Orthostatic Hypotension

Orthostatic Hypotension (Postural Hypotension)

🩺 Overview

Orthostatic hypotension, also known as postural hypotension, is a condition in which blood pressure drops significantly when standing up suddenly after sitting or lying down. This leads to reduced blood flow to the brain and may cause dizziness, loss of balance, fainting, or falls.

Symptoms may occur in the following situations:

Standing up suddenly after sitting.
Sitting up quickly after lying down.
Waking up in the morning.
After eating a large meal.
During or after physical exercise.
During episodes of anxiety or panic.

🔍 Causes of Orthostatic Hypotension

Orthostatic hypotension can result from several underlying causes, including:

Chronic diseases such as diabetes, heart failure, or atherosclerosis.
Medications, including diuretics, certain antidepressants, and blood pressure–lowering drugs.
Neurological disorders, such as Parkinson’s disease and some types of dementia.
Dehydration.
Vitamin B12 deficiency or anemia.
Alcohol abuse.
Prolonged bed rest.

⚠️ Symptoms

Orthostatic hypotension symptoms are often more pronounced in the morning, as blood pressure is typically at its lowest. Symptoms vary from person to person and may include:

Dizziness when standing.
Feeling faint or experiencing falls.
Headache or blurred vision.
Pressure or discomfort in the back of the neck or shoulders.
Nausea or excessive sweating.
General weakness or fatigue.

🧠 Possible Complications

People with orthostatic hypotension are at a higher risk of developing complications, such as:

Bone fractures or concussions due to falls.
Postprandial hypotension, which occurs 30 minutes to 2 hours after eating, especially carbohydrate-rich meals.
Shock or organ failure if blood pressure remains extremely low.
Stroke or heart disease caused by repeated blood pressure fluctuations.

🧪 Diagnosis

Diagnosis involves measuring blood pressure while lying down, sitting, and standing. The physician may also perform a physical examination and request additional tests, including:

Blood tests.
Electrocardiogram (ECG).
Echocardiography (cardiac ultrasound).
Exercise stress test.
Other specialized tests to evaluate fainting episodes.

💊 Treatment

Treatment focuses on identifying and managing the underlying cause. In many cases, treating the primary condition or adjusting the dosage of causative medications helps control symptoms. Management strategies may include lifestyle modifications such as:

Increasing fluid intake to prevent dehydration.
Standing up slowly and avoiding prolonged standing.
Avoiding sitting with crossed legs.
Sitting upright for short periods when confined to bed.
Rising gradually from bed and sitting on the edge for a few minutes before standing.
Performing simple exercises (e.g., squeezing a rubber ball or towel) to raise blood pressure before standing.
Elevating the head of the bed.
Wearing compression stockings.

🛡️ Prevention Tips

To reduce symptoms and prevent complications, the following measures are recommended:

Inform your doctor about any symptoms and discuss medication adjustments if needed.
Get out of bed slowly by sitting on the edge first before standing.
Take your time when changing positions.
Sit while showering, dressing, or working in the kitchen.
Perform gentle leg or foot movements before standing.
Ensure there is a stable object nearby to hold onto when standing.
Avoid walking if you feel dizzy.
Drink 6–8 glasses of water daily, unless otherwise advised by your doctor.
Avoid hot baths or showers.
Sleep with extra pillows to keep the head elevated.

Orthostatic Hypotension