This resource was developed by bpac
nz
for the Health Quality & Safety Commission based on the STEADI falls campaign by the US Centres for Diseases Control and Prevention (CDC).
Patient name: Date: Time: AM/PM
NHI: Test carried out by:
Measuring Blood Pressure:
Detecting Postural Hypotension
Patients who experience hypotension when rising to a standing position are at increased risk of falling. Use the
assessment below to check if your patient may have postural hypotension, as they may benet from a review of
medicines to reduce their risk of falling.
1. Ask the patient to lie down and rest for ve minutes.
2. Measure their blood pressure and pulse rate.
3. Ask the patient to stand.
4. Repeat blood pressure and pulse rate measurements when patient has been standing for one minute, and again at
three minutes.
Postural (or orthostatic) hypotension is dened as a reduction in systolic blood pressure of ≥ 20 mmHg or in diastolic
blood pressure of ≥ 10 mmHg within three minutes of standing.
1
If the patient experiences light-headedness or
dizziness on standing, this is also considered a symptom of postural hypotension and therefore means there is a higher
risk of them falling.
Position Time BP Associated symptoms
Lying Down 5 Minutes
HR
BP
Standing 1 Minute
HR
BP
Standing 3 Minutes
HR
BP
Postural hypotension is more common in older people,
2
however, the prevalence of hypertension also increases with
age. Blood pressure treatment targets for older patients with hypertension should be adjusted to reduce the risk of low
blood pressure-related falls.
References:
1. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens. 2013;(7):1281–357.
2. Chaudhry KN, Chavez P, Gasowski J, et al. Hypertension in the elderly: some practical considerations. Cleve Clin J Med. 2012;79(10):694–704.
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