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Orthostatic Hypotension

The Basics

Written by the doctors and editors at UpToDate пїЅ пїЅ

What is orthostatic hypotension? " пїЅ Orthostatic hypotension is a sudden drop in blood pressure that happens when a person stands up. This drop in blood pressure can make you feel dizzy or lightheaded. It can even make you pass out. Another term for orthostatic hypotension is "postural hypotension. " пїЅ пїЅ пїЅ

What are the symptoms of orthostatic hypotension? " пїЅ The symptoms all happen when you stand up. They can include: пїЅ пїЅ

  • Feeling lightheaded or dizzy
  • Blurry or dim vision
  • Weakness
  • Fainting (this is called syncope)

What can cause orthostatic hypotension? " пїЅ There are many causes of orthostatic hypotension. It can happen if: пїЅ пїЅ

  • There is not enough fluid in your arteries " пїЅ This can happen if you lose blood or if you are "dehydrated, " пїЅ meaning you do not have enough fluids. You can become dehydrated if:You do not drink enough fluidsYou have severe diarrhea or vomitingYou sweat a lot (for example, during exercise)
  • Your heart doesnt pump strongly enough
  • The nerves and hormones in your body that control the blood vessels are not working properly
  • You take certain medicines

In some people, orthostatic hypotension is tied to another problem, such as diabetes or Parkinson disease. But people who are otherwise healthy can have the condition, too. Older people are more likely than younger people to have orthostatic hypotension. пїЅ пїЅ

Should I see a doctor or nurse? " пїЅ Yes. If you feel dizzy or like you might pass out when you stand up, see your doctor or nurse. пїЅ пїЅ

Is there a test for orthostatic hypotension? " пїЅ Yes. There are a few tests that can help your doctor or nurse find out if orthostatic hypotension is causing your symptoms. The simplest test is to take your blood pressure and pulse while you are sitting or lying down and then again after you stand up. Other tests could include: пїЅ пїЅ

  • Blood tests to see if you have a condition called "anemia, " пїЅ which happens if you have too few red blood cells
  • Blood tests to check that your blood has the right chemical balance and that your fluid levels are in the right range
  • Tests to make sure your heart is pumping correctly

How is orthostatic hypotension treated? " пїЅ The first thing your doctor or nurse will want to do to "treat " пїЅ your orthostatic hypotension is find out if it is caused by any medicines you take. If so, he or she might switch you to another medicine or lower your dose. Medicines that can cause orthostatic hypotension include those used to treat: пїЅ пїЅ

  • High blood pressure
  • Chest pain caused by heart disease (called "angina " пїЅ)
  • Depression

There are also medicines to treat orthostatic hypotension directly. If necessary, your doctor or nurse can prescribe 1 of these medicines. пїЅ пїЅ

Is there anything I can do on my own to feel better? " пїЅ Yes. There are a few things you can do to reduce the problems caused by orthostatic hypotension (listed below). But you should try these things only after talking to your doctor or nurse. пїЅ пїЅ

  • Stand up slowly and give your body time to adapt. This is especially important when you get out of bed in the morning. Start by sitting up and waiting a moment. Then swing your legs over the side of the bed and wait some more. When you do stand up, make sure you have something to hold onto in case you start to feel dizzy.
  • Avoid running, hiking, or doing anything that takes a lot of energy in hot weather. These things can make orthostatic hypotension worse.
  • Make sure you drink enough fluids, especially in hot weather.
  • Put blocks under the posts at the head of your bed. This will raise your head above your heart slightly.
  • Wear "compression " пїЅ stockings; ones that go to your waist are most helpful, but they are hard to wear.
  • Avoid drinking much alcohol.

All topics are updated as new evidence becomes available and our peer review process is complete. пїЅ пїЅ

This topic retrieved from UpToDate on: Nov 04, 2014. пїЅ пїЅ

Topic 16502 Version 5.0 пїЅ пїЅ

Release: 22.8 - C22.206 пїЅ пїЅ

пїЅ пїЅ 2014 UpToDate, Inc. All rights reserved. пїЅ пїЅ

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пїЅ пїЅ 2014 UpToDate, Inc. All rights reserved. пїЅ пїЅ