Orthostatic hypotension is a form of low blood pressure. It happens when the blood vessels do not constrict (tighten) as you stand up. It is usually a symptom of an underlying disorder rather than a disease in itself. The condition is also known as postural hypotension.
Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when standing after sitting or lying down. Orthostatic hypotension can cause dizziness or lightheadedness and possibly fainting. Orthostatic hypotension can be mild.
In people with orthostatic hypotension, hypoperfusion to other organs contributes to an increased risk of life-threatening health problems, including heart attack or heart failure, a heart rhythm abnormality called atrial fibrillation , stroke, or chronic kidney failure.
Causes of orthostatic hypotension
Fever. Prolonged bed rest. Excessive amounts of alcohol. Some medications, such as some diuretics or antihypertensive (high blood pressure) medications.
Loss of fluid within the blood vessels is the most common cause of symptoms linked to orthostatic hypotension. This could be due to dehydration brought about by diarrhea, vomiting, and the use of medication, such as diuretics or water pills.
In most cases, dizziness associated with heart problems is accompanied by other symptoms. These may include shortness of breath, swollen extremities, frequent fatigue or chest pain. In the event heart disease is suspected, you will undergo one or more tests to get to the root of your problem.
Left untreated, however, iron-deficiency anemia can make you feel tired and weak. You may notice pale skin and cold hands and feet. Iron-deficiency anemia can also cause you to feel dizzy or lightheaded.
Symptoms of orthostatic hypotension. When the person stands up they may feel lightheaded, dizzy, or what is called a “head rush”. They may feel unsteady and some people can fall. Their vision may change and become blurred or there may be spots, color loss, tunnel vision, or the vision can go completely black.
Warning signs and symptoms of heart failure include shortness of breath, chronic coughing or wheezing, swelling, fatigue, loss of appetite, and others. Heart failure means the heart has failed to pump the way it should in order to circulate oxygen-rich blood throughout the body.
“Red flag” symptoms should alert you to a non-vestibular cause: persistent, worsening vertigo or dysequilibrium; atypical “non-peripheral” vertigo, such as vertical movement; severe headache, especially early in the morning; diplopia; cranial nerve palsies; dysarthria, ataxia, or other cerebellar signs; and ...
Brain hypoperfusion, resulting from orthostatic hypotension from any cause, can lead to symptoms of orthostatic intolerance (eg, lightheadedness) and falls, and if the hypotension is severe, to syncope.
Risk factors for orthostatic hypotension include being age 65 or older, certain diseases, some medications, pregnancy, and alcohol use. In older people, the condition may indicate an increased risk of stroke, heart attack, or heart failure.
Previous studies have revealed an increased prevalence of orthostatic hypotension with age. In community dwelling individuals >65 years of age, its prevalence is approximately 20%; in those >75 years of age it is as high as 30%.
Routine blood tests – Tests for blood sugar, blood counts, electrolytes and thyroid function help identify cases of dizziness. For example anemia and low blood sugar are known to cause dizziness. This should be differentiated from vertigo. Audiometry tests are performed to detect Ménière's disease.
The Fukuda Stepping test may be done at home or by a physical therapist. The test helps assess dizziness so your physical therapist can recommend the best treatment. The test involves stepping in place with your eyes closed for 100 steps and then measuring how much you turned during the test.
If you are dizzy right now and have any of the following neurological symptoms along with your dizziness or vertigo, call 911 immediately: New confusion or trouble speaking or understanding speech. New slurred speech or hoarseness of voice. New numbness or weakness of the face, arm, or leg.
SMI warning signs
It can feel like an uncomfortable pressure, squeezing, or pain. Discomfort in other upper-body areas, such as one or both arms, the back, the neck, the jaw, or the stomach. Shortness of breath before or during chest discomfort. Breaking out in a cold sweat, or feeling nauseated or lightheaded.