From the Research
Orthostatic hypertension is not a widely recognized medical condition, and the provided evidence primarily discusses orthostatic hypotension, which is a drop in blood pressure upon standing. However, based on the available information, indicators for orthostatic changes in blood pressure, which could be related to orthostatic hypertension, include:
- Systolic hypertension
- Diastolic hypertension
- Excessive narrowing of the pulse pressure
- Tachycardia after standing for at least 3 minutes 1 These indicators are associated with excessive venous pooling, which can be a cause of orthostatic circulatory derangements 1. It's essential to note that the primary concern with orthostatic changes is usually orthostatic hypotension, which is a drop in blood pressure upon standing, and not orthostatic hypertension. The key indicators for orthostatic hypotension include:
- Lightheadedness
- Dizziness
- Blurry vision
- Weakness
- Fatigue
- Cognitive impairment
- Nausea
- Headache
- Syncope (fainting) upon standing 2, 3, 4 Physical findings may include pallor, diaphoresis (sweating), and tachycardia as compensatory mechanisms. Risk factors for orthostatic hypotension include advanced age, dehydration, certain medications, neurological disorders, diabetes, and prolonged bed rest 2, 3, 4. Given the lack of direct evidence on orthostatic hypertension, the most appropriate approach is to focus on the diagnosis and management of orthostatic hypotension, which is a well-established medical condition. The diagnosis of orthostatic hypotension is confirmed by a decrease in systolic blood pressure of 20 mmHg or a decrease in diastolic blood pressure of 10 mmHg within three minutes of standing from the supine position 2, 3, 4. Treatment goals for orthostatic hypotension involve improving hypotension without excessive supine hypertension, relieving orthostatic symptoms, and improving standing time 3, 4. Nonpharmacologic strategies, such as dietary modifications, compression garments, and physical maneuvers, are recommended as initial treatment 4. First-line medications for orthostatic hypotension include midodrine and droxidopa 4.