What is orthostatic hypotension?

Orthostatic hypotension is a drop in blood pressure that can happen when you stand up after sitting or lying down.

What is the cause?

Whenever you stand up, the force of gravity pulls your blood downward and the blood tends to settle in your legs. Blood pressure can start to fall, so there is less blood going to your brain. Normally, reflexes within the body make up for this change. The heart beats faster, and the veins and arteries in the legs squeeze to get narrower. The squeezing keeps blood from pooling in the legs and keeps your blood pressure normal.

Sometimes these normal reflexes can weaken or fail. This is more likely to happen as you get older.

Some medicines are another possible cause. Many drugs affect these reflexes and may cause orthostatic hypotension, especially in older adults. Diuretics, nitrates, blood pressure medicines, and antidepressants are all medicines that may cause the problem.

Some diseases that damage nerves may also cause orthostatic hypotension. Diabetes is the most common disease of this sort.

What are the symptoms?

Symptoms may include:

• Feeling lightheaded, dizzy, or faint soon after you get up
• Sweating
• Blurred vision
• Passing out

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider may check your blood pressure when you are lying down, sitting, and standing up.

How is it treated?

If you are having this problem because of a medicine you are taking, your healthcare provider may change the medicine or your dosage.

In more severe cases, your provider may prescribe medicine that may help.

How can I take care of myself?

Here are some things you can do to help prevent the symptoms.

• When you stand up, do it slowly. If you have been lying down, sit for awhile before standing. This allows sluggish reflexes to adjust.
• Wear support stockings, which squeeze the legs and help prevent pooling of blood. Ask your healthcare provider which stockings to buy and how to use them.
• Make sure that you drink plenty of fluids unless your healthcare provider has asked you to limit your fluids because of heart or other problems.
• Tell your healthcare provider if you think that a medicine you are taking may be making your symptoms worse. Check with your provider about nonprescription medicines and supplements before you start taking them.
• Avoid eating large meals and using alcohol. It may also help to avoid exercising after meals.
• Tensing your leg muscles and flexing your knees a little instead of locking them may help if you have to stand for long periods of time.
• Wear elastic compression stockings.