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What Is The Best Treatment For Orthostatic Hypotension?

A condition such as orthostatic hypotension cannot be attributed to a specific disease. Rather, it is a violation of the regulation of blood pressure caused by a weakening of vascular tone and the inability of blood vessels to maintain blood pressure.

What Is The Best Treatment For Orthostatic Hypotension?

The methods of treatment used for hypotension depend on the causes of the development of the disease. So, if such a condition provokes due to the intake of medications, first of all, the drugs are canceled or they are replaced.

If hypotension attacks occur infrequently and occur in a mild form, the patient should adhere to the following recommendations to normalize the condition:

  • Avoid sudden changes in body position. In the morning, you should not jump out of bed immediately after waking up, it is better to lie down for several minutes and only then slowly get up. Ignoring this rule can lead to loss of consciousness, falling and getting injured, which is especially dangerous for older people and pregnant women.
  • If the onset of characteristic symptoms is associated with varicose veins, wearing compression underwear (special elastic stockings or tights) is recommended.
  • Patients who are forced to observe bed rest for a long time are advised to perform light physical exercises, sit down more often, and change their body position.
  • With reduced pressure, it is allowed to increase the salt content in the diet, you can eat salted vegetables, salted herring, smoked meats, canned food, meat products. Of course, such a recommendation does not apply to the elderly and patients with pathologies of the cardiovascular system.
  • Patients with orthostatic hypotension are recommended to lead a healthy lifestyle, completely give up smoking and drinking alcohol, spend more time in the fresh air, and do adequate physical work. It is very important to observe the drinking regime (1.5-2 liters of fluid per day), eat properly and fully, increase the consumption of fresh vegetables and fruits, meat and fish, dairy products.(2)(3)(4)

Chronic Stage Orthostatic Hypotension

If orthostatic hypotension has gone into a chronic stage, you need medications. The doctor will select a treatment regimen taking into account the cause of the disease, the severity of the manifestation, the age of the patient, the presence of concomitant diseases and other individual characteristics. Medicines used are:

  • Adrenergic drugs with a vasoconstrictor effect. Their use eliminates a sharp drop in pressure when changing the position of the body.
  • Adaptogens – drugs that stimulate the central nervous system and autonomic nervous system, responsible for the normal functioning of the respiratory system, blood circulation, excretion, metabolism.
  • Mineralocorticoids – This helps in blood sodium ions retention. As a result, a spasm of peripheral vessels is observed, which leads to the exclusion of a sharp drop in pressure when the body position changes from horizontal to vertical.
  • If necessary, NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed, which, in addition to their direct purpose, have a spasmodic effect on the peripheral vessels and thereby prevent a pressure drop.
  • Beta-blockers – drugs of this group enhance the effect of mineralocorticoids; positively affect the tone of the autonomic nervous system and blood pressure.

If puberty or pregnancy becomes the cause of orthostatic hypotension, drug treatment is not used, you just need to wait out this period. After the body is rebuilt, it will be able to adapt to pressure changes on its own, without the help of drugs.(5)

Alternative Remedies For Orthostatic Hypotension

Reducing the severity of symptoms of orthostatic hypotension helps herbal preparations or decoctions and infusions of medicinal herbs that can be independently prepared at home.

  • Eleutherococcus;
  • Ginseng;
  • Golden root.
  • Immortelle;
  • Rhodiola;
  • Schisandra Chinensis;
  • Tartaric

You can buy the above herbs in dried form, brew according to the instructions and drink instead of tea. In this case, you need to pay attention to possible contraindications, since some herbal remedies cannot be used for diseases of the heart and digestive system. Take decoctions and infusions should be in consultation with the doctor and strict accordance with his recommendations.(5)

Orthostatic hypotension is a common problem among the elderly, but often characteristic symptoms are observed in puberty when the vascular system does not keep pace with the needs of a growing organism. Here in the future, the condition stabilizes.

It is expressed in a sharp drop in systolic and diastolic pressure at the time when a person gets up. When moving from horizontal to vertical, blood, under the action of gravity, accumulates in the veins of the limbs and organs located in the lower body resulting drop in blood pressure as blood coming back to the heart reduces. So, severe weakness, dizziness, and fainting may occur.

Orthostatic hypotension is diagnosed in those cases when, after 2–3 minutes of standing upright, systolic pressure decreases by more than 20 mmHg and diastolic – more than 10 mm Hg. There are characteristic symptoms associated with poor blood supply and insufficient blood flow to the heart and brain.(1)


  1. Palma JA, Kaufmann H. Epidemiology, diagnosis, and management of neurogenic orthostatic hypotension. Movement disorders clinical practice. 2017;4(3):298-308.
  2. Hewitt LA, Adler CH, Claassen DO, Gibbons CH, Raj SR. Management and Treatment of Neurogenic Orthostatic Hypotension: Results From a Survey of Patients and Caregivers (P2. 130). AAN Enterprises; 2018.
  3. Arnold AC, Raj SR. Orthostatic hypotension: a practical approach to investigation and management. Canadian Journal of Cardiology. 2017;33(12):1725-1728.
  4. McGrath R, McGrath R, Snih S, Markides K, Hall O, Peterson M. The Burden of Health Conditions for Aging Adults in the United States: Disability-Adjusted Life Years. Journal of the American Medical Directors Association. 2019;20(3):B33.
  5. Hale GM, Valdes J, Brenner M. The treatment of primary orthostatic hypotension. Annals of Pharmacotherapy. 2017;51(5):417-428.

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Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:May 10, 2020

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