This type of hypotension (low blood pressure) occurs when a person stands up after sitting or lying down. It is called orthostatic hypotension or postural hypotension. When it happens you may experience dizziness, lightheadedness, or fainting (rarely). In most cases, this hypotension type is mild but if you experience a chronic form it may lead to serious health problems. Immediately contact a healthcare professional if you experience lightheadedness frequently when standing up.
Usually, postural hypotension occurs due to certain obvious reasons such as dehydration or resting in bed for a long time. Additionally, if you experience chronic orthostatic hypotension it may mean you have a more serious health problem. The treatment is often different among patients because it depends on the severity of the condition, its form, and other factors.
Symptoms
The main postural hypotension symptoms are lightheadedness and dizziness, which last roughly 1-2 minutes. Check below other symptoms:
- Blurred vision
- Weakness
- Confusion
- Fainting (syncope)
However, if you experience occasionally mild dizziness or lightheadedness, it is usually not a reason for concern because these symptoms can be caused by overheating, low blood sugar, mild dehydration, or standing after sitting for long periods.
Immediately visit a doctor if you lose consciousness even for a few seconds.
Causes
In normal circumstances, when a person sits or lies for a long time the blood tends to collect in the belly and legs. Therefore, less blood flow to the heart which causes a drop in blood pressure. In such cases, there are special cells (baroreceptors) located near the heart and neck arteries that send signals to the brain. As a result, the brain tells the heart to beat faster which helps to pump more blood and improve blood pressure.
Commonly, this hypotension type occurs when something in the body processes interacts with blood pressure causing it to drop. However, there are different health conditions that may provoke orthostatic hypotension. Examples include:
- Dehydration – The most common causes of dehydration include fever, not drinking fluids, severe diarrhea, and excessive sweating. A reduced blood volume can occur due to dehydration. Thus, orthostatic hypotension can occur.
- Heart problems – There are some heart diseases that could lead to postural hypotension. For example extremely low heart rate (bradycardia), heart valve problems, myocardial infarction, heart failure, and others.
- Endocrine disorders – You can also experience this hypotension type due to the following health conditions. Examples include adrenal insufficiency (Addison’s disease), hypoglycemia (low blood sugar), and thyroid diseases.
- Nervous system conditions – These conditions also can lead to orthostatic hypotension. For example amyloidosis, multiple system atrophy, Lewy body dementia, Parkinson’s disease, and pure autonomic failure.
- Foods – Some people may experience low blood pressure after eating meals (postprandial hypotension). It usually happens in older adults.
Risk Factors
The following factors could elevate your risk of developing postural hypotension. Examples include:
- Age – This low blood pressure type happen commonly in people older than 65 years old. It occurs because baroreceptors slow with aging.
- Medicines – For example medications used to treat hypertension or heart problems including diuretics, alpha-blockers, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and nitrates.
However, there are other medicines that could also increase your risk of orthostatic hypotension. Examples include medicines used to treat Parkinson’s disease, antidepressants, antipsychotics, muscle relaxants, narcotics, and drugs used to treat erectile dysfunction (ED). - Health Conditions – These include heart diseases (including heart valve disease, heart attack, and heart failure), nervous system disorders (such as Parkinson’s disease), diabetes, and others. Consult with your healthcare provider for more details.
- Hot environment – Many people experience excessive sweating and sometimes mild dehydration when are exposed to heat for long periods. However, it also can trigger this hypotension type.
- Bed rest – If you are lying in bed for long periods it also can cause postural hypotension.
- Alcohol
What Are The Potential Orthostatic Hypotension Complications?
If you experience postural hypotension frequently, it may lead to some unpleasant complications or even serious health problems. Examples include:
- Stroke – Persistent swings in blood pressure from standing and sitting caused by postural hypotension may increase your risk of getting a stroke.
- Cardiovascular diseases – This type of hypotension also can elevate your risk of developing cardiovascular diseases. For example chest pain, heart failure, or heart rhythm problems.
- Falls – Some people may experience fainting due to orthostatic hypotension. Moreover, it is one of the most common complications in people who suffer from this low blood pressure type.
Diagnosis
The physician’s goal is to identify the cause of postural hypotension. However, to determine the cause is not always possible. They can also ask you some questions about symptoms and medical history. In addition, you may need to do some tests that will help your doctor determine whether you have orthostatic hypotension or not. For example:
- Regular blood pressure tests – If you notice that blood pressure drops with 20 millimeters of mercury (mmHg) in the systolic blood pressure (top number) within 2-5 minutes of standing, it is a symptom of postural hypotension.
- Blood tests – Physicians usually perform this test to check for low blood sugar and anemia (low red blood cells).
- Electrocardiogram (EKG or ECG) – This is a fast and painless test that helps to measure the heart’s electrical activity. It helps to check for abnormal heart rhythm, heart structure, and other heart issues.
- Echocardiogram – A test that involves sound waves to produce pictures of the heart in motion. It can show blood flow through the heart and heart valves and determine if a patient has heart disease.
- Stress test – This test is performed during exercise (including walking on a treadmill) while the heart is monitored with echocardiography and other tests.
- Tilt table test – During this test, the patient will lie down on a flat table that tilts to raise the upper part of the body. Thereafter, doctors will take your blood pressure frequently as the table tilts.
- Valsalva maneuver – This test helps doctors to understand how well your nervous system works.
Treatment
Treating the underlying condition usually helps to get rid of this hypotension type. For instance, if your postural hypotension is caused by dehydration, your doctor may recommend drinking plenty of water but if your hypotension is caused by medicines, physicians may lower the dose or even change the medicine.
People who experience mild forms of orthostatic hypotension usually do not require treatment. Doctors recommend lying or sitting back down right away after lightheadedness happens. However, sometimes medicines are required.
Medicines
Doctors usually prescribe medicines for orthostatic hypotension when lifestyle changes are not enough and you continue to experience this low blood pressure type. These include Midodrine, Droxidopa, Fludrocortisone, and Pyridostigmine. It is not allowed to administer any of the previous drugs without a doctor’s recommendation because it may lead to unpleasant outcomes.
Frequently Asked Questions
What is the most common postural hypotension cause?
Usually, the most common cause of this hypotension type is the inability of the heart to pump enough blood. Talk with your healthcare professional for more details.
What happens if orthostatic hypotension is left untreated?
It is not recommended to avoid postural hypotension symptoms because it may lead to serious health problems. These include myocardial infarction, heart failure, atrial fibrillation, stroke, and chronic kidney failure.
What foods should be avoided by people with low blood pressure?
- Tomatoes
- Sunflower seeds
- Kelp
- Onions
- Green and red beans
- Melons
- Watermelons
- Celery
- Spinach
Ask your healthcare professional if you have additional questions.
