1. Evaluation And Treatment Of Orthostatic Hypotension / October 1, 1997, AFP Evaluation and Treatment of Orthostatic hypotension. When these adjustments are not accomplished, orthostatic hypotension occurs. http://www.aafp.org/afp/971001ap/engstrm.html

Advanced Search Articles Departments Patient Information ... Special Medical Reports Evaluation and Treatment of Orthostatic Hypotension JOHN W. ENGSTROM, M.D., and MICHAEL J. AMINOFF, M.D. University of California, San Francisco, School of Medicine San Francisco, California Orthostatic hypotension is defined as a decrease of at least 20 mm Hg in systolic blood pressure when an individual moves from a supine position to a standing position. Nonneurogenic causes of orthostatic hypotension are related to cardiac pump failure, reduced intravascular volume, venous pooling or a medication side effect. Neurogenic causes include both central and peripheral nervous system lesions. The diagnostic evaluation requires a systematic review of medications and coexisting medical conditions along with a neurologic examination to search for treatable factors that may be contributing to orthostatic hypotension. Specific testing of autonomic function is useful for detecting subclinical orthostatic hypotension or for monitoring autonomic function over a period of time. Treatment is directed at improving the patient's symptoms rather than achieving arbitrary blood pressure goals. Homeostatic control of blood pressure and heart rate requires frequent and rapid cardiovascular adjustments as an individual changes from supine to sitting and standing positions throughout the day. When these adjustments are not accomplished, orthostatic hypotension occurs. Some patients with severe orthostatic hypotension are severely incapacitated, and their families assume a significant burden in their care.

2. MedlinePlus Medical Encyclopedia: Blood Pressure - Low Return to top. hypotension; Low blood pressure common cause type of low blood pressure is orthostatic hypotension, which results from a sudden change in body position http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm

@import url(http://www.nlm.nih.gov/medlineplus/images/advanced.css); Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Blood pressure - low Contents of this page: Illustrations Alternative names Definition Considerations ... What to expect at your health care provider's office Illustrations Effects of age on blood pressure Alternative names Return to top Hypotension; Low blood pressure Definition Return to top Low blood pressure is an abnormal condition where a person's blood pressure (the pressure of the blood against the walls of the blood vessels during and after each beat of the heart) is much lower than usual, which can cause symptoms such as dizziness or lightheadedness. Considerations Return to top When the blood pressure is too low, there is inadequate blood flow to the heart, brain, and other vital organs. A blood pressure level that is borderline low for one person may be normal for another. The most important factor is how the blood pressure changes from the normal condition. Most normal blood pressures fall in the range of 90/60 mm Hg to 130/80 mm Hg, but a significant change, even as little as 20 mm Hg, can cause problems for some people. Common Causes Return to top Low blood pressure is commonly caused by drugs such as the following Medications used for surgery Anti-anxiety agents Treatment for high blood pressure Diuretics Heart medicines Some antidepressants Narcotic analgesics Alcohol Other causes of low blood pressure include the following: Dehydration Heart failure Heart attack Changes in heart rhythm (

3. THE MERCK MANUAL OF GERIATRICS, Sec. 11, Ch. 86, Hypotension Chapter 86. hypotension. Subnormal arterial blood pressure. Baroreflex mechanisms regulate systemic blood pressure by increasing or decreasing heart rate and vascular resistance in response to transient decreases or increases in arterial pressure. progressively declines, and the risk of hypotension increases. Baroreflex function is most impaired http://www.merck.com/mrkshared/mm_geriatrics/sec11/ch86.jsp

4. NINDS Orthostatic Hypotension Information Page Orthostatic hypotension (a sudden fall in blood pressure that occurs when a person stands up) information sheet compiled by the National Institute of http://www.ninds.nih.gov/health_and_medical/disorders/orthosta_doc.htm

