Orthostatic hypotension is a condition where blood pressure drops below normal values when a person suddenly rises from a sitting or lying position.
An orthostatic drop in blood pressure develops due to an inadequate response of the cardiovascular system to a change in body position. This inadequate reaction consists of the insufficiently rapid narrowing of the blood vessels of the lower body, which is necessary to maintain normal blood pressure when standing up. As a result, the blood is retained longer in the vessels of the legs, it returns to the heart in a smaller amount, leading to a decrease in cardiac output and blood pressure.
Can You Die From Orthostatic Hypotension?
According to the results of various studies, orthostatic hypotension is associated with a significant increase in the risk of death from coronary artery disease, heart failure, and stroke.
In one study, 29% to 64% of patients with orthostatic hypotension died during the 10-year study period, depending on how fast the dizziness sets in and its duration. In contrast, only 9% of individuals in the placebo group died (healthy individuals).(3)
Can Orthostatic Hypotension Cause Brain Damage?
Scientists have observed that orthostatic hypotension can be linked to a 15% increase in the risk of developing dementia in the long term, such as Alzheimer’s disease. The most obvious explanation for these findings is that frequent transient cerebral hypoperfusion during orthostatic hypotension may lead to brain damage.
Low blood pressure can also damage your brain. Additionally, fainting due to low blood pressure may cause serious impact injuries to the head or other body areas. Because of a lack of blood supply to the heart muscle, low blood pressure can sometimes cause pain in the chest or shortness of breath (angina).
Treatment Of Orthostatic Hypotension
The origin of its development depends on the root cause. Doctors always try to influence the underlying disease, rather than the decrease in blood pressure itself.
With mild orthostatic hypotension, you just need to sit down or lie down immediately after dizziness occurs. When low blood pressure is caused by taking medication, treatment consists of changing their dosage or completely stopping their use.
Several drugs may be used to treat orthostatic pressure reduction.
The fludrocortisone tends to raise the blood flow, thus helping to raise the blood pressure.
Doctors often prescribe the drug midodrine, which limits the ability of blood vessels to expand, which increases the level of blood pressure.
With orthostatic hypotension associated with Parkinson’s disease, droxidopa can be used.
With the ineffectiveness of lifestyle changes and these drugs, pyridostigmine, non-steroidal anti-inflammatory drugs, caffeine and epoetin are sometimes used.(4) (5)
Orthostatic differs from normal hypotension in that the blood pressure decreases only with a sudden rise from a sitting or lying position, after which in most cases it normalizes relatively quickly. With normal hypotension, low blood pressure is observed almost constantly, regardless of body position.
Duration of orthostatic hypotension for more than a few minutes after getting up can be a sign of serious illness, so people with this problem need to see a doctor – therapist or cardiologist. Only the identification of the causes of a decrease in blood pressure and their elimination can lead to a complete recovery.(1)
Causes Of Orthostatic Hypotension
Orthostatic hypotension has many potential causes. Its symptoms most often develop due to a decrease in blood volume inside the vessels. Common causes are:
- Alcohol abuse and addiction
- Blood loss and other causes of anemia
- Disorders of the nervous system
- Elderly age
- Endocrine problems
- Heart disease
- Mental Health Medications
- Postprandial hypotension
- Sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis)
Symptoms Of Orthostatic Hypotension
Symptoms of pathology orthostatic hypotension – that is, a decrease in blood pressure with a rapid change in body position – is associated with insufficient blood supply to the brain. They include:
- Blurred vision;
- Dizziness after suddenly standing from a lying or sitting position;
- Tremor and unsteady walking.
These symptoms can quickly disappear as the body adjusts to a standing position. However, sometimes a person quickly has to crouch or lie down to prevent a fall or fainting.(2)
- Freeman R, Abuzinadah AR, Gibbons C, Jones P, Miglis MG, Sinn DI. Orthostatic hypotension: JACC state-of-the-art review. Journal of the American College of Cardiology. 2018;72(11):1294-1309.
- Suraj R, Hodge S, Spence EE, et al. Cerebrovascular Consequences of Chronic Orthostatic Hypotension. The FASEB Journal. 2019;33(1_supplement):533.516-533.516.
- Ricci F, Manzoli L, Sutton R, et al. Hospital admissions for orthostatic hypotension and syncope in later life: insights from the Malmö Preventive Project. Journal of hypertension. 2017;35(4):776-783.
- Centi J, Freeman R, Gibbons CH, Neargarder S, Canova AO, Cronin-Golomb A. Effects of orthostatic hypotension on cognition in Parkinson disease. Neurology. 2017;88(1):17-24.
- Rosario MG, Gonzalez M. Orthostatic Hypotension in People with Human Immunodeficiency Virus. The FASEB Journal. 2018;32(1_supplement):517.511-517.511.
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