{"id":31263,"date":"2020-04-17T16:39:58","date_gmt":"2020-04-17T11:09:58","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=31263"},"modified":"2020-04-17T16:39:58","modified_gmt":"2020-04-17T11:09:58","slug":"orthostatic-hypotension-classical-delayed-and-initial","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/orthostatic-hypotension-classical-delayed-and-initial\/","title":{"rendered":"Orthostatic hypotension &#8211; classical, delayed and initial"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/9_hxKImpTJE\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Orthostatic hypotension &#8211; classical, delayed and initial<\/span><\/h2>\n<p>Orthostatic hypotension (OH) has been divided into classical, delayed and initial.<\/p>\n<p><em>Classical OH<\/em> is sustained fall in systolic blood pressure of&nbsp; at least 20 mm Hg or diastolic blood pressure of&nbsp; 10 mm Hg within three minutes of standing or head up tilt test. Compensatory tachycardia may be seen, but can be absent in case of autonomic failure [1].<\/p>\n<p><em>Delayed OH&nbsp;<\/em> sustained fall in blood pressure after 3 minutes of standing or head up tilt test. Half of them can progress to classical OH in the long run in a 10 year follow up study [2].<\/p>\n<p><em>Initial OH <\/em>is defined as a fall in systolic blood pressure of at least 40 mm Hg and\/or fall in diastolic blood pressure of at least 20 mm Hg within 15 seconds of standing with symptoms of cerebral hypoperfusion [3]. It is more common in younger patients, but may also occur in the elderly [1]. It occurs mostly on active standing than passive tilt table testing and is thought to be due to marked fall in peripheral vascular resistance leading to a mismatch between cardiac output and peripheral resistance. As it is transient, only beat to beat blood pressure monitoring during active standing can document this condition.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Freeman R, Abuzinadah AR, Gibbons C, Jones P, Miglis MG, Sinn DI. <a href=\"http:\/\/www.onlinejacc.org\/content\/72\/11\/1294\">Orthostatic Hypotension: JACC State-of-the-Art Review<\/a>. J Am Coll Cardiol. 2018 Sep 11;72(11):1294-1309.<\/li>\n<li>Gibbons CH, Freeman R. Clinical implications of delayed orthostatic hypotension: A 10-year follow-up study. Neurology. 2015 Oct 20;85(16):1362-7.<\/li>\n<li>Wieling W, Krediet CT, van Dijk N, Linzer M, Tschakovsky ME. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17199559\">Initial orthostatic hypotension: review of a forgotten condition<\/a>. Clin Sci (Lond). 2007 Feb;112(3):157-65.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Orthostatic hypotension &#8211; classical, delayed and initial Orthostatic hypotension (OH) has been divided into classical, delayed and initial. Classical OH is sustained fall in systolic blood pressure of&nbsp; at least 20 mm Hg or diastolic blood pressure of&nbsp; 10 mm Hg within three minutes of standing or head up tilt test. Compensatory tachycardia may be [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":31271,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-31263","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Orthostatic hypotension - classical, delayed and initial - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"description\" content=\"Orthostatic hypotension - classical, delayed &amp; initial are 3 different types. 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Classical within 3 minutes, delayed after 3 minutes, initial in 15 seconds.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/orthostatic-hypotension-classical-delayed-and-initial\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2020-04-17T11:09:58+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Orthostatic hypotension &#8211; classical, delayed and initial\",\"datePublished\":\"2020-04-17T11:09:58+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/\"},\"wordCount\":275,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/\",\"name\":\"Orthostatic hypotension - classical, delayed and initial - All About Cardiovascular System and Disorders\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/orthostatic-hypotension-classical-delayed-and-initial\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2020-04-17T11:09:58+00:00\",\"description\":\"Orthostatic hypotension - classical, delayed & initial are 3 different types. 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