Interventions for Treatment of Orthostatic Hypotension
OH can be managed through both non-pharmacological and pharmacological methods, although initial therapy emphasizes non-pharmacological treatment. Adequate fluid and salt intake is advised to maintain plasma volume while consumption of diuretics such as alcohol and caffeine is discouraged. SCI patients need also be aware of symptoms associated with OH and assume a recumbent position once symptomatic (Claydon et al. 2006; Popa et al. 2010). Non-pharmacological management may also include electrical stimulation of limbs, as well as compression/pressure devices (Gillis et al. 2008). Pharmacological management of OH includes using fludrocortisone, a cortiscosteroid, to expand plasma volume. Alternatively, midodrine hydrochloride, a sympathomimetic alpha1-agonist, improves OH by increasing BP through peripheral vasoconstriction, thus increasing total peripheral vascular resistance (Claydon et al. 2006; Phillips et al. 2014).
