What is an Orthostatic Hypotension

Orthostatic hypotension is a sudden drop in blood pressure that happens when you quickly change positions, such as when you get up from a seated or lying position.

Blood pressure is a measurement of how strongly, or weakly, your blood is pressing against the walls of your arteries. Arteries are blood vessels that carry blood from your heart throughout your body.

When blood pressure is too low, you may not get enough blood to your brain or to the rest of your organs. This can cause weakness, light-headedness, rapid heartbeat, and fainting. This can last for just a few seconds or for up to a few minutes.

Orthostatic hypotension is usually not a serious problem. However, if it happens frequently or gets worse, it may be a sign of something more serious.

What are the causes?

This condition may be caused by:

• Sudden changes in posture, such as standing up quickly after you have been sitting or lying down.
• Blood loss.
• Loss of body fluids (dehydration).
• Heart problems.
• Hormone (endocrine) problems.
• Pregnancy.
• Severe infection.
• Lack of certain nutrients.
• Severe allergic reactions (anaphylaxis).
• Certain medicines, such as blood pressure medicine or medicines that make the body lose excess fluids (diuretics). Sometimes, this condition can be caused by not taking medicine as directed, such as taking too much of a certain medicine.

What increases the risk?

Certain factors can make you more likely to develop orthostatic hypotension, including:

• Age. Risk increases as you get older.
• Conditions that affect the heart or the central nervous system.
• Taking certain medicines, such as blood pressure medicine or diuretics.
• Being pregnant.

What are the signs or symptoms?

Symptoms of this condition may include:

• Weakness.
• Light-headedness.
• Dizziness.
• Blurred vision.
• Fatigue.
• Rapid heartbeat.
• Fainting, in severe cases.

How is this diagnosed?

This condition is diagnosed based on:

• Your medical history.
• Your symptoms.
• Your blood pressure measurement. Your health care provider will check your blood pressure when you are:
  • Lying down.
  • Sitting.
  • Standing.

A blood pressure reading is recorded as two numbers, such as “120 over 80” (or 120/80). The first (“top”) number is called the systolic pressure. It is a measure of the pressure in your arteries as your heart beats. The second (“bottom”) number is called the diastolic pressure. It is a measure of the pressure in your arteries when your heart relaxes between beats. Blood pressure is measured in a unit called mm Hg. Healthy blood pressure for adults is 120/80. If your blood pressure is below 90/60, you may be diagnosed with hypotension.

Other information or tests that may be used to diagnose orthostatic hypotension include:

• Your other vital signs, such as your heart rate and temperature.
• Blood tests.
• Tilt table test. For this test, you will be safely secured to a table that moves you from a lying position to an upright position. Your heart rhythm and blood pressure will be monitored during the test.

How is this treated?

Treatment for this condition may include:

• Changing your diet. This may involve eating more salt (sodium) or drinking more water.
• Taking medicines to raise your blood pressure.
• Changing the dosage of certain medicines you are taking that might be lowering your blood pressure.
• Wearing compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.

In some cases, you may need to go to the hospital for:

• Fluid replacement. This means you will receive fluids through an IV tube.
• Blood replacement. This means you will receive donated blood through an IV tube (transfusion).
• Treating an infection or heart problems, if this applies.
• Monitoring. You may need to be monitored while medicines that you are taking wear off.

Follow these instructions at home:

Eating and drinking

• Drink enough fluid to keep your urine clear or pale yellow.
• Eat a healthy diet and follow instructions from your health care provider about eating or drinking restrictions. A healthy diet includes:
  • Fresh fruits and vegetables.
  • Whole grains.
  • Lean meats.
  • Low-fat dairy products.
• Eat extra salt only as directed. Do not add extra salt to your diet unless your health care provider told you to do that.
• Eat frequent, small meals.
• Avoid standing up suddenly after eating.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
  • Follow instructions from your health care provider about changing the dosage of your current medicines, if this applies.
  • Do not stop or adjust any of your medicines on your own.

General instructions

• Wear compression stockings as told by your health care provider.
• Get up slowly from lying down or sitting positions. This gives your blood pressure a chance to adjust.
• Avoid hot showers and excessive heat as directed by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You vomit.
• You have diarrhea.
• You have a fever for more than 2–3 days.
• You feel more thirsty than usual.
• You feel weak and tired.

Get help right away if:

• You have chest pain.
• You have a fast or irregular heartbeat.
• You develop numbness in any part of your body.
• You cannot move your arms or your legs.
• You have trouble speaking.
• You become sweaty or feel lightheaded.
• You faint.
• You feel short of breath.
• You have trouble staying awake.
• You feel confused.