orthostatic hypotension is not a special disease, but a manifestation of abnormal regulation of blood pressure for many reasons. It refers to the decrease of systolic blood pressure by more than 20 mmHg within 3 minutes after standing on the lying position, or the decrease of systolic blood pressure by more than 90 mmHg, or the decrease of diastolic blood pressure by more than 10 mmHg. When a normal person stands in a lying position, due to gravity, blood is prone to accumulate in the venous volume of the lower body. Then, transient return of the heart blood volume and cardiac discharge decrease, and blood pressure decreases. However, the body can use a series of compensatory mechanisms such as reflex arterioles and arteries contraction, aortic arch and carotid sinus reflex responsiveness to accelerate the heart rate, muscle activity and small venous reflex constriction to increase venous return , plasma adrenaline and norepinephrine content increases, etc., which can also keep blood pressure at a certain level, and cerebral blood flow also has a certain perfusion pressure.
01 Diagnosis of orthostatic hypotension
1. Most patients with orthostatic hypotension often experience symptoms such as fainting, dizziness, dizziness, disordered consciousness, blurred vision when they stand suddenly or after sitting for a long time. Fatigue, exercise, drinking or a full meal can aggravate the symptoms. Severe reduction in blood supply to the brain can lead to fainting or even coma.
2. Doctors can make a diagnosis based on the symptoms. If the patient's blood pressure drops significantly when standing and his blood pressure returns to normal after lying down, the diagnosis of orthostatic hypotension can be determined. Of course, further finding the causes of orthostatic hypotension.
3. If the elderly complain of stance dizziness and mild confusion, the clinician cannot think that he is suffering from orthostatic hypotension. The patient should first lie flat for at least 5 minutes and then measure the blood pressure and pulse rate , then stand quietly for 1 minute and then measure the blood pressure and pulse rate. After continuing to stand for 3 minutes, the blood pressure and pulse rate may be measured immediately or delayed after standing. In order to find that the hypotensive reaction in the performance may be prolonged standing time or a tilt test is performed. Blood pressure should be measured multiple times before starting treatment to confirm the persistence of stance hypotension.
02 The cause of orthostatic hypotension
1. Heart disease: The most common heart disease is orthostatic hypotension caused by heart failure . Due to heart failure , the heart's blood pumping function is weakened, resulting in reduced cardiac bleeding, which leads to hypotension .
2. Drug Effect: Many drugs can dilate blood vessels, lower blood pressure, and lead to orthostatic hypotension such as nitroglycerin , etc.
3. Long-term bed rest causes malnutrition: Many patients who need to rest in bed are under a long-term lack of exercise and nutritional disorders, resulting in hypoglycemia, which leads to orthostatic hypotension.
4. Secondary to certain diseases: it can be secondary to spinal cord disease, endocrine disorders, acute infectious diseases or severe infections (such as lobular pneumonia).
03 Preventive measures
1. Eat a reasonable diet and ensure comprehensive and sufficient nutrients.
2. Avoid eating too much or being too hungry. Do not move immediately after meals. You can rest for a few minutes before standing up or doing other things, and do not drink alcohol.
3. Adhere to appropriate physical exercise and strengthen physical fitness.
4. Ensure full sleep time. When sleeping, raise your head about 15-30cm, which helps maintain cerebral blood flow .
5. Avoid overwork and long standing time.
6. When you sweat a lot after activity, drink more water to increase your blood volume and increase your blood pressure.
7. Regularly measure blood pressure and pay attention to the changes in the blood pressure in the lying and vertical positions.
8. Do not stand up suddenly after taking antihypertensive drugs, sedatives, and vasodilators. It is best to lie quietly for 1-2 hours. If you feel dizzy after standing, you should continue to rest in bed.
9. Elderly people with lower limb varicose veins should wear elastic socks or tights to increase venous return.
10. When getting up or standing, you should move slowly, and do not be too fast and too fast to prevent your blood pressure from dropping suddenly. When changing posture, you should do a good job of transition, that is, lying to the seated position and sitting to the standing position to avoid the occurrence of orthostatic hypotension.
The above content is excerpted from the Internet. I would like to express my gratitude to the original author!
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-