Abstract
I read with interest the nonpharmacologic manipulations for management of orthostatic hypotension (OH) detailed by Drs. Newton and Frith.1 Regardless of guidelines,2 OH is clinically meaningless in the absence of regular or inevitable syncope, as systolic blood pressure (SBP), syncope, and cerebral arteriosclerosis do not necessarily run pari passu. While fall in SBP is a part of the guidelines, it is the diastolic blood pressure (DBP) that determines steady cerebral blood flow. A total of 480 mL tap water consumed within 5 minutes will neither be fully absorbed by the gastrointestinal system nor will be retained fully by the renal tubular system. No wonder only 56% of participants of a tiny cohort responded with a modest rise in SBP while DBP remained unaffected.1 While standing cross-legged is truly enigmatic, will abdominal compression and elastic stockings improve or worsen venous return in uncomplicated hypotensive nonobese elderly?
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