Filed under: Heart & Vascular
Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint.
Orthostatic hypotension is often mild, lasting a few seconds to a few minutes after standing. However, long-lasting orthostatic hypotension can be a sign of more-serious problems, so talk to your doctor if you frequently feel lightheaded when standing up. It's even more urgent to see a doctor if you lose consciousness, even momentarily.
Mild orthostatic hypotension often doesn't need treatment. Many people occasionally feel dizzy or lightheaded after standing, and it's usually not cause for concern. The treatment for more-severe cases of orthostatic hypotension depends on the cause.
The most common symptom of orthostatic hypotension is feeling lightheaded or dizzy when you stand up after sitting or lying down. This feeling, and other symptoms, usually happens shortly after standing up and generally only lasts a few seconds. Orthostatic hypotension symptoms include:
When to see a doctor
Occasional dizziness or lightheadedness may be relatively minor — the result of mild dehydration, low blood sugar, or too much time in the sun or a hot tub, for example. Dizziness or lightheadedness may also happen when you stand after sitting for a long time, such as in a lecture, concert or church. If these symptoms happen only occasionally, it's usually not cause for concern.
It's important to see your doctor if you experience frequent symptoms of orthostatic hypotension because they sometimes can point to more-serious problems. It can be helpful to keep a record of your symptoms, when they occur, how long they lasted and what you were doing at the time. If these occur at times that may endanger you or others, discuss this with your doctor.
When you stand up, gravity causes blood to pool in your legs. This decreases blood pressure because there's less blood circulating back to your heart to pump. Normally, special cells (baroreceptors) near your heart and neck arteries sense this lower blood pressure and counteract it by triggering your heart to beat faster and pump more blood, which stabilizes blood pressure. In addition, these cells cause blood vessels to narrow, which increases resistance to blood flow and increases blood pressure.
Orthostatic or postural hypotension occurs when something interrupts the body's natural process of counteracting low blood pressure. Orthostatic hypotension can be caused by many different things, including:
The risk factors for orthostatic hypotension include:
While mild forms of orthostatic hypotension may be a nuisance, more-serious complications are possible, especially in older adults. These complications include:
No special preparations are necessary to have your blood pressure checked. But, it's helpful if you wear a short-sleeved shirt or a loosefitting long-sleeved shirt that can be pushed up during your evaluation so that the blood pressure cuff can fit around your arm properly.
Because appointments can be brief and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor may be limited, so preparing a list of questions may help you make the most of your time together. List your questions from most important to least important in case time runs out. For low blood pressure, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
The goal in evaluating orthostatic hypotension, as with all forms of low blood pressure, is to find the underlying cause. This helps determine the correct treatment and identify any heart, brain or nervous system problems that may be responsible for your low blood pressure. To help reach a diagnosis, your doctor may recommend one or more of the following:
The treatment for orthostatic hypotension depends on the underlying cause. Your doctor will try to address the underlying health problem — dehydration or heart failure, for example — rather than the low blood pressure itself. For mild orthostatic hypotension, one of the simplest treatments is to sit or lie down immediately after feeling lightheaded upon standing. Your symptoms of orthostatic hypotension usually disappear.
When low blood pressure is caused by medications, treatment usually involves changing the dose of the medication or stopping it entirely. There are usually several options for treating orthostatic hypotension, including:
There are many simple steps to managing or preventing orthostatic hypotension. Some suggestions your doctor may have include: