From the Research
Orthostatic hypertension management is largely undefined due to limited and variable evidence, but prioritizing the most recent and highest quality study, no specific recommendations have been developed 1.
Current Understanding
The pathophysiology of orthostatic hypertension (OHT) involves dysfunction of the autonomous nervous system, similar to orthostatic hypotension, and it has significant associations with essential hypertension 1. However, the definition of OHT varies across studies, making the comparison of outcomes problematic.
Management Considerations
Given the lack of specific guidelines for OHT management, treatment approaches may need to be individualized, focusing on addressing the underlying pathophysiological disturbances and associated conditions such as essential hypertension.
- Non-pharmacological approaches might include lifestyle modifications, although evidence specifically for OHT is limited.
- Pharmacological treatment is not well-defined, but managing associated conditions like hypertension might involve common antihypertensive medications, with consideration of the potential impact on orthostatic changes.
Clinical Implications
The clinical significance and prognostic role of OHT remain largely undefined due to the variability in its definition and the limited evidence on its treatment 1. Therefore, management strategies should be cautious and tailored to the individual patient's condition, considering both the potential benefits and risks of different interventions.
Prioritizing Patient Outcomes
In the absence of strong evidence for specific OHT management strategies, the primary goal should be to minimize morbidity, mortality, and improve quality of life, considering the patient's overall health status, comorbidities, and the potential impact of interventions on orthostatic hypertension and associated conditions 1.