National Institute of Neurological Disorders and Stroke Accessible version Science for the Brain The nation's leading supporter of biomedical research on disorders of the brain and nervous system Browse all disorders Browse all health organizations More about Orthostatic Hypotension Studies with patients Research literature Press releases Search NINDS... (help) Contact us My privacy NINDS is part of the National Institutes of Health NINDS Orthostatic Hypotension Information Page Synonym(s): Postural Hypotension, Bradbury-Eggleston Syndrome Reviewed 07-01-2001 Get Web page suited for printing Email this to a friend or colleague Table of Contents (click to jump to sections) What is Orthostatic Hypotension? Is there any treatment? What is the prognosis? What research is being done? ... Organizations What is Orthostatic Hypotension? Orthostatic hypotension is a sudden fall in blood pressure that occurs when a person assumes a standing position. It may be caused by hypovolemia (a decreased amount of blood in the body), resulting from the excessive use of diuretics, vasodilators, or other types of drugs, dehydration, or prolonged bed rest. The disorder may be associated with Addison's disease, atherosclerosis (build-up of fatty deposits in the arteries), diabetes, and certain neurological disorders including Shy-Drager syndrome and other dysautonomias. Symptoms, which generally occur after sudden standing, include dizziness, lightheadedness, blurred vision, and syncope (temporary loss of consciousness).

5. Hypotension Book. Royal Prince Alfred Hospital. hypotension. Introduction 3 Risk of hypotension reduces with increasing postnatal age. Consequences http://www.cs.nsw.gov.au/rpa/neonatal/html/newprot/hypotefn.htm

6. Orthostatic Hypotension - December 15, 2003 - American Family Physician PROBLEMORIENTED DIAGNOSIS. Orthostatic hypotension. When these mechanisms are faulty or if the patient is hypovolemic, orthostatic hypotension may occur. http://www.aafp.org/afp/20031215/2393.html

Advanced Search PROBLEM-ORIENTED DIAGNOSIS Orthostatic Hypotension JOHN G. BRADLEY, M.D., and KATHY A. DAVIS, R.N. Southern Illinois University School of Medicine, Decatur, Illinois A PDF version of this document is available. Download PDF now (6 pages /76 KB). More information on using PDF files. See page 2306 for definitions of strength-of-evidence levels. O rthostatic hypotension, which is a physical finding, not a disease, may be symptomatic or asymptomatic. The American Autonomic Society (AAS) and the American Academy of Neurology (AAN) define orthostatic hypotension as a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing up. [Evidence level C, consensus/expert guidelines] The AAS and AAN also provide a tilt-table definition. This determination has limited usefulness for the approach outlined in this article and appears to have a high rate of false-positive results. Orthostatic hypotension has been observed in all age groups, but it occurs more frequently in the elderly, especially in persons who are sick and frail.

7. Johns Hopkins Children's Center John Hopkins Hospital looks at this order indepth as to what it is, causes of symptoms, how it is diagnosed and treatment. Offered are helpful hints and extensive diet information. http://ww2.med.jhu.edu/peds/cfs.html

When Swallowing Disorders are Missed When Hana Pitt’s breathing became increasingly raspy, her parents paid a visit to their pediatrician, who concluded that Hana’s uneven breathing patterns and spitting up after feeding were normal. But when the breathing worsened and they returned to the doctor’s office, the Pitts were told their 2 month-old daughter probably had asthma, and they got their first lesson in how to use an inhaler. But that didn’t help when Hana suffered her next severe episode and ended up in the emergency room at Howard County General Hospital. May 18, 2004 ABC 2 to Host 21st Annual Telethon to Benefit the Johns Hopkins Children's Center May 15, 2004 Researchers Identify Cancer-Causing Gene Involved in Aggressive Leukemia, Lymphoma May 2, 2004 Even Drug-Resistant HIV Infection Responds to Right Treatment Apr 5, 2004 Low Activity Levels Found Among Children with Asthma Due to Parental Health Beliefs, Disease Severity Johns Hopkins Medicine About This Site

