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Postural or Orthostatic Hypotension

BP must be recorded in lying, sitting and standing positions especially when postural hypotension is suspected. When there is a fall in systolic pressure of > 20 mm Hg after standing for 3 minutes, from the lying posture, the patient is said to have postural hypotension.
Causes of orthostatic hypotension
1.Hypovolaemia (blood or fluid loss)
2.Autonomic insufficiency
  • Diabetes
  • Alcoholism
  • Shy drager syndrome
3. Drugs
  • Diuretics
  • Alfa blockers
  • ACE inhibitors
  • Ganglion blocking agents
  • Centrally acting anti-hypertensives
4. Myocardial pump failure
5. Secondary hypertension (pheochromocytoma).