If you stand up from sitting or lying down suddenly, you may experience orthostatic hypotension, which causes a sudden drop in your blood pressure. It can result in dizziness, lightheadedness, or fainting. A variety of factors can cause orthostatic hypotension, including dehydration, medications, or nervous system disorders. It is possible to diagnose orthostatic hypotension by measuring your blood pressure in different positions or using a tilt table. According to the cause and severity of orthostatic hypotension, lifestyle changes, medications, or compression stockings may be used to treat it. Staying hydrated, rising slowly, and avoiding triggers, such as alcohol or heat, can help prevent orthostatic hypotension.
Normally, when you stand up, gravity causes blood to pool in your legs and lower body. Orthostatic hypotension occurs when your body does not adjust your blood pressure as you change your posture. By doing so, your heart beats faster and harder, and your blood vessels constrict and maintain your blood pressure as a result. Your nervous system compensates by sending signals to your heart to beat faster and harder. Orthostatic hypotension, however, occurs when these mechanisms are impaired or overwhelmed, resulting in insufficient blood flow to the brain.
Orthostatic hypotension can be caused or contributed to by the following factors:
Your blood volume can be reduced and your blood pressure can drop due to dehydration
These medications can lower your blood pressure or interfere with your nervous system, such as diuretics, blood pressure medications, antidepressants, or erectile dysfunction drugs
You are more likely to develop orthostatic hypotension with aging, which weakens your nervous system and blood vessel elasticity
Disorders of the nervous system, such as Parkinson's disease, multiple system atrophy, or diabetic neuropathy, that can damage your nerves and affect your ability to regulate blood pressure
The ability of your heart to pump blood is reduced by conditions such as heart failure, heart attack, or arrhythmia
You can suffer from anemia, which reduces your red blood cell count and oxygen delivery to your tissues
Blood pressure and fluid balance can be affected by hormonal disorders such as adrenal insufficiency, hypothyroidism, or diabetes
A prolonged period of bed rest can reduce your blood volume and muscle tone, and make you more susceptible to changes in posture
As a result of orthostatic hypotension, you may feel dizzy, lightheaded, or faint when standing up from a seated or lying position. The symptoms usually last for a few seconds or minutes and go away when you sit or lie down again. Some, however, may experience severe or prolonged symptoms, such as:
Seeing spots or blurred vision
Vomiting or nausea
Pain in the neck or head
Fatigue or weakness
Disorientation or confusion
Palpitations or chest pain
Falling or losing consciousness
Orthostatic hypotension is diagnosed through a combination of symptoms, medical history, and physical examination. Your doctor will ask you about your symptoms, when they occur, how long they last, and what triggers them. Additionally, your doctor will ask you about your medical history, especially any conditions or medications that may affect your blood pressure. In addition to your blood pressure and heart rate measurements, your doctor will also perform a physical examination in different positions, including lying down, sitting, and standing. The doctor may also check your pulse, temperature, skin color, and reflexes.
Tests may also be ordered by your doctor to confirm the diagnosis and rule out other causes, such as:
You can have blood tests done to check your blood count, electrolytes, kidney function, thyroid function, and hormone levels
Testing your urine for hydration, urine output, and urine specific gravity
During an electrocardiogram (ECG), your heart's electrical activity is measured and abnormalities, such as arrhythmia and ischemia, are detected
Sound waves can be used to create an image of your heart and check its structure and function with an echocardiogram
Your blood pressure and heart rate can be monitored with a tilt table test, which simulates the posture changes that trigger your symptoms
Tests of autonomic function measure your nervous system's response to various stimuli, such as breathing, temperature, or stress
It is important to consider the cause and severity of orthostatic hypotension, as well as the patient's overall health and preferences when treating this condition. As part of the treatment, the primary objective is to relieve the symptoms, prevent complications, and address the underlying causes. Some of the options include:
You can maintain your blood volume, your blood pressure, and your muscle tone by consuming enough fluids, eating a balanced diet, avoiding alcohol and caffeine, rising slowly, wearing compression stockings, elevating the head of your bed, and exercising regularly.
Treatments that increase blood volume, blood pressure, or nervous system activity, such as fludrocortisone, midodrine, pyridostigmine, or droxidopa.
Consult your doctor before discontinuing or adjusting the dose of any medications that may lower your blood pressure or interfere with your nervous system, such as diuretics, blood pressure drugs, antidepressants, or medications for erectile dysfunction.
Orthostatic hypotension may be caused or contributed to by underlying conditions such as dehydration, anemia, heart failure, or diabetes.
You can reduce your risk of orthostatic hypotension by following some preventive measures, including:
Drink enough fluids, especially water, and avoid alcohol and caffeine, which can dehydrate you and lower your blood pressure
The best way to raise your blood pressure is to slowly rise by sitting on the edge of the bed for a few minutes before standing up, and then changing your posture gradually and carefully.
You should avoid triggers, such as heat, exercise, or large meals, that can dilate your blood vessels and lower your blood pressure.
You can raise your blood pressure by wearing compression stockings, which can squeeze your legs and prevent blood from pooling in your lower body
Regular exercise, such as walking, cycling, or swimming, can improve your blood circulation and strengthen your muscles
Monitoring your blood pressure at home or at the pharmacy and reporting any abnormal readings to your doctor
