Orthostatic hypotension

Orthostatic hypotension is defined as a significant drop in the blood pressure when standing up rapidly.

What are the causes?

  • Aging – the elderly is prone to orthostatic hypotension
  • Hypovolemia and dehydration due to bleeding, diarrhea, elevated blood sugar level, vomiting and certain medications such as thiazide and loop diuretics.
  • Pregnancy
  • Dehydration
  • Immobility
  • Heart conditions such as heart failure, heart attack, valve disease and erratic heart rhythm
  • Parkinson’s disease
  • Anemia
  • Warm weather
  • Medications given for depression, anxiety, Parkinson’s disease or erectile dysfunction
  • Substances that are taken along with blood pressure drugs such as barbiturates, alcohol and other medications
    Orthostatic hypotension

    The usual indication of orthostatic hypotension is dizziness or lightheadedness when standing up.

  • Endocrine diseases including thyroid conditions, diabetes and adrenal insufficiency
  • Drugs utilized for treating high blood pressure such as calcium channel blockers, beta blockers, nitrates, ACE inhibitors and angiotensin II blockers

What are the indications?

The usual indication of orthostatic hypotension is dizziness or lightheadedness when standing up. In some instances, the individual might faint.

Other symptoms that might be present include:

  • Fatigue
  • Blurry vision
  • Feeling weak
  • Chest pain
  • Nausea
  • Confusion or disorientation
  • Falling

Remember that these symptoms typically settle once the individual sits or lies down for a few minutes.

Management of orthostatic hypotension

If an individual experiences episode of orthostatic hypotension, the doctor will initially determine if the individual has been diagnosed with other conditions responsible for it. In most instances, the treatment of the underlying condition can stop the episodes.

In case a certain drug is triggering orthostatic hypotension, the doctor might adjust the dose or switch to a different drug.

Other measures in managing orthostatic hypotension involves changes in the daily life such as the following:

  • Increase the intake of fluids if dehydration is suspected
  • Avoid or limit the intake of alcoholic beverages
  • Stand up slowly when moving out of a chair
  • Avoid crossing the legs while sitting
  • When moving out of bed, get up slowly and sit on the edge of the bed for several minutes before standing up.
  • If the individual must remain in bed for medical reasons, he/she can try sitting up for brief periods of time.
  • Isometric exercises can be performed before moving into the upright position. These exercises increase the blood pressure and can prevent a serious drop in the blood pressure when standing up.
  • Raise the level of the bed head.
  • Use compression stockings that place pressure on the legs and assists with the blood circulation.
  • Avoid standing for prolonged periods of time.

The doctor might suggest a drug to manage orthostatic hypotension which work by increasing the blood volume or constricting the blood vessels.


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