We also used personal archived references, which included our published work and National Institute for Health and Care Excellence (NICE) guidelines.
The prevalence of postural hypotension increases with age. One in five community-dwelling adults over 60 years old and one in four people in long term residential care have postural hypotension, as per a systematic review and meta-analysis (26 studies, >25 000 people). 5 Two large …