Orthostatic Low Blood Pressure (Hypotension)

A blood pressure reading is made up of 2 numbers that are measured in millimeters of mercury (mmHg). There is a top number over a bottom number. The top number is the systolic pressure. The bottom number is the diastolic pressure. A normal blood pressure is a systolic pressure less than 120 mmHg over a diastolic pressure less than 80 mmHg. Low blood pressure (hypotension) is generally defined as a systolic blood pressure less than 90 mmHg. However, any drop in blood pressure greater than 40 mmHg from your normal baseline may be considered low blood pressure for you. Generally, the lower the blood pressure you have the better. However, it becomes a problem when it causes symptoms.

Orthostatic hypotension is a type of low blood pressure that occurs only when you change position from lying or sitting to standing. Any drop in systolic pressure of 20 mmHg or diastolic pressure of 10 mm Hg when standing is considered significant. This drop in blood pressure can cause dizziness, lightheadedness, or fainting. Orthostatic hypotension is most commonly related to low blood volume or an abnormal neurological reflex. It is also more common as we age. However, it can be a sign of an underlying illness that may need further evaluation.

Some medicines can cause orthostatic hypotension. These include:

  • High blood pressure medicines

  • Water pills (diuretics)

  • Some heart medicines

  • Some antidepressants

  • Pain, anxiety, sedative, and sleep medicines

Other causes include:

  • Dehydration from vomiting, diarrhea, or not getting enough fluids

  • Severe infection

  • High fever

  • Blood loss, such as bleeding from the stomach or intestines

  • Neurological diseases that affect the autonomic nervous system

Treatment will depend on what is causing your low blood pressure.

Home care

Follow these guidelines when caring for yourself at home:

  • Rest until your symptoms get better.

  • Change positions slowly from lying to standing. When getting out of bed, sit on the side of the bed with your legs down for at least 30 seconds before standing. This gives your body time to adjust to the position change.

  • Follow the treatment plan described by your healthcare provider.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Dizziness, lightheadedness, or fainting

  • Black or red color in your stools or vomit

  • Diarrhea or vomiting that doesn’t go away

  • Not being able to eat or drink

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Burning when you urinate

  • Foul-smelling urine

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