8. Hypotension hypotension. hypotension is the clinical term for low blood pressure, which can mean inadequate blood flow to the heart, brain and other vital organs. is known as postural hypotension, orthostatic hypotension or neurally mediated orthostatic hypotension http://www.lebanonhealth.com/condi/46337.htm

9. For Parents Of Sick And Worn-Out Children Deals with pediatric chronic fatigue syndrome, neurally mediated hypotension, fibromyalgia and other related syndromes. By Frank Albrecht, PhD. http://www.bluecrab.org/health/sickids/sickids.htm

10. NINDS Multiple System Atrophy With Orthostatic Hypotension Information Page Multiple System Atrophy with Orthostatic hypotension information sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS). http://www.ninds.nih.gov/health_and_medical/disorders/mult_sys_atrophy_doc.htm

National Institute of Neurological Disorders and Stroke Accessible version Science for the Brain The nation's leading supporter of biomedical research on disorders of the brain and nervous system Browse all disorders Browse all health organizations More about Multiple System Atrophy with Orthostatic Hypotension Studies with patients Research literature Press releases Search NINDS... (help) Contact us My privacy NINDS is part of the National Institutes of Health NINDS Multiple System Atrophy with Orthostatic Hypotension Information Page Synonym(s): Shy-Drager Syndrome Reviewed 12-01-2003 Get Web page suited for printing Email this to a friend or colleague Table of Contents (click to jump to sections) What is Multiple System Atrophy with Orthostatic Hypotension? Is there any treatment? What is the prognosis? What research is being done? ... Organizations What is Multiple System Atrophy with Orthostatic Hypotension? Multiple system atrophy with orthostatic hypotension is the current classification for a neurological disorder that was once called Shy-Drager syndrome. A progressive disorder of the central and autonomic nervous systems, it is characterized by orthostatic hypotension (an excessive drop in blood pressure when standing up) which causes dizziness or fainting. Multiple system atrophy can occur without orthostatic hypotension, but it is rare. Doctors classify the disorder into 3 types: the Parkinsonian-type includes symptoms of Parkinson's disease such as slow movement, stiff muscles, and tremor; the

11. THE MERCK MANUAL, Sec. 16, Ch. 200, Orthostatic Hypotension And Syncope An article about orthostatic hypotension and syncope. http://www.merck.com/pubs/mmanual/section16/chapter200/200b.htm

This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 16. Cardiovascular Disorders Chapter 200. Orthostatic Hypotension And Syncope Topics Orthostatic Hypotension Syncope Syncope (Fainting) A sudden brief loss of consciousness, with loss of postural tone. Etiology and Pathophysiology Bradyarrhythmias (especially those with abrupt onset) can cause syncope. These include the sick sinus syndrome, with or without tachyarrhythmias, and high-grade atrioventricular block. Although bradyarrhythmias occur at all ages, they are most frequent in the elderly and are usually due to ischemia or fibrosis of the conduction system. Digitalis, -blockers (including ophthalmic -blockers), Ca blockers, and other drugs may also cause bradyarrhythmias. Supraventricular or ventricular tachyarrhythmias that cause syncope may be related to ischemia, heart failure, drug toxicity (quinidine syncope is the best known), electrolyte abnormalities, preexcitation, and other disorders. Syncope with chest pain of myocardial ischemia is usually related to arrhythmia or heart block but rarely may reflect substantial ischemic ventricular dysfunction with a reduced cardiac output. Syncope can be due to atrioventricular block in acute inferior MI. Many other mechanisms, often in combination, may limit cardiac output, such as a decrease in systemic BP due to peripheral vasodilation, decreased venous return to the heart, hypovolemia, and cardiac outflow obstruction. Diminished cerebral perfusion may also be caused by cerebral vasoconstriction, eg, induced by hypocapnia.

