The older heart is simply unable to compensate for preload reduction and other stresses by increasing heart rate and cardiac output. The prevalence of orthostatic hypotension increases with age. However, data from the National Health and Nutrition Survey indicate that orthostatic hypotension is related to systolic hypertension. Indeed, among individuals with systolic blood pressure above 160, prevalence of orthostatic hypotension remains uniformly high regardless of age. This suggests that hypertension, rather than age, may be the principal factor underlying orthostatic hypotension.
Orthostatic hypotension is widespread and can be dangerous to the elderly patient.
It appears to be an independent predictor of all-cause and cardiovascular mortality, as well as an indicator of physical frailty. Finally, orthostatic hypotension is associated with a twofold increase in subsequent falls among nursing home residents with previous falls. These risks are greatest for patients with multiple episodes, highlighting the need for periodic measurement of blood pressure to determine the possible presence of persistent orthostatic hypotension. Postprandial Hypotension Postprandial hypotension is defined as a 20 mm Hg or greater decline in systolic blood pressure occurring within an hour of eating a meal. It is an often overlooked cause of syncope-related falls.