Supine Hypertension and Orthostatic Hypotension

 

 

 

supine_hypertension70

 

 

Supine Hypotension (仰卧位高血压)
It happens when a pregnant woman is lying on her back, a fall in blood pressure occurs. It is caused by impaired venous return that results from pressure of the gravid uterus on the vena cava. It is also called vena caval syndrome.

Vena Caval Syndrome
Partial occlusion of the vena cava and the descending aorta by uterine contents, resulting in hypotension when in a supine position; it is corrected by assuming a side-lying position. Called also supine hypotension.

Supine Hypertension and Orthostatic Hypotension
This is a difficult situation because treatment of one aspect complicates the other. One option is treating supine hypertension during the night with a nitroglycerin patch and removing it in the morning before ambulation, though care must be taken in a patient who frequently needs to get up in the night going to bathroom.

 

 

US National Library of Medicine
National Institutes of Health
Journal ListPostgrad Med Jv.82(966); 2006 AprPMC2579630
Coexistent supine hypertension 体位性高血压/體位性高血壓 and orthostatic hypotension (SH‐OH) 姿位性低血壓 pose a particular therapeutic dilemma, as treatment of one aspect of the condition may worsen the other. Studies of SH‐OH are to be found by and large on patients with autonomic nervous disorders as well as patients with chronic arterial hypertension. In medical practice, however, the aetiologies and clinical presentation of the syndrome seem to be more varied. In the most typical cases the diagnosis is straightforward and the responsible mechanism evident. In those patients with mild or non‐specific symptoms, the diagnosis is more demanding and the investigation may benefit from results of the tilt test, bedside autonomic tests as well as haemodynamic assessment. Discrete patterns of SH‐OH may be recognisable. This review focuses on the management of the patient with coexistent SH‐OH…..
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體位性高血壓
所謂體位性高血壓是指患者在站立或坐位時血壓增高,而在平卧位時血壓正常。這種高血壓在國內高血壓患者中占4.2%,國外報道占10%。 此病的特點是它一般沒有高血壓的特徵,多數在體檢或偶然的情況發現,其血壓多以舒張壓升高為主,且波動幅度較大。個別嚴重者可伴有心悸、易疲倦、入睡快等。血液檢查血漿腎素活性較正常人高,甚至超過一般高血壓病患者。…….
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Orthostatic hypotension, also known as postural hypotension or shortened to orthostasis and colloquially called head rush, occurs when a person’s blood pressure falls when suddenly standing up from a lying or sitting position. It is defined as a fall in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg when a person assumes a standing position….
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姿位性低血壓
姿位性低血壓 (orthostatic hypotension、postural hypotension、orthostasis),或稱「直立性低血壓」。主要指患者在站姿時血壓變低,臥姿時血壓恢復正常的症狀。但也有平臥時血壓反而降低的姿位性低血壓。多出現在中老年患者身上,男性發病率高於女性……
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Dr Mandell