Patient education: Orthostatic hypotension (The Basics)

What is orthostatic hypotension? — Orthostatic hypotension is a drop in blood pressure that can happen to some people when they stand 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."

What are the symptoms of orthostatic hypotension? — The symptoms all happen when you stand up after sitting or lying down. They can include:

●Feeling lightheaded or dizzy

●Blurry or dim vision

●Weakness

●Fainting (this is called syncope)

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

●There is not enough fluid in your arteries – This can happen if you lose blood or if you are "dehydrated," meaning you do not have enough fluids. You can get dehydrated if:

•You do not drink enough fluids

•You have severe diarrhea or vomiting

•You sweat a lot (for example, during exercise)

●Your heart doesn't pump out enough blood

●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 orthostatic hypotension, too. Older people are more likely than younger people to have it.

Should I see a doctor or nurse? — Yes. If you often feel dizzy or like you might pass out when you stand up, see your doctor or nurse. If you do pass out (faint), you should let your doctor know.

Is there a test for orthostatic hypotension? — 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:

●Blood tests to see if you have a condition called "anemia," which is when the body has 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? — The first thing your doctor or nurse will do to "treat" your orthostatic hypotension is find out if it is caused by any medicines you take. If so, they might switch you to another medicine or lower your dose. Medicines that can cause orthostatic hypotension include those used to treat:

●High blood pressure

●Chest pain caused by heart disease (called "angina")

●Depression

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

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

●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.

●Limit activities in hot weather that could make you overheat or sweat a lot. Examples include taking hot showers, running, or hiking. These things can make orthostatic hypotension worse.

●Make sure you drink enough fluids, especially in hot weather

●Use extra pillows or an adjustable bed to make the head of your bed higher. This will raise your head above your heart slightly.

●Wear "compression" stockings. The ones that go to your waist are most helpful, but they can be hard to use.

●Avoid drinking a lot of alcohol

More on this topic

Patient education: Syncope (fainting) (The Basics)
Patient education: Anemia caused by low iron (The Basics)

Patient education: Syncope (fainting) (Beyond the Basics)
Patient education: Anemia caused by low iron in adults (Beyond the Basics)