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Suggest Treatment For Orthostatic Hypertension
my mother in law is 89 and has this problem, orthostatic hypertension. she has been basically in bed with a few hours a day in a chair. they are doing pt daily, her condition does not seem to be improving. we are trying to get her into an alternative facility as she must leave this rehab facility Thursday. we are (politically correctly) trying to ascertain longevity to decide between assisted living, 24/7 home health care, nursing home, etc. they have resources but not unlimited. if we are looking at months then home health care is an option, years not so much. thanks for anything you can advise.
Wed, 21 Nov 2018
Hi,
Because whenever one stands normally there is decreased intravascular volume, which is compensated by simultaneous vasoconstriction, which is impaired in autonomic failure.
Due to this blood accumulates in the legs and there is decreased blood to heart and then to brain. This sometimes leads to further activation of vagal nerve from the heart which sometimes may lead to a further decrease in pulse rate as well as leading syncope or fainting which probably happened during the testing.
So in treatment, I agree with increased fluid intake, exercise and Florinef. Because increasing intravascular volume will be helpful.
The drug-induced cause is less likely as she is not on any such drugs. It's important that you see neurologist or movement disorders specialist as from symptoms like handwriting changes and slowness of movement, there is a possibility of underlying neurological disease which is causing all these symptoms.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Ivan R. Rommstein,
General Surgeon
Because whenever one stands normally there is decreased intravascular volume, which is compensated by simultaneous vasoconstriction, which is impaired in autonomic failure.
Due to this blood accumulates in the legs and there is decreased blood to heart and then to brain. This sometimes leads to further activation of vagal nerve from the heart which sometimes may lead to a further decrease in pulse rate as well as leading syncope or fainting which probably happened during the testing.
So in treatment, I agree with increased fluid intake, exercise and Florinef. Because increasing intravascular volume will be helpful.
The drug-induced cause is less likely as she is not on any such drugs. It's important that you see neurologist or movement disorders specialist as from symptoms like handwriting changes and slowness of movement, there is a possibility of underlying neurological disease which is causing all these symptoms.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Ivan R. Rommstein,
General Surgeon
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