Orthostatic hypotension in school children and youth

Introduction. Haemodynamic disturbances occurring solely in a standing position, consisting of a simultaneous drop in systolic and diastolic blood pressure and an increased pulse rate are defined as orthostatic hypotension (OH). Aim. To determine the incidence of OH in school population and to provide its clinical characteristics. To determine the influence of the applied treatment on the arterial blood pressure, well-being, learning results and sickness absence. Materials and methods. The study involved 1208 students, aged 7–18, and 400 students referred by the Psycho-Educational Counselling Centre who reported a variety of health and school problems. Medical histories guided to detect faintness and syncope were collected from all the studied patients. Crampton test (a screening test) was performed, and when the results were incorrect – Schellong’s orthostatic test (a diagnostic test). Results and discussion. A significant decrease in the arterial pressure amplitude with a simultaneously increased pulse rate revealed in Schellong’s test were assumed to be diagnostic and differential criteria with common hypotension. Based on these criteria, medical histories and examinations, OH was diagnosed: in 71 cases (5.8%) in the randomly chosen group and in 39 (9.8%) students referred by the PsychoEducational Counselling Centre. Girls aged 13–15 (8.7%), of an asthenic body structure type, formed the most numerous group. Long-term treatment was devised for the students diagnosed with OH, mainly focusing on changing their lifestyles and intensifying their physical activities. The observation period lasted 3–4 years, the longest – 10 years. Among the adults, 9 people manifested OH, which may testify to constitutional aetiology (family) of the disease. Conclusions. OH is a significant problem, especially in the case of girls at puberty. The obtained results point to a need for co-operation between a physician, teacher and parents.