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Initial orthostatic complaints originate from a transient rapid fall in arterial pressure occurring upon active standing. This fall in blood pressure is a physiological response (Sprangers et al., 1991). However, normally blood pressure does not drop for more than 40 mm Hg systolic and 20 mm Hg diastolic (See chapter Wieling & Karemaker). The onset of symptoms between 5-10 s and disappearance within 20 seconds after the onset of standing up is typical for this condition. The diagnosis can only be confirmed by a stand test with continuous beat-to-beat blood pressure monitoring (figs. 5 and 6)(Wieling et al., 2007). Because initial orthostatic hypotension is associated with ‘active’ arising (fig. 5), tilt testing (i.e. head up tilting) wil not reveal a diagnosis. | Initial orthostatic complaints originate from a transient rapid fall in arterial pressure occurring upon active standing. This fall in blood pressure is a physiological response (Sprangers et al., 1991). However, normally blood pressure does not drop for more than 40 mm Hg systolic and 20 mm Hg diastolic (See chapter Wieling & Karemaker). The onset of symptoms between 5-10 s and disappearance within 20 seconds after the onset of standing up is typical for this condition. The diagnosis can only be confirmed by a stand test with continuous beat-to-beat blood pressure monitoring (figs. 5 and 6)(Wieling et al., 2007). Because initial orthostatic hypotension is associated with ‘active’ arising (fig. 5), tilt testing (i.e. head up tilting) wil not reveal a diagnosis. | ||