postural hypotension is a significant fall in systolic BP upon standing
it may also have postural tachycardia
Measurement
lie patient down for 5 minutes
measure BP and HR
have the patient stand up (if safe to do so, provide support if dizzy)
if standing is not possible or safe, patient can sit on the side of bed with feet on the floor
repeat BP and HR at 1 minute and at 3 minutes
a drop in systolic BP of ≥20 mm Hg (> 30mmHg is often used if patient has baseline hypertension), or in diastolic BP of ≥10 mm Hg, or experiencing lightheadedness or dizziness is considered abnormal
some patients may only have postural tachycardia
a more detailed assessment especially for those who cannot stand uses a tilt table
Clinical features
may be asymptomatic
usually causes lightheartedness on standing which may result in falls risk or be mistaken for vertigo