12. Hypotension Information Diseases Database hypotension Blood pressure low, systemic, Disease Database Information http://www.diseasesdatabase.com/sieve/item1.asp?glngUserChoice=6539

13. The Center For Pediatric Hypotension Information about the investigation, evaluation, and treatment of adolescents and children with syncope, orthostatic tachycardia, and other forms of chronic orthostatic intolerance including CFS. http://www.syncope.org/

syncope.org;http://www.nymc.edu/fhp/centers/syncope; syncope.org;http://www.nymc.edu/fhp/centers/syncope;

14. Hypotension -- ECureMe.com UPDATED SARS INFORMATION Check health symptoms, make a self diagnosis, ask a doctor or veterinarian online, view an encyclopedia of diseases treatments, buy discount medical supplies. hypotension is a condition in which the blood pressure (an index of the body's circulatory system) falls below and pallor of skin, all point to hypotension. However, a person may http://www.ecureme.com/emyhealth/data/Hypotension.asp

DisplayAd("468","60"); Select a Health Topic ADD/ADHD Allergy Alternative Medicine Arthritis Asthma Beyond Dieting Body Aches and Pains Breast Cancer Cancer Awareness Cardio Health Children's Health Colon Cancer Contraception COPD/Emphysema Dental Health Diabetes Elder Care Emergency Room Epilepsy Erectile Dysfunction Eye Care Fertility Fitness Gastrointestinal Health Glands and Hormones Gynecologic Health Hair Loss Headache Healthcare Today Healthy Aging HIV and AIDS Infectious Diseases Kidney Health Leukemia Liver Health Lung Cancer Lymphoma Multiple Sclerosis Men's Health Mental Health Nutrition Osteoporosis Parkinson's Disease Sexual Health Skin Health Sleep Disorders Special Events Stroke Surgeries and Procedures Teen Health Thyroid Health Urologic Health Vascular Disease Women's Health Workplace Health June 2, 2004 Resource Links Physician Search Your Questions, E-mail Doctor ... Hospital Directory Hypotension more about Hypotension Low blood pressure Hypotension is a condition in which the blood pressure (an index of the body's circulatory system) falls below what is considered to be normal. Blood pressure is a relative term that may vary with the patient's age (e.g., lower in infants, 80/40 millimeters of mercury), underlying medical condition, levels of stress, activity, medications and environment. Blood pressure below 90mmHg systolic or 60mmHg diastolic (a drop in blood pressure) that results in symptoms such as dizziness, fainting (especially upon standing), cold extremities and pallor of skin, all point to

15. Orthostatic Hypotension Information:CWRU Autonomic Lab Instructions for patients with orthostatic hypotension. Orthostatic hypotension means that when you are standing ( static ) upright http://mediswww.meds.cwru.edu/dept/neurology/autonomic/orthostatic.html

Instructions for patients with orthostatic hypotension Orthostatic hypotension means that when you are standing ("static") upright ("ortho"), your blood pressure ("tension") falls ("hypo"), and causes you to become dizzy or even pass out. There are several causes for this, including not taking enough fluids and salts, some medications (for example, the tricyclic antidepressants and the anti-hypertensives, of course), and some hormonal problems. However, much of the time, the problem is due to the fact that the nerves are not telling the vessels to close down when you stand up. You may not realize this, but whenever you stand, the blood vessels in the rest of the body must close down, so that blood can continue flowing to the brain. The nerves (specifically, the autonomic nerves) are responsible for this. If they are not working, as sometimes happens in diabetes or in Parkinson's disease, the vessels do not close properly, and result in orthostatic hypotension. First, a diagnosis must be obtained, to understand the origin and severity of the problem. This will usually include autonomic testing, including blood pressure testing, perhaps some bloodwork, and sometimes some imaging of the brain. Second, some basic simple measures will help greatly:

16. Listing Of Directory: /dazzlnstrz/myhomepage/ For teenagers going through chronic illnesses, mainly hypotension and chronic fatigue syndrome. This site helps them to connect and relate to each other. http://hometown.aol.com/dazzlnstrz/myhomepage/

Main htmlAdWH('7002679', '234', '60'); Listing of directory: /dazzlnstrz/myhomepage/ FileName Last Modified Size Parent Directory index.qp 20-Jun-2002 19:34 quotes.html 16-Jan-2004 19:56

