Orthostatic hypotension or postural hypotension

Orthostatic hypotension is a type of hypotension that occurs when you suddenly stand up or lie down. Orthostatic or postural hypotension is generally mild and lasts for a few minutes. You may feel dizzy and faint.

What is Orthostatic Hypotension?

There are two types of orthostatic hypotension: occasional (acute orthostatic hypotension) or chronic orthostatic hypotension. Occasionally orthostatic hypotension can be caused by dehydration, hypoglycemia, overheating, or after prolonged lying down. Chronic orthostatic hypotension, on the other hand, can be caused by some underlying health problem. When blood pressure drops sharply, blood flow to the organs decreases, causing dizziness.

Gravity causes blood to collect in the abdomen and legs when you stand up, and less blood returns to the heart, which lowers your blood pressure.

Usually, near the arteries in the heart and neck, there are some special cells named baroreceptors that sense this low blood pressure. They signal the brain, beating the heart faster and instructing it to pump more blood. This stabilizes your blood pressure. These cells can also narrow blood vessels and raise blood pressure.

If this process does not work properly, it can lead to orthostatic hypotension.

Orthostatic hypotension (postural hypotension) becomes more common with age. In addition, anemia, dehydration due to diarrhea, diabetes, thyroid, heart disease, neurological problems, pregnancy or long-term immobility can increase the risk of orthostatic hypotension.

Here are some ways to diagnose orthostatic hypotension:

  • Blood pressure monitoring: Doctors measure blood pressure both when sitting and when standing and compare the readings. If diastolic blood pressure drops by 10 mm Hg within 2-5 minutes of standing, or systolic blood pressure drops by 20 mm Hg, or if standing causes signs or symptoms, the doctor will report orthostatic hypotension. Diagnose.
  • Blood test You can detect hypoglycemia (hypoglycemia) or anemia (low red blood cell level). Both can lead to low blood pressure.
  • Electrocardiography (ECG or EKG): This non-invasive test detects irregularities in the rhythm and structure of the heart
  • Echocardiography..
  • Stress test: The stress test is done during exercise, like walking on a treadmill.
  • Valsalva maneuver: This is a non-invasive test that checks the function of the autonomic nervous system by analyzing heart rate and blood pressure after taking deep breaths and repeating deep breaths that push air out of the lips. I’m trying to blow up a hard balloon.
  • Tilt test: this The test diagnoses how the body reacts to changes in position. Lying on a flat table that leans to lift the upper body, simulating the movement from lying down to standing.Blood pressure is measured frequently when the table is tilted

What are the symptoms?

Orthostatic hypotension occurs mainly in the morning. The reason is that blood pressure is lowest in the morning. The main sign or symptom is dizziness when suddenly rising from a lying or sitting position. Syncope is also a sign of orthostatic hypotension.

Other signs and symptoms of orthostatic hypotension are:

  • Blurred vision
  • headache
  • nausea
  • Hot or sweaty
  • Chest, shoulder and neck pain
  • Loss of concentration
  • Palpitations
  • Dyspnea

When do you see a doctor?

If you sometimes suffer from orthostatic hypotension, it’s not serious. You may feel dizzy or lightheaded due to dehydration or hypoglycemia. Talk to your doctor if you have frequent symptoms of orthostatic hypotension. Frequent symptoms of orthostatic hypotension can mean that there is a serious underlying health problem. Seek medical attention immediately if you lose consciousness for even a moment, as you may have a stroke.

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How can you prevent orthostatic hypotension?

You can prevent orthostatic hypotension by taking the following measures.

  • Drink plenty of water: Drink plenty of water and rehydrate to prevent low blood pressure and its symptoms.
  • Avoid alcohol: Alcohol should be avoided as it can exacerbate the symptoms of orthostatic hypotension.
  • Exercise: Regular aerobic exercise helps relieve the symptoms of orthostatic hypotension.
  • Do not bend your hips: Do not bend your hips. When choosing something from the floor, rather crouch on your knees.
  • Get up slowly: Sit or lie down to get up slowly. After sleeping and waking up, sit and stand near the edge of the bed for a while.
  • Raise your head when lying in bed: You need to raise your head a little while you sleep to avoid the effects of gravity.
  • Move your legs while standing: If you have symptoms of orthostatic hypotension, try crossing your thighs and squeezing. This helps relieve symptoms.
  • If your blood pressure drops after a meal, your doctor may recommend that you eat small meals frequently.

How is Orthostatic Hypotension Treated?

The main purpose of treatment is to maintain normal blood pressure. Therefore, proper blood supply to the lower limbs and increased blood supply are needed. Treatment of orthostatic hypotension includes treatment of the underlying cause of orthostatic hypotension.

For mild orthostatic hypotension (postural hypotension), treatment includes lying down as soon as you feel dizzy. If you feel dizzy because of your medication, you can ask your doctor to change your medication or dosage. Treatment of orthostatic hypotension includes:

  • Compression stockings: Orthostatic hypotension occurs especially when blood flow to the lower extremities is inadequate. Compression stockings and abdominal binders may help increase blood flow and reduce the symptoms of orthostatic hypotension.
  • Medications: Certain medications may be used to treat orthostatic hypotension or postural hypotension. Fludrocortisone helps raise blood pressure, but it has serious side effects. Pyridostigmine in combination with midodrine is also an effective drug.
  • Lifestyle Changes: Your doctor may suggest some lifestyle changes, such as hydration, avoiding alcohol, and avoiding crossing your legs when standing up or sitting.


Orthostatic hypotension is not a serious illness unless it is due to an underlying health problem. If it occurs frequently, consult your doctor immediately. Your doctor will diagnose the cause of your orthostatic hypotension and treat it accordingly.

Frequently Asked Questions (FAQ)

Will Orthostatic Hypotension Cure?

Symptoms of orthostatic hypotension can be controlled by medication, compression stockings, and exercise.

Is walking suitable for orthostatic hypotension?

Regular walking, jogging, and swimming can help reduce the symptoms of orthostatic hypotension. However, avoid training in humid and extremely hot weather. Bend and stretch your calf muscles before you sit down. If symptoms occur, press on the thighs together, including the abdominal and buttocks muscles. March, crouch, or stand on your toes in place.

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