Orthostatic hypertension (OHT) is associated with a rise in blood pressure when the person assumes a vertical position. The patient may present for evaluation of resistant hypertension.
The definition of orthostatic hypertension varies with different authors.
Author
Definition
Streeten et al
diastolic blood pressure <= 90 mm Hg when supine, diastolic blood pressure > 90 mm Hg when erect
Kario
increase in systolic blood pressure >= 20 mm Hg at 6-10 minutes after going from supine to erect
Pathogenesis: uncertain
Risk factors:
(1) autonomic and/or baroreflex dysfunction, especially diabetes
(2) mast cell activation disorder
(3) vascular adrenergic hypersensitivity
Testing on a tilt table can be helpful to standardize the patient evaluation.
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