Orthostatic hypotension: Difference between revisions

Orthostatic hypotension
Synonyms	Postural hypotension
Pronounce	N/A
Specialty	N/A
Symptoms	Dizziness, lightheadedness, fainting
Complications	Falls, syncope, stroke
Onset	Sudden upon standing
Duration	Seconds to minutes
Types	Neurogenic, non-neurogenic
Causes	Dehydration, blood loss, medications, neurological disorders
Risks	Age, diabetes, Parkinson's disease, prolonged bed rest
Diagnosis	Blood pressure measurement, tilt table test
Differential diagnosis	Vasovagal syncope, cardiac arrhythmia
Prevention	Hydration, compression stockings, medication adjustment
Treatment	Fludrocortisone, midodrine, lifestyle changes
Medication	N/A
Prognosis	Varies, can be managed
Frequency	Common in older adults
Deaths	N/A

Latest revision as of 05:06, 6 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
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Orthostatic hypotension (OH), also known as postural hypotension, is a form of low blood pressure that happens when you stand up from sitting or lying down. It can make you feel dizzy or lightheaded, and maybe even cause you to faint.

Pathophysiology[edit]

Orthostatic hypotension occurs when the body's normal mechanisms for maintaining blood pressure fail to respond adequately to the change in posture. Normally, when a person stands up, gravity causes blood to pool in the veins of the legs and trunk. This pooling reduces the amount of blood returning to the heart, and consequently, the heart pumps less blood, leading to a drop in blood pressure. The body compensates by increasing heart rate and constricting blood vessels to maintain blood pressure and blood flow to the brain. In individuals with orthostatic hypotension, these compensatory mechanisms are impaired. This can be due to various reasons, including dehydration, prolonged bed rest, certain medications, or underlying medical conditions such as Parkinson's disease, diabetes, or autonomic neuropathy.

Symptoms[edit]

The primary symptoms of orthostatic hypotension include:

Dizziness or lightheadedness upon standing
Blurred vision
Weakness
Fatigue
Nausea
Palpitations
Headache

In severe cases, it can lead to syncope (fainting), which can result in falls and injuries.

Diagnosis[edit]

Diagnosis of orthostatic hypotension is typically made by measuring blood pressure in different positions. A significant drop in blood pressure when moving from a lying or sitting position to a standing position is indicative of the condition. A drop of 20 mmHg in systolic blood pressure or 10 mmHg in diastolic blood pressure within three minutes of standing is considered diagnostic.

Treatment[edit]

Treatment of orthostatic hypotension focuses on the underlying cause and may include:

Increasing salt and fluid intake to expand blood volume
Wearing compression stockings to reduce blood pooling in the legs
Medications such as fludrocortisone or midodrine to increase blood pressure
Lifestyle changes, such as rising slowly from a sitting or lying position, avoiding alcohol, and eating smaller, more frequent meals

