ABOUT THE CONDITION
What is orthostatic hypotension?
Orthostatic, or postural, hypotension is when your blood pressure drops suddenly when you change position from lying to standing. This can make you feel light-headed or dizzy.
It can happen when you:
- Suddenly stand from a bending, stooping or a lying position
- Sit or stand still for a long time, for example in a bus or in a queue
- One to two hours after you have eaten a meal
- When you are dehydrated
- When you are in a hot environment
Who is likely to get orthostatic hypotension?
Orthostatic hypotension can occur at any age. It is more common in:
- Older adults
- People taking blood pressure tablets, water tablets or medication for Parkinson’s disease
- People with diabetes
- After an illness causing dehydration
How do you check for orthostatic hypotension?
After you have been lying down for 5 minutes, your blood pressure will be checked. You will be asked to stand up, and immediately your blood pressure will be checked again. While you are still standing, your blood pressure will be checked again in 3 minutes.
There is a postural drop in blood pressure if:
- there is a drop of 20 mm Hg or more in the systolic blood pressure (the top number ) when you stand up, or
- a drop of 10mm Hg or more in the diastolic blood pressure (the bottom number) when you stand up
This will need to be repeated a few times before you are given a diagnosis of orthostatic hypotension.
What symptoms does orthostatic hypotension cause?
When blood pressure drops suddenly, less blood reaches the brain. You can feel dizzy, light-headed, unsteady, have a ‘swimmy’ or ‘fuzzy’ head, or may fall.
What should I do if I get these symptoms?
- Sit down. Lean forward and place your head between your knees.
- If possible, lie down. Lying down quickly makes most people feel better.
- Put your legs up against a wall or on a chair while lying down on the floor.
When your symptoms have gone, carefully sit up, then stand up gradually.
If you faint, fall, injure yourself, or you get these symptoms often, contact your GP.
How can I reduce these symptoms?
There are several simple things you can do to help prevent or reduce symptoms of orthostatic hypotension:
- Be extra careful when you wake up. This is when your blood pressure is usually lowest.
- Change your position slowly. Do not stand up quickly from a lying position. For example, get out of bed in stages:
- Move your legs and arms whilst in bed to get the blood moving
- Sit up carefully
- Move your legs and arms again
- Stand up carefully and be ready to sit down again if you feel unwell.
- Install a handle or rail near the toilet.
- Stay well hydrated. Drink at least 2 litres of water every day. Pale yellow or clear urine is a good sign of hydration.
- Increase the amount of salt in your diet after discussing it with your GP. Do not do this if you have high blood pressure.
- If you are taking medication, ask your GP or pharmacist to review it, as it may be affecting your blood pressure.
- Drinking strong tea or coffee may help to keep your blood pressure up. Avoid drinking more than 5 cups a day.
- Avoid drinking too much alcohol. This may make your symptoms worse.
- Avoid sitting or standing for too long.
- Move your legs regularly. Clench and unclench your calf muscles or rock forward on the balls of your feet to increase blood flow.
- Wear knee-length compression stockings. These are available over the counter or prescribed by your GP.
- Consider raising the head of your bed with blocks.
- If your symptoms happen one to two hours after a meal, consider eating smaller meals more often instead of large meals.
If lifestyle changes do not control your symptoms, your doctor may refer you to a specialist.
Further information
Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.