Defined when one of the following is present

  1. A drop in systolic BP of 20mmHg or more (with or without symptoms)
  2. A drop to below 90mmHg on standing even if the drop is less than 20mmHg (with or without symptoms)
  3. A drop in diastolic BP of 10mmHg with symptoms (although clinically much less significant than a drop in systolic BP).