Understanding Orthostatic hypotension: Causes, Symptoms, and Management

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Orthostatic hypotension

by Alike Medical Team ∙ Updated on June 13, 2023

Additional names

This group contains additional names: - Neurally mediated hypotension

General

Orthostatic hypotension- also called postural hypotension- is a form of low blood pressure that happens when standing after sitting or lying down. Orthostatic hypotension can cause dizziness or lightheadedness and possibly fainting.

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Signs & symptoms

The most common symptom of orthostatic hypotension is lightheadedness or dizziness when standing after sitting or lying down. Symptoms usually last less than a few minutes. Orthostatic hypotension signs and symptoms include: * Lightheadedness or dizziness upon standing * Blurry vision * Weakness * Fainting (syncope) * Confusion

Diagnosis

A doctor's goal in evaluating orthostatic hypotension is to find the cause and determine treatment. The cause isn't always known. A doctor might review medical history, medications and symptoms and conduct a physical exam to help diagnose the condition. A doctor also might recommend one or more of the following: * Blood pressure monitoring. * Blood tests. * Electrocardiogram (ECG) * Echocardiogram. * Stress test. * Valsalva maneuver- This noninvasive test determines how well the autonomic nervous system is working. It requires breathing in deeply and pushing the air out through the lips, as though trying to blow up a stiff balloon. Heart rate and blood pressure are checked during the test.

Treatment

Treatment for orthostatic hypotension is directed at the cause rather than the low blood pressure itself. For example, if dehydration causes orthostatic hypotension, your health care provider may suggest lifestyle changes such as drinking more water. If a medication causes low blood pressure when standing, treatment may involve changing the dose or stopping the drug. For mild orthostatic hypotension, one of the simplest treatments is to sit or lie back down immediately after feeling lightheaded upon standing. Often, symptoms will disappear. Sometimes, medications are needed to treat orthostatic hypotension. Medications If orthostatic hypotension doesn't improve with lifestyle changes, medications may be needed to increase blood pressure or blood volume. The type of medication depends on the type of orthostatic hypotension. Drugs that may be used to treat orthostatic hypotension include midodrine (Orvaten), droxidopa (Northera), fludrocortisone or pyridostigmine (Mestinon, Regonol). Talk to your health care provider about the risks and benefits of these drugs to determine which one is best for you.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

National Institutes of Health ∙ World Health Organization ∙ MedlinePluse ∙ Centers for Disease Control and Prevention

☝ All information has been reviewed by certified physicians from Alike

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Hi. It is a confusing symptom that doctors don't understand well. I get the same thing. Sorry they weren't more helpful to you. I've found it helpful to read about **Orthostatic Hypertension**. And also Dysautonomia, specifically Complex Dysautonomia. There's a helpful YouTube video on that. Then regarding the symptoms you described, they make me wonder what your heart rate was doing at the time, did it go up quickly too when you stood? That's postural tachycardia. An increase of 20bpm or more is significant.