Orthostatic hypotension is a condition of abnormal blood pressure regulation upon standing. The blood pressure quickly decreases, more than 20/10 mm Hg, when rising from a lying down or sitting position to a standing position.
Measuring of Blood Pressure
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As you stand, blood falls toward your lower body in response to gravity. To help keep blood in the upper body:
Blood pressure is also affected by the amount of blood in the blood vessels. Low levels of blood will decrease the blood pressure and make it harder for the body to compensate when you stand. Low blood volume called, hypovolemia, is the most common cause of orthostatic hypotension. It may be due to:
Orthostatic hypotension will occur when one or more of these factors does not work as expected. It may be associated with:
Factors that increase your chance of orthostatic hypotension include:
Orthostatic hypotension may cause:
Exercise or having eaten a heavy meal may worsen symptoms.
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.
When possible treatment will focus on resolving the orthostatic hypotension completely. If a complete resolution is not possible, treatment will focus on managing symptoms.
Treatment will depend on the cause. Examples include:
Common approaches include:
The doctor may recommend prescription medications to increase blood pressure.
Dietary changes may also help increase blood pressure or prevent very low blood pressure. A dietitian may help create a diet plan. Steps may include:
Behavioral changes that may help include:
National Institute of Neurological Disorders and Stroke
National Organization for Rare Disorders
Heart and Stroke Foundation
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NINDS orthostatic hypotension information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/orthostatic_hypotension/orthostatic_hypotension.htm. Updated September 30, 2011. Accessed August 21, 2014.
Orthostatic syncope. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 25, 2014. Accessed August 21, 2014.
Shibao C, Grijalva CG, et al. Orthostatic hypotension-related hospitalizations in the United States. Am J Med. 2007;120:975-980.
3/24/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills PB, Fung CK, et al. Nonpharmacologic management of orthostatic hypotension: A systematic review. Arch Phys Med Rehab. 2015;96(20):366-375.
Last reviewed August 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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