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Orthostatic hypotension

Also known as Postural Hypotension

Orthostatic hypotension, also known as postural hypotension, orthostasis, and colloquially as head rush or dizzy spell, is a form of hypotension in which a person's blood pressure suddenly falls when standing up or stretching. Medically it is defined as a fall in systolic blood pressure of at least 20mm Hg and diastolic blood pressure of at least 10 mm Hg when a person assumes a standing position.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with orthostatic hypotension, 86% report having dizziness, 69% report having fainting, and 54% report having weakness. The symptoms that are highly suggestive of orthostatic hypotension are dizziness and fainting, although you may still have orthostatic hypotension without those symptoms.


What might my doctor prescribe?

Common Tests and Procedures

Patients with orthostatic hypotension often receive hematologic tests, complete blood count, electrocardiogram, radiographic imaging procedure, intravenous fluid replacement, glucose measurement, electrolytes panel and plain x-ray .

Common Medications

The most commonly prescribed drugs for patients with orthostatic hypotension include midodrine, fludrocortisone, nortriptyline, flecainide, nadolol, diatrizoate, aspirin / dipyridamole, memantine (namenda), acetaminophen / diphenhydramine / pseudoephedrine, dofetilide (tikosyn), glycerin (fleet), amlodipine / valsartan and repaglinide (prandin) .

Midodrine
$106
(28 days)
Fludrocortisone
$23
(28 days)
Nortriptyline
$8
(28 days)
Flecainide
$39
(28 days)
Nadolol
$13
(28 days)
Diatrizoate

Memantine (Namenda)
$157
(28 days)
Dofetilide (Tikosyn)
$185
(28 days)
Glycerin (Fleet)
$4
(21 days)
Repaglinide (Prandin)
$165
(28 days)

Who is at risk?

Groups of people at highest risk for orthostatic hypotension include age 75+ years. On the other hand, age < 1 years almost never get orthostatic hypotension.

Age

< 1 years
0.0x
1-4 years
0.1x
5-14 years
0.3x
15-29 years
0.5x
30-44 years
0.6x
45-59 years
0.8x
60-74 years
1.3x
75+ years
4.2x

Sex

Male
1.1x
Female
1.0x

Race/Ethnicity

Black
0.7x
Hispanic
0.7x
White
1.2x
Other
0.9x
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