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Definition

Orthostatic hypotension is a condition of abnormal blood pressure regulation upon standing. The blood pressure dramatically decreases, more than 20/10 mm Hg, when rising from a lying down or sitting position to a standing position.

Measuring of Blood Pressure

Placement of Blood Pressure Cuff
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Causes

Orthostatic hypotension has several causes.

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Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

  • Increased age
  • Use of certain drugs:
    • Loop diuretics
    • Vasodilators
    • MAO inhibitors
    • Tricyclic antidepressants
    • Tetracyclic antidepressants
    • Phenothiazine antipsychotic drugs
    • Quinidine
    • Levodopa
    • Barbiturates
    • Alcohol
  • Inadequate fluid intake
  • Prolonged bedrest
  • Certain diseases or conditions:
    • Atherosclerosis]]>
    • Advanced ]]>heart failure]]>
    • Addison’s disease
    • Diabetes
    • Pernicious anemia
    • Amyloidosis
    • Guillain-Barre syndrome
    • Riley-Day syndrome
    • Shy-Drager syndrome

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Symptoms

Symptoms include:

  • Mild to moderate reduction in brain blood flow:
    • Faintness
    • Light-headedness
    • Dizziness
    • Weakness
    • Confusion
    • Visual blurring
  • Severe reduction in brain blood flow:
    • Fainting]]> or brief loss of consciousness (syncope)

Exercise or having eaten a heavy meal may worsen symptoms.

If you experience any of these symptoms do not assume it is due to orthostatic hypotension. These symptoms may be caused by other health conditions. If you experience any one of them, see your doctor.

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Diagnosis

Orthostatic hypotension is diagnosed when symptoms are present and there is a measured reduction in blood pressure while standing, which is relieved by lying down. The underlying cause must be determined on an individual basis.

Treatment

Treatment for orthostatic hypotension depends on the cause.

Treatments include:

Adjusting Dosage or Type of Medication

When orthostatic hypotension is due to hypovolemia related to medications, an adjustment in the dosage or discontinuing the medication may be needed to reverse the condition.

Treating Dehydration

Orthostatic hypotension resulting from dehydration is treated with fluids and electrolyte (mainly sodium) replacement.

Minimizing Bedrest

If bedrest is the cause of orthostatic hypotension, symptoms of orthostatic hypotension may be improved by increasing time spent sitting up in bed.

Medications

A number of medications may be given to boost blood pressure, including:

Other Interventions

In some cases, individuals may be encouraged to increase their intake of salt. Fitted elastic stockings that go up to the waist may be worn. Individuals may need to be taught to rise from lying down, to sit up, and to stand in a slow and gradual fashion. Similarly, they should be discouraged from standing still for too long a time.

If you are diagnosed with orthostatic hypotension, follow your doctor's instructions .

Prevention

There is no way to prevent orthostatic hypotension if it is a result of other diseases or conditions. However, if your orthostatic hypotension relates to medications, dehydration, or bedrest, you should talk with your healthcare provider about adjusting your medications, drinking adequate fluids, and minimizing bed rest, respectively.