Orthostatic hypotension is a condition that results in a sudden drop in blood pressure when standing up from a sitting or lying position. This can cause dizziness and lightheadedness, which can be dangerous if you are driving or performing other tasks that require concentration. While orthostatic hypotension can be uncomfortable, it is usually not dangerous and can be treated with lifestyle changes or medication.
Meaning of Hypotension
Blood pressure (BP) is the force of blood pushing against the walls of the arteries as the heart pumps blood. Hypotension, or low blood pressure, is a condition in which the blood pressure in the arteries is lower than normal. Generally, the BP reading is less than 90/60 mmHg among Australian adults.
A person’s low blood pressure may be fine for another. There can be no noticeable symptoms but can be life-threatening. Hypotension can also be a sign of an underlying health condition, especially if it happens together with symptoms.
First responders and first aiders received training in taking blood pressure manually or electronically. If you’re interested to be first aid certified in Cheltenham or in any CPR First Aid locations, see our list of first aid courses here.
Types of Low Blood Pressure
Hypotension can be acute, meaning it develops suddenly and severely, or chronic, meaning it occurs gradually. Below are some of the low blood pressure types that commonly occur in Australians.
When rising from a seated position, there is a dramatic drop in blood pressure. This mostly affects seniors. We’re highlighting this type in this article.
Hypotension after eating
This decrease in blood pressure happens one to two hours after a meal, particularly in people with excessive blood pressure or illnesses of the autonomic nervous system, including Parkinson’s disease. This scenario mostly impacts seniors.
Hypotension with neural mediation
Characterised by a dip in blood pressure that occurs after prolonged standing, which mostly affects children and young adults.
Orthostatic Hypotension together with multiple system atrophy
An uncommon condition known as Shy-Drager syndrome affects the neurological system, which regulates involuntary processes including blood pressure, heart rate, respiration, and digestion. It is believed to be linked to extremely high blood pressure when lying down.
What Medical Conditions Causes Low BP?
- Conditions of the heart and heart valves
- Illnesses relating to hormones (endocrine disorders)
- Loss of blood
- Septicemia – a serious infection
- Anaphylaxis – significant allergic response
- A diet lacking in nutrition
The risk of having low blood pressure may rise with cardiac issues. Severe hypotension can lower the body’s oxygen levels, which can harm the heart and the brain.
Medications That May Result in Low BP
- Diuretics such as furosemide and water tablets, hydrochlorothiazide
- Alpha blockers like prazosin
- Beta blockers, such as propranolol and atenolol
- Parkinson’s medication, such as pramipexole or levodopa-containing medications
- Specific antidepressant medications e.g. imipramine and doxepin
- Sildenafil and tadalafil, especially when used with the heart medicine nitroglycerin – are medications for erectile dysfunction
Fast Facts About Orthostatic Hypotension
- Commonly known as postural hypotension
- Occurs while getting up from a chair or lying down.
- Can result in fainting, dizziness, or lightheadedness, as well as the possibility for a patient to fall and incur secondary trauma wounds
- typically less severe and short
- Long-lasting orthostatic hypotension is harmful if left untreated since it may indicate more serious issues.
What Happens During Orthostatic Hypotension?
Every time you get out of a sitting or reclining position, gravity has a significant impact on blood flow. On average, approximately 300 to 800ml of blood momentarily pools in the blood vessels of the legs. Blood pressure falls as a result of less blood returning to the heart, a consequence of blood pooling.
Specific cells called baroreceptors, detect the decline in BP. The cardiovascular system and autonomic nervous system swiftly react in a healthy individual by speeding up the heart rate and telling the blood vessels in the legs and belly to constrict or tighten. These actions keep the brain’s blood pressure at a healthy level.
In a person with orthostatic hypotension, this compensatory process to raise blood pressure may not happen or may be delayed. They continue to have low blood pressure, which results in symptoms. Once the individual sits or lies down again, blood pressure usually recovers to normal, although this depends on how serious the underlying problem is.
Who is Prone to Orthostatic Hypotension?
Patients 65 years of age and older are most likely to experience orthostatic hypotension, in part because of diminished baroreceptor sensitivity. Within that age range, the prevalence can reach 18.2 percent.
Other Conditions Putting People At Risk
- Orthostatic hypotension is also more likely to occur in patients with cardiovascular conditions such as aortic stenosis, pericarditis or myocarditis, or arrhythmias.
- Younger and middle-aged patients are equally susceptible to it; however, they typically have a persistent autonomic failure in the absence of volume depletion.
Symptoms of Postural Hypotension
The most common symptom of orthostatic hypotension is lightheadedness or dizziness upon standing. Other symptoms may include:
- feeling faint or unsteady
- feeling like you are going to black out
- confusion or having trouble focusing
- blurred vision
- nausea and wanting to vomit
- weakness or body malaise
Extreme low blood pressure, on the other hand, can lead to a condition known as shock. Symptoms which may need immediate medical attention are:
- confusion, most frequently in the elderly
- clammy, cold skin
- reduction in skin colour (pallor)
- shallow, rapid breathing
- weak and quick pulsations
- brief loss of consciousness
If you or the person you are taking care of experiences any of these symptoms, it is important to seek medical attention as orthostatic hypotension can be a sign of a more serious condition.
When Do Symptoms Occur?
Here are some daily scenarios that can bring about orthostatic hypotension.
- abrupt standing or sitting up
- early in the day, when blood pressure naturally drops
- after a heavy meal
- large alcohol consumption
- when exercising
- straining on the toilet
- when sick
How Do I Prevent Orthostatic Hypotension?
There are a few ways that you can treat orthostatic hypotension, depending on the underlying cause.
If you have dehydration, drinking plenty of fluids and adding salt to your diet may help to prevent postural hypotension.
If the condition is due to a medication you are taking, your doctor may be able to adjust your dosage or switch you to a different medication.
If an underlying condition is causing your orthostatic hypotension, treating that condition may help to improve your symptoms. For example, if you have diabetes, tightly control your blood sugar levels. Another circumstance would be, if a heart condition is present, such as irregular heartbeats or heart failure, treating that condition may help to reduce episodes of orthostatic hypotension.
Emergency Care for Orthostatic Hypotension
- If a person experiences dizziness or lightheadedness when standing up, let him or her sit or lie down immediately, and
- Try to raise the legs above the level of the person’s heart
- Give the affected person plenty of fluids and advise him or her to avoid standing for long periods of time.
- Wearing loose, comfortable clothing helps improve blood circulation.
If symptoms persist and you have any questions or concerns, it would be a good time to visit the doctor.
In conclusion, knowing the meaning and causes of high and low blood pressure can give you an idea to prevent both conditions from developing into something worse. Both can be dangerous to a person if not treated early on. CPR First Aid in Cheltenham has a variety of compliant and high quality courses tailored for anyone wanting to get certified. Take a tour of our website and find the training that will best suit your needs.