When to Worry about Orthostatic Hypotension
Do you ever feel lightheaded or dizzy as you stand up? You may have experienced orthostatic hypotension, a form of low blood pressure that affects roughly one in five people over age 65, explains cardiologist Amit Khera, MD. For some, it can happen only occasionally…for others, it can be chronic.
Compared to hypertension, or high blood pressure, hypotension means low blood pressure. Orthostatic hypotension, also called, appropriately, postural hypotension, happens with a change in posture, mostly when you go from lying or sitting to standing.
When you stand up, blood pools in your legs, causing a slight dip in blood pressure. Under normal circumstances, natural reflexes within the body’s autonomic nervous system prompt the veins to bring blood back to your heart, and your blood pressure adjusts. But when this doesn’t happen as fast as it should, the drop in blood pressure can cause symptoms.
The most common and frequent symptom of orthostatic hypotension is lightheadedness or feeling dizzy when standing up. Another is fatigue or a lack of energy. The most severe and worrisome symptom is fainting, and with it, the risk for injury should you fall.
Another significant consequence to orthostatic hypotension is loss of quality of life. If you don’t understand why these dizzy spells are happening to you and don’t take steps to address symptoms, you may become nervous about leaving your home, lose social connections and risk isolation.
Sometimes orthostatic hypotension simply happens with age. As you get older, your body doesn’t do as good a job of regulating circulation as it used to. Being dehydrated can make you more prone to it. By itself, an iron deficiency won’t cause you to feel dizzy when standing up, but being even a little anemic can intensify a predisposition to orthostatic hypotension.
Orthostatic hypotension also can be a side effect of certain medications, including those for pain, prostate conditions and high blood pressure, among many others. It also can be a warning sign of an endocrine or heart condition or a problem within your nervous system. Some people’s autonomous nervous system is not well-tuned. And in some people, dizzy spells can be a symptom of a neurologic disease, such as Parkinson’s disease or multiple sclerosis.
If you’re experiencing orthostatic hypotension symptoms, it’s important to identify and address the condition and/or any underlying cause. Your health-care provider will take your medical history and blood pressure readings when you’re lying down, sitting and standing. A clear sign is a drop of more than 20 points in the systolic, or top, number or 10 points in the diastolic, or bottom, number after you go from sitting or lying to standing. Your caregiver will next try to isolate factors contributing to orthostatic hypotension to determine what actions to take.
For age-related orthostatic hypotension, small changes may be enough to control it…
If your blood pressure is on the low side normally—around 100 mmHg or lower for the top number—you may be advised to add some salt to your diet or drink sports drinks high in electrolytes.
If your orthostatic hypotension is medication-related, your doctor should be able to switch you to another drug. If it could be the result of a medical condition, tests may be ordered to find the specific cause, and treatment for that condition may help.