17. ClinicalTrials.gov - Information On Clinical Trials And Human Research Studies: Resources Help What's New About. Browse By Condition By Disease Heading Heart and Blood Vessel Diseases hypotension. Include trials that are no longer recruiting patients. 3 studies were found. Droxidopa in Treating Patients With Neurogenic hypotension. Conditions ShyDrager Syndrome; Orthostatic http://clinicaltrials.gov/ct/screen/BrowseAny?path=/browse/by-condition/hier/BC1

18. THE MERCK MANUAL, Sec. 16, Ch. 200, Orthostatic Hypotension And Chapter 200. Orthostatic hypotension And Syncope. Orthostatic hypotension. An excessive fall in BP (typically 20/10 mm Hg) on assuming the upright posture. http://www.merck.com/mrkshared/mmanual/section16/chapter200/200a.jsp

19. MedlinePlus: Low Blood Pressure Multiple System Atrophy with Orthostatic hypotension ( National Institute of Neurological Stroke) Short Summary. Orthostatic hypotension ( National Institute of Neurological http://www.nlm.nih.gov/medlineplus/lowbloodpressure.html

@import url(http://www.nlm.nih.gov/medlineplus/images/advanced.css); Skip navigation Other health topics: A B C D ... List of All Topics Low Blood Pressure Contents of this page: General/Overviews Diagnosis/Symptoms Research Organizations ... Information from the Medical Encyclopedia Search MEDLINE for recent research articles on Low Blood Pressure You may also be interested in these MedlinePlus related pages: High Blood Pressure Heart and Circulation General/Overviews Blood Pressure (American Heart Association) Low Blood Pressure (American Heart Association) Clinical Trials ClinicalTrials.gov: Hypotension (National Institutes of Health) ClinicalTrials.gov: Shy-Drager Syndrome (National Institutes of Health) Diagnosis/Symptoms Blood Pressure Testing and Measurement (American Heart Association) Tilt-Table Test (Mayo Foundation for Medical Education and Research) Research Effects of Blood Pressure Measurements on Mortality (American College of Physicians) Specific Conditions/Aspects Autonomic Nervous System (American Heart Association) Blood Pressure Drops When You Stand Up (Mayo Foundation for Medical Education and Research) Multiple System Atrophy with Orthostatic Hypotension (National Institute of Neurological Disorders and Stroke) - Short Summary Orthostatic Hypotension (National Institute of Neurological Disorders and Stroke) - Short Summary Organizations American Heart Association National Heart, Lung, and Blood Institute

20. The Pediatric Network For Chronic Fatigue Syndrome, Fibromyalgia, And Orthostati Resources for all concerned with pediatric chronic fatigue syndrome, fibromyalgia, neurally mediated hypotension, postural orthostatic tachycardia syndrome, and related conditions. http://www.pediatricnetwork.org

for Chronic Fatigue Syndrome, Fibromyalgia, and Orthostatic Intolerance Home News Forum Contribute ... Forum Hot Topics Stay Connected! Welcome to this network for parents, youth, and professionals concerned with chronic fatigue syndrome, fibromyalgia, and orthostatic intolerance. See our live chat announcements and website updates below. Share our brochur es to help others become a part of this network. Receive our newsletter by registering and posting in the forum . We will e-mail the newsletter to the address you provide during forum registration. Participate in forum discussions to hear about others' medical and school experiences, and to learn of opportunities to volunteer, participate in studies, or meet other families. Today's Tip: Please Support Our Work: Donate : Learn how you can contribute through direct gifts, shopping at Amazon.com, or applying for a VISA card Shop Amazon.com through our store . Explore products like these: Search Now: Welcome to the Pediatric Network! June Highlights: Taking a summer vacation when your child has CFS Our Disney World Vacation and CFS What is the relationship between POTS and CFS? How to join our forum community Explore Our Site: Medical Articles Diagnosis and treatment of CFS, FM, OI, NMH, POTS, syncope, and related conditions

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