EFNS guidelines on the diagnosis and management of orthostatic hypotension.

摘要: Orthostatic (postural) hypotension (OH) is a common, yet under diagnosed disorder. It may contribute to disability and even death. can be the initial sign, lead incapacitating symptoms in primary secondary autonomic disorders. These range from visual disturbances dizziness loss of consciousness (syncope) after postural change. Evidence based guidelines for diagnostic workup therapeutic management (non-pharmacological pharmacological) are provided on EFNS guidance regulations. The final literature research was performed March 2005. For diagnosis OH, structured history taking measurement blood pressure (BP) heart rate supine upright position necessary. OH defined as fall systolic BP below 20 mmHg diastolic 10 baseline within 3 min position. Passive head-up tilt testing recommended if active standing test negative, especially suggestive or patients with motor impairment. initially consists education, advice training various factors that influence pressure. Increased water salt ingestion effectively improves OH. Physical measures include leg crossing, squatting, elastic abdominal binders stockings, careful exercise. Fludrocortisone valuable starter drug. Second line drugs sympathomimetics, such midodrine, ephedrine, dihydroxyphenylserine. Supine hypertension has considered.