Orthostatic Hypotension
- Yeju Lee
- Jun 6
- 2 min read
What is orthostatic hypotension?
Orthostatic hypotension is a sudden drop in blood pressure after a long time of sitting or lying down. It causes mild symptoms such as dizziness and blurriness to serious conditions like fainting. It is a relatively common condition that happens frequently among people in a mild and brief form.
Causes of orthostatic hypotension
Orthostatic hypotension happens when there is a drop in blood pressure. It is specifically defined as when blood pressures drop between 20mm Hg or 10mm Hg(shown in the table above) from one’s normal blood pressure. This happens because when you are sitting or lying down, it is easier to regulate blood flow from your limbs to your heart. As you stand up, your heart has to suddenly do more work to pump blood through your body. This causes blood pressures to temporarily drop. Normally, the body maintains blood pressure as special cells called baroreceptors quickly respond when pH levels fluctuate and even out blood pressure, but orthostatic hypotension occurs when something else disturbs this process. For instance, dehydration is a common disturbance that causes the symptom. When there is not enough water in the body, the amount of blood in the body declines, causing blood pressures to drop more easily. In addition, issues within the heart of the body affects blood pressure. If the heart cannot pump blood fast enough or experience heart failure, it may disturb the body from regulating blood pressure. Simply eating a meal can also contribute to the symptoms. To digest the food you’ve eaten, the body uses blood to supply oxygen and nutrients to your intestines. If you’re lying down after a meal and get up, the digestion process prevents your body from quickly adjusting to the sudden low blood pressure and causes dizziness.
Symptoms of orthostatic hypotension
As blood pressures drop, not enough blood and oxygen reach the brain, causing symptoms such as lightheadedness, blurry vision, confusion, nausea, fatigue, and even fainting and strokes.
Diagnosis of orthostatic hypotension
There are several ways to evaluate orthostatic hypotension. Blood pressure monitoring is a method of measuring blood pressure while sitting and standing through 2 to 5 minutes. Blood tests measure the level of blood sugar and red blood cells which can both cause orthostatic hypotension when lacking. Electrocardiogram is a test that measures the activity of the heart. By detecting heart rhythm changes, it is possible to know the supply of oxygen to the heart. The tilt table test shifts the body from a lying to standing position like the image below, and by observing the response of the heart and nervous system during the shift, it can measure blood pressure.
Treatments to orthostatic hypotension
Simple ways to avoid orthostatic hypotension include sitting upright in bed, wearing elastic socks so that blood can flow well, and taking in fluids and salt in case of dehydration. Physical exercising ensures effective breathing and postures. Specific drugs for the condition can be taken such as midodrine, fludrocortisone, and pyridostigmine, all effective for treating the causes of hypotension.
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