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Orthostatic hypotension, also known as postural hypotension, is a condition in which blood pressure drops suddenly when a person stands up from a sitting or lying position. This sudden decrease in blood pressure may cause dizziness, blurred vision, or even fainting. Orthostatic hypotension is more common in older adults, but it can also affect younger individuals in certain situations.

What Is Orthostatic Hypotension?

Blood pressure is measured using two values:

• Systolic blood pressure: The pressure in the arteries when the heart pumps blood.

• Diastolic blood pressure: The pressure in the arteries when the heart rests between beats.

A person is diagnosed with orthostatic hypotension when systolic blood pressure drops by at least 20 mmHg or diastolic blood pressure drops by at least 10 mmHg within 3 minutes of standing up.

Under normal conditions, the body automatically adjusts blood pressure and blood flow to the brain when changing position. In people with orthostatic hypotension, this compensatory mechanism does not function properly, leading to the symptoms described below.

Symptoms of Orthostatic Hypotension

Symptoms may range from mild to severe, depending on how much blood pressure drops and how well the body compensates. Common symptoms include:

1. Dizziness or lightheadedness:

The most common symptom, caused by reduced blood flow to the brain.

2. Blurred vision:

Occurs when the eyes do not receive enough blood supply.

3. Fatigue:

Reduced blood and oxygen delivery to organs may cause weakness or exhaustion.

4. Fainting (syncope):

In severe cases, orthostatic hypotension may lead to temporary loss of consciousness.

5. Rapid heartbeat:

The body attempts to compensate by increasing heart rate, though this is often insufficient.

6. Nausea or general discomfort:

Some individuals may experience stomach discomfort or nausea.

If these symptoms occur frequently or worsen over time, medical attention is necessary to reduce the risk of falls and other complications.

Causes of Orthostatic Hypotension

Orthostatic hypotension can result from a wide range of causes, from temporary conditions to more serious underlying diseases. Common causes include:

1. Dehydration

Excessive fluid loss due to diarrhea, vomiting, or heavy sweating reduces blood volume and lowers blood pressure.

2. Reduced blood volume

Blood loss from injury or surgery may lead to a sudden drop in blood pressure.

3. Cardiovascular conditions

• Heart failure reduces the heart’s ability to pump blood effectively.

• Abnormal heart rhythms may also contribute to orthostatic hypotension.

4. Endocrine disorders

Conditions such as hypothyroidism, adrenal insufficiency, or low blood sugar can impair blood pressure regulation.

5. Nerve damage

Neurological conditions such as Parkinson’s disease or diabetic neuropathy may interfere with blood pressure control.

6. Medications

Diuretics, antihypertensive drugs, antidepressants, and vasodilators may lower blood pressure as a side effect.

7. Pregnancy

Circulatory changes during pregnancy may cause orthostatic hypotension in some women.

8. Aging

Older adults are more susceptible due to reduced efficiency of the cardiovascular system.

Diagnosis of Orthostatic Hypotension

To diagnose orthostatic hypotension, doctors may use the following methods:

1. Blood pressure measurements:

Blood pressure is measured while lying down, sitting, and standing to assess changes.

2. Blood tests:

Help identify anemia, hormonal disorders, or electrolyte imbalances.

3. Electrocardiogram (ECG):

Used to detect heart rhythm abnormalities or cardiac dysfunction.

4. Tilt table test:

Evaluates the body’s cardiovascular response to changes in position.

5. Echocardiography:

Assesses heart structure and function.

Treatment of Orthostatic Hypotension

Treatment depends on the underlying cause. Common management strategies include:

1. Lifestyle modifications

• Drinking adequate fluids to prevent dehydration.

• Changing positions slowly and avoiding sudden standing.

• Eating smaller, more frequent meals to help stabilize blood pressure.

• Limiting alcohol intake, as alcohol can lower blood pressure.

2. Medications

In some cases, doctors may prescribe medications to increase blood pressure or improve circulation.

3. Physical therapy

Exercises that strengthen muscles and improve circulation may help reduce symptoms.

4. Compression stockings

Medical compression stockings help prevent blood pooling in the legs and support stable blood pressure.

5. Treating underlying conditions

Managing conditions such as heart failure or neurological disorders can significantly improve symptoms.

Prevention of Orthostatic Hypotension

Prevention plays an important role in reducing the risk of orthostatic hypotension. Recommended measures include:

• Adequate hydration: Especially important during hot weather or physical activity.

• Increased salt intake: May be beneficial in some cases, but only under medical supervision.

• Regular, gentle exercise: Helps improve circulation and muscle tone.

• Wearing compression stockings: Effective for people with frequent symptoms.

• Routine health check-ups: Enable early detection of underlying health issues.

Conclusion

Orthostatic hypotension is a common condition that can significantly affect quality of life if not properly managed. Recognizing symptoms early, identifying the underlying cause, following appropriate treatment strategies, and early detection through annual health check-ups at DYM Medical Center can help you stay healthy and reduce the risk of complications.

For consultation and follow-up of orthostatic hypotension at DYM Medical Center Vietnam, please contact:

• DYM Medical Center Saigon: Room B101-B103, Basement 1, mPlaza Saigon Building, No. 39 Le Duan, Sai Gon Ward, Ho Chi Minh City

• DYM Medical Center Phu My Hung: Room 3A01, 3A Floor, The Grace Building, 71 Hoang Van Thai Street, Tan My Ward, Ho Chi Minh City

• DYM Medical Center Hanoi: B1 Basement, Epic Tower, Alley 19 Duy Tan, Cau Giay Ward, Ha Noi

• Hotline: 1900 29 29 37