Orthostatic Hypotension

What is Orthostatic Hypotension?

Orthostatic Hypotension is a kind of low blood pressure that occurs when standing up after lying down or sitting for a period of time. Many people simply call it a head rush. When it hits, it is usually mild and lasts for only a few seconds. Rarely does it last any longer than a couple of minutes. Orthostatic hypotension that continues for any significant period of time could be an indication of a more serious underlying condition and should be evaluated by a medical professional.

The condition often becomes more frequent as a person ages. It is also known to occur in cases of mild dehydration, pregnancy, anemia, various heart conditions, low blood sugar, and thyroid issues. Some medications could cause episodes of orthostatic hypotension, as can exposure to hot environments, lengthy periods of bed rest, and alcohol consumption.

What are the Symptoms of Orthostatic Hypotension?

The symptoms of orthostatic hypotension set in within seconds of standing up and frequently include:

  • Blurred vision
  • Disorientation
  • Nausea
  • Confusion
  • Fatigue
  • Feeling weak
  • Chest pain
  • Dizziness
  • Falling
  • Lightheadedness

In some cases, orthostatic hypotension may cause a person to faint or pass out.

Orthostatic Hypotension Causes

Orthostatic hypotension has many possible causes, with some causes affecting only a particular part of the circulatory system supplying blood to the brain, and other causes affecting two or three. Losing fluid in the blood vessels is one of the most common causes for developing orthostatic hypotension symptoms. But some particular causes for orthostatic hypotension include:

  • Dehydration occurring as fluid intake fails to keep pace with fluid lost by the body.
  • Blood loss and other forms of anemia that decrease the amount of red blood cells carrying oxygen through the bloodstream, which can cause the symptoms of orthostatic hypotension in the body.
  • Medications which directly affect your autonomic nervous system can cause orthostatic hypotension.
  • Beta blocker medications like metoprolol (Inderal), as their name implies, block the beta-adrenergic receptors preventing your heart from speeding up and from contracting as aggressively, which dilates blood vessels.
  • Medications like Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are a class of medication that is known to cause orthostatic hypotension.
  • Orthostatic hypotension is common amongst people who are 65 years of age or older as special (baroreceptors) cells located near your heart and neck arteries, which regulate your blood pressure, slow with age.

How is Orthostatic Hypotension Treated?

Patients who experience occasional mild orthostatic hypotension generally do not require treatment. It is a very common occurrence that almost everyone experiences at one point or another, and there is rarely cause for concern. Most of the time, the condition will clear up quickly or can be helped along by sitting or lying down for a couple of minutes.

More severe cases are treated based on the cause. Orthostatic hypotension that is the result of another medical condition will often improve once that condition is brought under control. If medications are causing frequent head rushes, the dosage can be changed. Staying hydrated, avoiding alcohol, limiting sodium intake, wearing compression stockings, and standing up slowly are a few lifestyle changes that may also help.

Orthostatic Hypotension Prevention

Preventing orthostatic hypotension involves the targeted treatment of its causes while avoiding risk factors. Patients undergoing postoperative orthopedic surgery have an elevated risk of developing orthostatic hypotension because of the medications involved, the possibility of dehydration, and extended immobility.

Patients that are currently taking a high-risk medication should ask their doctor for alternatives if the medication is critical, and whether it can be avoided while they heal, in order to avoid orthostatic hypotension. Fluid volume depletion must also be addressed quickly and your input and output of essential fluids should be monitored closely in order to ensure sufficient hydration. The risk factor of immobility must be addressed with prompt and sufficient physical therapy commencing soon after any orthopedic or medical procedure.

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Last Reviewed:
October 07, 2016
Last Updated:
January 18, 2018