Which combination defines orthostatic hypotension changes after standing?

• A. 20 mmHg drop in systolic, 10 mmHg drop diastolic, 15 bpm increase
• B. 10 mmHg drop systolic, 5 mmHg drop diastolic, 5 bpm increase
• C. 30 mmHg drop systolic, 20 mmHg drop diastolic, 0 bpm
• D. 25 mmHg drop systolic, 15 mmHg drop diastolic, 20 bpm increase

Answer: (A)

Orthostatic hypotension is diagnosed when standing causes a meaningful drop in blood pressure within about 3 minutes. The key threshold is a decrease of at least 20 mm Hg in systolic pressure or at least 10 mm Hg in diastolic pressure, often accompanied by a compensatory rise in heart rate as the body tries to maintain cerebral perfusion. The pattern shown with a 20 mm Hg drop in systolic, a 10 mm Hg drop in diastolic, and a 15 bpm increase in heart rate fits these criteria: the blood pressure thresholds are met and the heart rate increases as expected to compensate. The other patterns either don’t reach the necessary BP drop, or lack the heart rate response (which could suggest autonomic dysfunction rather than a typical orthostatic response).