Responds Gaetano Lanza , medical director of Cardiology, Policlinico Gemelli in Rome
The term orthostatic hypotension indicates a fall in blood pressure that occurs when a person stands up. More precisely, a reduction of at least 20 mmHg in systolic blood pressure (the "Maximum") and / or at least 10 mm Hg diastolic (the "minimum") occurring in the first 3 minutes after the upright position. If the pressure gets too low, orthostatic hypotension does not cause problems, but if the pressure drop is significant symptoms appear, such as dizziness, blurred vision, confusion, loss of consciousness (syncope), due to a reduction of blood flow the brain, which are resolved quickly, however, lying down. A syncope, orthostatic hypotension, therefore, does not ipso facto consequences. However, if this results in a fall on the ground can also cause serious trauma to the patient. It 'should be emphasized that, in case of syncope, it is important to exclude causes other potentially serious (such as cardiac arrhythmia), which could put at risk in the future life of the patient.
Orthostatic hypotension is in most cases a problem of old age , when the reflections that prevent a drop in pressure in the feet are less swift and efficient. It can also be enhanced by antihypertensive drugs, once again, especially in older people. At the time of initiating antihypertensive therapy (and subsequent controls), when it comes to people who came to old age, so you should always measure the pressure in orthostatic position to make an informed choice of drugs and doses to use and avoid the onset of orthostatic hypotension. The rarity of cases of orthostatic hypotension in younger people means that, in general, doctors do not submit to this control, unless there are complaints that suggest an opportunity. However, the orthostatic hypotension can be easily detected by any patient, even older. All you need is an automatic blood pressure monitor and measure the pressure first and then sitting down in the first 3 minutes after taking the orthostatic position. How to care for hypertension, there is no doubt that they serve. A high pressure for a long time can cause damage to various organs (heart, kidney, brain) and maintain the pressure within normal values (under 140/90 mm Hg) significantly reduces the risk of cardiovascular disease, particularly stroke. To come at the last question, is risky hypertension in the elderly as in young people, so should always be treated. In patients who become hypertensive over 80 years, however, consider a less aggressive treatment, starting, for example, a therapy only for values above 160/90 mmHg.
