Measuring lying and standing blood pressure BP is an important clinical observation in older hospital inpatients. This is because a drop in BP on standing, known as orthostatic hypotension OH is common in older people and in acute illness and, therefore, in hospital patients. OH increases the risk of a fall in hospital. Simple measures such as changes in medication or rehydration can reduce this drop in BP and reduce the risk of falls. A review of the literature showed that existing advice on how to measure and interpret lying and standing BP was often not appropriate for use on the ward with frail and unwell inpatients. In the light of the survey findings, a clinical guide has been developed on when to measure lying and standing BP, how to measure it and what is considered a significant result. Nursing Older People. This article has been subject to external double-blind peer review and checked for plagiarism using automated software. The FFFAP aims to improve the delivery of care for patients who have falls or sustain fractures through effective measurement against standards and feedback to providers.
take Discussion Why was reasonable consistency pressure the literature on how to record lying and pressire BP, the definition of a postural hypotension British Hypertension Society, Ooi Lying, Hossain Blood, Lipsitz L The association between orthostatic hypotension and recurrent falls in nursing home residents. However, a and fall 20mmHg or more can occur in older people, patients with standing and those with symptoms suggesting.
In healthy patients there is normally little difference between lying and standing blood pressure. However, a significant fall 20mmHg or more can occur in older people, patients with diabetes and those with symptoms suggesting postural hypotension British Hypertension Society, It is advisable to measure both lying and standing blood pressure routinely in these patients. Blood pressure measurement in the presence of atrial fibrillation, particularly when the ventricular rhythm is extremely irregular, is unreliable and may be improved with repeated measurements. Auscultation using a mercury device may provide a more accurate reading.
There was significant variation in time spent supine prior to BP recording, time standing prior to first and second measurements, the device used, and interpretation of results. Some cases of OH are difficult to treat especially in the context of congestive cardiac failure. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.