WHEN STANDING UP RAISES BP

Is there any health significance to the phenomenon of “reverse orthostasis,” i.e., BP that rises on standing?
—John S. Carr, MD, Loganville, Ga.

The finding of postural hypertension (“reverse orthostasis”) is not well evaluated but is likely of limited clinical significance. I came across only one study designed to evaluate this question, using subjects from the Honolulu Heart Program longitudinal cohort (3,741 Japanese-American men aged 71-93). Prevalence of postural hypertension in this cohort was approximately 39%, but the study failed to find any significant correlation with morbidity or mortality (Hawaii Med J. 2000;59:48-50). Whether this finding can be extrapolated to other groups is not clear from the available data.
—Daniel G. Tobin, MD (115-16)

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