Brief Orthostatic Test

Performing the test

1. Measureblood pressure and heart rate after the patient has been in a supine position for 5 minutes.
2. The patient stands up quickly.
3. Measure blood pressure and heart rate 1 and 3 minutes after the patient stood up, and also record the patient's symptoms.

Printable form .

Interpretation

Normally, changing from supine to standing position is followed by a mild decrease (5-10 mmHg) in the systolic blood pressure, a mild elevation (5-10 mmHg) in the diastolic blood pressure and an increase in the heart rate (10-25 beats/min).

In orthostatic hypotension the mechanisms compensating for the blood pressure drop function in an inadequate manner and standing up causes a higher than normal reduction in blood pressure.

• The systolic blood pressure decreases at least 20 mmHg or the diastolic blood pressure decreases at least 10 mmHg within 3 minutes after standing up, and the patient has clear orthostatic symptoms.
• Also a decrease of systolic blood pressure to a level below 90 mmHg can be regarded as orthostatic hypotension in a symptomatic patient whose starting blood pressure is low (< 110 mmHg).

Many medications (alpha blocking agents, antidepressants, antipsychotics, diuretics, nitrates, PDE5 inhibitors, antihypertensive drugs, among others) may cause or aggravate orthostatic hypotension.