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Supine hypertension with transient papilledema
Author(s) -
Igase Michiya,
Kohara Katsuhiko,
Nomura Takuo,
Yamamoto Yoshikuni,
Miki Tetsurou
Publication year - 2002
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1046/j.1444-1586.2002.00032.x
Subject(s) - medicine , papilledema , orthostatic vital signs , supine position , blood pressure , sitting , cardiology , pediatrics , anesthesia , surgery , pathology
A 68‐year‐old male, married, retired public official was admitted to hospital for thorough examination and appropriate treatment of gait disturbance and dizziness. He had been diagnosed with diabetes mellitus and hypertension for at least 28 years, and had been treated with insulin and antihypertensive medications intermittently at another hospital. We identified the major cause of his complaints as orthostatic hypotension, and controlled his casual systolic blood pressure (BP) to within the range of 140–160 mmHg in a sitting position. After a few weeks, on ophthalmic study, right papilledema was diagnosed. There was no progression of visual disturbance nor circulatory impairment in the optic fundi. Based on the results of 24‐h ambulatory BP monitoring, we assumed that his supine systolic hypertension triggered the papilledema, so we controlled his supine systolic BP to within the range of approximately 140–160 mmHg. After 2 weeks of controlled BP the papilledema improved. Visual disturbance was not reported during 1 year of follow up. In case of severe autonomic disorder such as orthostatic hypotension, attention should be paid to changes in the optic fundi, and ophthalmoscopic examination should be performed regularly.