@@ Line 1: / Line 1: @@
-{{Redirect|Head rush|the television science series|Head Rush (TV series)}}
+{{SI}}
-{{Infobox medical condition (new)
+{{Infobox medical condition
-| name            = Orthostatic hypotension
+| name                    = Orthostatic hypotension
-| synonyms        = Orthostasis, postural, positional hypotension
+| image                   = [[File:Tetrahydrocannabinol.svg|250px]]
-| image           =
+| caption                 = Diagram of a chemical structure
-| caption         =
+| field                   = [[Cardiology]], [[Neurology]]
-| field           = [[Cardiology]], [[Neurology]]
+| synonyms                = Postural hypotension
-| symptoms        = symptoms that are worse when sitting or standing and improve when lying down, <br>including lightheadedness, vertigo, tinnitus, slurred speech, <br>confusion, coathanger pain in neck and shoulders, <br>grayed or blurred vision, severe fatigue, <br>fainting or near fainting
+| symptoms                = [[Dizziness]], [[lightheadedness]], [[fainting]]
-| complications   = cumulative brain damage, sudden death from falls
+| complications           = [[Falls]], [[syncope]], [[stroke]]
-| onset           =
+| onset                   = Sudden upon standing
-| duration        =
+| duration                = Seconds to minutes
-| types           =
+| types                   = [[Neurogenic]], [[non-neurogenic]]
-| causes          =
+| causes                  = [[Dehydration]], [[blood loss]], [[medications]], [[neurological disorders]]
-| risks           =
+| risks                   = [[Age]], [[diabetes]], [[Parkinson's disease]], [[prolonged bed rest]]
-| diagnosis       = in-office (lay down for at least 20 minutes, take BP;<br> stand for 3 minutes, take BP), or tilt-table testing by an autonomic specialist
+| diagnosis               = [[Blood pressure]] measurement, [[tilt table test]]
-| differential    =
+| differential            = [[Vasovagal syncope]], [[cardiac arrhythmia]]
-| prevention      =
+| prevention              = [[Hydration]], [[compression stockings]], [[medication adjustment]]
-| treatment       = identify and treat causes (medications, dehydration),<br> midodrine, compression garments, bed tilting
+| treatment               = [[Fludrocortisone]], [[midodrine]], [[lifestyle changes]]
-| medication      =
+| prognosis               = Varies, can be managed
-| prognosis       = depends on frequency, severity, and underlying cause; <br>neurogenic orthostatic hypotension is a chronic, <br>debilitating, and often progressively fatal condition
+| frequency               = Common in older adults
-| frequency       =
-| deaths          =
 }}
-Orthostatic hypotension (OH) is a type of [[low blood pressure]] that occurs upon standing or when changing from a lying or seated position to standing. This transition can cause light-headedness, fainting, and falls, posing a significant health risk, particularly in older adults.
+'''Orthostatic hypotension''' (OH), also known as postural hypotension, is a form of low blood pressure that happens when you stand up from sitting or lying down. It can make you feel dizzy or lightheaded, and maybe even cause you to faint.
+== Pathophysiology ==
-=== Understanding Orthostatic Hypotension ===
+Orthostatic hypotension occurs when the body's normal mechanisms for maintaining blood pressure fail to respond adequately to the change in posture. Normally, when a person stands up, gravity causes blood to pool in the veins of the legs and trunk. This pooling reduces the amount of blood returning to the heart, and consequently, the heart pumps less blood, leading to a drop in blood pressure. The body compensates by increasing heart rate and constricting blood vessels to maintain blood pressure and blood flow to the brain.
+In individuals with orthostatic hypotension, these compensatory mechanisms are impaired. This can be due to various reasons, including dehydration, prolonged bed rest, certain medications, or underlying medical conditions such as [[Parkinson's disease]], [[diabetes]], or [[autonomic neuropathy]].
-Orthostatic hypotension is a physical finding defined by the American Autonomic Society and the American Academy of Neurology as a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing.
+== Symptoms ==
+The primary symptoms of orthostatic hypotension include:
-It's the result of the body's inadequate response to the shift in gravitational stress when moving from a reclining or seated position to standing. Normally, when an individual stands, gravity pulls blood into the lower extremities, leading to a decrease in blood pressure. The body typically compensates by narrowing blood vessels and increasing heart rate to maintain blood flow to the brain. However, in individuals with orthostatic hypotension, these compensatory mechanisms fail, leading to decreased cerebral blood flow and symptoms of cerebral hypoperfusion.
+* Dizziness or lightheadedness upon standing
+* Blurred vision
-=== Symptoms and Consequences ===
+* Weakness
+* Fatigue
-People with orthostatic hypotension may experience dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, headache, and syncope (fainting). In severe cases, it can lead to falls and injuries, particularly in the elderly.
+* Nausea
+* Palpitations
-=== Causes and Risk Factors ===
+* Headache
+In severe cases, it can lead to syncope (fainting), which can result in falls and injuries.
-Orthostatic hypotension can occur for various reasons, including [[dehydration]], prolonged bed rest, pregnancy, diabetes, heart problems, burns, excessive heat, varicose veins, certain neurological disorders, and advanced age. Certain medications, like diuretics, beta-blockers, and drugs for Parkinson's disease, may also induce orthostatic hypotension.
+== Diagnosis ==
+Diagnosis of orthostatic hypotension is typically made by measuring blood pressure in different positions. A significant drop in blood pressure when moving from a lying or sitting position to a standing position is indicative of the condition. A drop of 20 mmHg in systolic blood pressure or 10 mmHg in diastolic blood pressure within three minutes of standing is considered diagnostic.
-=== Diagnosis ===
+== Treatment ==
+Treatment of orthostatic hypotension focuses on the underlying cause and may include:
-The diagnosis of orthostatic hypotension is based on a physical examination, patient history, and the characteristic decrease in blood pressure upon standing. Further tests may be conducted to ascertain the cause of the condition, such as blood tests, electrocardiograms, stress tests, or tilt-table tests.
+* Increasing salt and fluid intake to expand blood volume
+* Wearing compression stockings to reduce blood pooling in the legs
-=== Treatment and Management ===
+* Medications such as fludrocortisone or midodrine to increase blood pressure
+* Lifestyle changes, such as rising slowly from a sitting or lying position, avoiding alcohol, and eating smaller, more frequent meals
-Treatment of orthostatic hypotension focuses on the underlying cause, if identifiable, and symptomatic relief. Depending on the cause, treatment options might involve lifestyle changes, medications, or compression stockings to improve blood flow. It's important to speak with a healthcare provider for an accurate diagnosis and appropriate treatment.
-== References ==
-<references />
 == See Also ==
 * [[Hypotension]]
-* [[Syncope (medicine)|Syncope]]
 * [[Autonomic nervous system]]
-* [[Dehydration]]
+* [[Syncope]]
-[[Category:Cardiology]]
+* [[Blood pressure]]
-[[Category:Blood pressure]]
+{{Cardiovascular system}}
-[[Category:Medical symptoms]]
+[[Category:Cardiovascular diseases]]
-{{stub}}
-{{Autonomic diseases}}
-{{Vascular diseases}}
-{{DEFAULTSORT:Orthostatic Hypotension}}
-[[Category:Vascular diseases]]
-[[Category:Hypotension]]
-[[Category:Peripheral nervous system disorders]]