Orthostatic hypotension, also called postural hypotension, is a sudden fall in blood
pressure that occurs when you stand up quickly. Hypotension is the term for low blood pressure. Blood pressure is the force of
your blood against the walls of your arteries.
When you stand up, gravity pulls blood into
your legs, and your blood pressure begins to fall. Certain reflexes in your
body compensate for this change. Your heart beats faster to pump more blood.
And your blood vessels constrict to prevent blood from pooling in your legs.
Many drugs can affect these normal reflexes
and lead to orthostatic hypotension. These reflexes may also begin to weaken as
you age. For this reason, orthostatic hypotension is more common in older
20 percent of people older than 65 years of age experience orthostatic
hypotension, according to research published in American Family Physician.
People with orthostatic hypotension may feel
dizzy when they stand up. The condition is often mild and lasts for just a few
minutes after standing. Some people may faint, or lose consciousness.
What causes orthostatic hypotension?
There are many causes for orthostatic
hypotension. These include:
- anemia, or low red blood cell count
- a drop in blood volume, called hypovolemia, caused by certain
drugs such as thiazide diuretics and loop diuretics
- heart conditions, such as a heart attack or valve disease
- diabetes, thyroid conditions, and other diseases of the endocrine
- Parkinson’s disease
- long-term bed rest or immobility
- hot weather
- blood pressure medications and antidepressants
- alcohol or drug use while taking blood pressure medications
What are the symptoms of orthostatic
The most common symptoms of orthostatic
hypotension are dizziness and lightheadedness upon standing up. The symptoms
will usually go away upon sitting or lying down.
Other common symptoms include:
- blurred vision
Less common symptoms, according to American Family
Physician, can include:
- chest pain
- neck and shoulder pain
How is orthostatic hypotension diagnosed?
If your doctor suspects that you have
orthostatic hypotension, they will check your blood pressure while you are
sitting, lying down, and standing. Your doctor can diagnose orthostatic
hypotension if your systolic blood pressure drops by 20 millimeters of mercury
(mm Hg), or your diastolic blood pressure drops by 10 mm Hg within three
minutes of standing up, according to the Mayo Clinic.
To find the underlying cause, your doctor may
- conduct a physical examination
- check your heart rate
- order certain tests
The tests your doctor may order include:
How is orthostatic hypotension treated?
Treatment for orthostatic hypotension depends
on the cause. Doctor-recommended treatment may include the following lifestyle
- Increase your fluid and water intake and limit your alcohol intake
if you’re dehydrated.
- Stand up slowly when getting out of a chair or bed.
- Perform isometric exercises before getting up to help raise your
blood pressure. For example, squeeze a rubber ball or a towel with your hand.
- Adjust the dose or switch to another medication if medication is
- Wear compression stockings to help with circulation in your legs.
- Avoid crossing your legs or standing for long periods of time.
- Avoid walking in hot weather.
- Sleep with the head of your bead slightly elevated.
- Avoid eating large carbohydrate-rich meals.
- Add additional salt to your daily meals to retain fluid.
For severe cases, your doctor may prescribe
drugs that work to increase blood volume or constrict blood vessels. According
to the Cleveland Clinic, these drugs
What can be expected long term?
In most cases, treating the underlying
condition will cure orthostatic hypotension. With treatment, people who
experience orthostatic hypotension can reduce or eliminate symptoms.