Orthostatic Hypotension

What is orthostatic hypotension?

Orthostatic hypotension is a drop in blood pressure that can happen when you stand up after sitting or lying down.

How does it occur?

Whenever you stand up, the force of gravity pulls your blood downward. The blood tends to settle in your legs. Blood pressure starts to fall, reducing the blood supply to your brain. Normally, reflexes within the body compensate for this change. The heart beats faster, and the veins and arteries in the legs constrict, or squeeze. The squeezing prevents the pooling of blood in the legs and keeps blood pressure in the normal range.

In some people these normal reflexes diminish or fail, usually just from getting older. That's why orthostatic hypotension is most common in older people. In some people, the reflexes may stop working for no apparent reason.

Drugs are another possible cause. Many drugs affect these reflexes and may cause orthostatic hypotension, particularly in older adults. Diuretics, nitrates, blood pressure medicines, and antidepressants are all drugs that may cause the problem.

Some diseases that damage nerves may also cause orthostatic hypotension. Diabetes is the most common disease of this sort.

What are the symptoms?

The most common symptoms are:

• feeling lightheaded, dizzy, or faint soon after arising
• sweating
• blurred vision
• passing out.

These symptoms can happen when there is not enough blood flow to the brain.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Your provider may check your blood pressure when you are lying down, sitting, and standing up.

How is it treated?

If the cause is a medicine, the prescription can be adjusted or changed. If the cause cannot be treated, there are things you can do to help prevent the symptoms.

First, when you stand up, do it slowly. If you have been lying down, sit for awhile before standing. This allows sluggish reflexes to adjust. Support hose, which squeeze the legs and help prevent pooling of blood, help many people with this condition. Drinking more fluid or slightly increasing the amount of salt you eat may also help. In more severe cases, medicine may help.

How long will the effects last?

Depending on the cause of the orthostatic hypotension, the effects may or may not be long lasting. For example if the hypotension is caused by a medicine you are taking, stopping that medicine may make the hypotension go away.

How can I take care of myself?

• Check with your healthcare provider if you think that a medicine you are taking may be making your orthostatic hypotension worse.
• Ask your provider about lifestyle factors, such as exercising after meals.
• Avoid large meals and alcohol use.
• Ask your provider about nonprescription medicines and supplements before you take them.
• Standing up slowly and tensing your leg muscles if you have been standing for long periods of time may help.
• Wear elastic stockings.
• Make sure that you drink enough liquids. Avoid getting dehydrated.