A comprehensive review of orthostatic hypotension highlights considerable discrepancies in diagnostic methodology and proposes a standardized protocol for bedside evaluation.
This review proposes a standardized algorithm and bedside protocol for the evaluation and diagnosis of orthostatic hypotension to address current methodological discrepancies.
PURPOSE: Orthostatic hypotension (OH) is a common and clinically important disorder. Published papers vary regarding the definitions of OH and methodologies of evaluation. Moreover, substantial gaps in the skills and knowledge required for assessment of OH have been reported by clinicians. We aimed to provide current information regarding the definition, classification and evaluation of OH. METHODS: We performed a comprehensive search of medical databases, using the following keywords: "postural hypotension" or "orthostatic hypotension", combined with: "definition", "classification", "diagnosis", "evaluation" or "meaning". We selected for this review the most relevant recent publications and key papers in the field, published in the English language. RESULTS: Current data regarding definitions, classification and the evaluation of OH are reviewed. The various aspects of OH assessment are extensively discussed. Considerable discrepancies exist between the published guidelines regarding the methodology of OH diagnosing. We propose an algorithm for OH evaluation and a standardized protocol for bedside determination of OH by healthcare providers. CONCLUSIONS: Correct assessment of OH is essential for its accurate diagnosis. The methodology of OH evaluation has not been sufficiently standardized. We emphasize the clinical importance of the uniform investigation of OH, according to the current guidelines for OH definition and meaning.
Tzur et al. (Mon,) conducted a review in Orthostatic hypotension. Orthostatic hypotension evaluation and classification was evaluated. A comprehensive review of orthostatic hypotension highlights considerable discrepancies in diagnostic methodology and proposes a standardized protocol for bedside evaluation.