Orthostatic Hypotension

Mrs. Miller complains of feeling lightheaded when being stood up by the attendants. It is interfering with her transfers and limits her standing tolerance. The nurse questions whether the patient is suffering from orthostatic hypotension (OH).
Q1. How common is orthostatic hypotension following SCI?
1. The prevalence of OH is greater in patients with higher spinal cord lesions, and thus it is more common in tetraplegia.
2. Individuals with cervical SCI also experience greater posture-related decreases in blood pressure than those with paraplegia. (See figure 5)
Q2. What factors lead to orthostatic hypotension in individuals with SCI?
The factors that lead to orthostatic hypotension are multifactorial                           
1. Loss of tonic sympathetic control           
2. Altered baroreceptor sensitivity              
3. Lack of skeletal muscle pumps              
4. Cardiovascular deconditioning               
5. Altered salt and water balance                

Figure 5.
Factors which lead to orthostatic hypotension post SCI.