Orthostatic blood pressure changes and silent cerebrovascular disease

We examined the relationship between orthostatic hypertension or hypotension and risk for cerebrovascular disease in 241 elderly hypertensive patients. Patients were grouped by orthostatic systolic blood pressure changes in response to a head-up tilt test: orthostatic hypertension (increase ≥ 20 mm Hg), orthostatic hypotension (decrease > 20 mm Hg), or orthostatic normotension (increase or decrease < 20 mm Hg). Silent cerebral infarcts were more prevalent in the groups with abnormal orthostatic changes, which appear to be risk factors for hypertensive cerebrovascular disease in the elderly.