In this Section:
The Blood Pressure Clinic of the Austin Hospital is happy to receive referrals from anywhere in Australia if they are referred by a medical practitioner. Our particular area of expertise is postural hypotension or autonomic nervous system dysfunction.
Referrals can be made by contacting Specialist Clinics on 03 9496 2444 or Fax: 03 9496 2097 and information can be obtained from Dr Chris O'Callaghan (firstname.lastname@example.org)
Postural hypotension or Autonomic Nervous System dysfunction is often difficult to diagnose. It classically manifests as fainting, but can also present as drop attacks, dyspnoea, fatigue or nocturia. More rarely it presents with symptoms that suggest a hyper-adrenergic state.
Our approach to postural hypotension combines frequent 24 hour ambulatory blood pressure monitoring with judicious manipulation of antihypertensive therapy and occasional use of pressor treatments.
It is important to note that:
-20 mm Hg systolic (at least) after 3 minutes standing from the supine position.
Patients, especially elderly, with significant postural hypotension may not complain of classic postural al symptoms. Also, falls in postural BP may be episodic and it is difficult to accurately measure postural BP changes over 3 minutes using manual measurements. Suspect autonomic failure in any patient with reversed diurnal variation of blood pressure.
Autonomic failure is frequently associated with day hypotension but night hypertension. The physiological renal response to hypotension is decreased urine production. Thus, patients with postural hypotension have day anuria, night polyuria and morning dehydration.