Evidence-Based Care Series: Assessing Etiology of Orthostatic Hypotension in Older Adults

What is Orthostatic Hypotension?

A drop in systolic blood pressure (BP) of at least 20 mmHg or a drop in diastolic BP of at least 10 mmHg within 3 minutes of standing from a supine or sitting position (Feldstein & Weder, 2012).

What are the Implications?

Orthostatic hypotension can increase the risk of falls, diminished function & decreased quality of life (Feldstein & Weder, 2012; Irvin & White, 2004; Lee, 2013; Ricci, De Caterina & Fedorowski, 2015; Lipsitz, 2017).

• The risk for orthostatic hypotension increases during hospitalization because of possible deconditioning and new medications.
• Continued close monitoring is needed in sub-acute care, assisted living, outpatient, or home settings.

Technique

Orthostatic blood pressure measurements should be included in the assessment of all older adults (Lipsitz, 2017):

1. Measure BP and HR in a lying position
2. Measure BP and HR in a sitting position
3. Measure BP and HR in a standing position

*Note, if the patient complains of dizziness or lightheadedness, refrain from asking them to stand.

Best Practice Approach to Assessing Etiology

Read More About It

You can learn more about Orthostatic Hypotension here:

• Try this: Assessing Etiology of Orthostatic Hypotension in Older Adults.PDF
• Best practices in Nursing care to Older Adults is a series provided by The Hartford Institute for Geriatric Nursing, NYU Rory Meyers College of Nursing