What are the main symptoms or signs of Orthostatic hypotension: dizzy when you stand up?

Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.

When should you see a doctor for Orthostatic hypotension: dizzy when you stand up?

See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.

Conditions

Orthostatic hypotension: dizzy when you stand up

Blood pressure that drops with gravity

Dr. Camille Roux

Internal medicine physician

6 min read

Medical illustration of Orthostatic hypotension: dizzy when you stand up

In simple terms

Why standing makes you light-headed, which medicines cause it, and simple measures that work.

What it is, in plain words

Orthostatic hypotension is a fall of blood pressure within three minutes of standing: at least 20 mmHg for the upper number or 10 mmHg for the lower one. Normally, standing triggers reflexes that tighten blood vessels and speed the heart. When those reflexes are slow or blunted, blood pools in the legs and the brain is briefly under-supplied.

Signs to look out for

Light-headedness, blurred or greyed-out vision on standing
Neck and shoulder aching, described as coat-hanger pain
Weakness, unsteadiness, sometimes fainting
Symptoms worse in the morning, after meals, in hot weather or after alcohol
Falls and injuries, especially in older people

Why it happens

Common causes are dehydration, prolonged bed rest, blood loss and anaemia. Medicines are the biggest culprit: blood pressure tablets, diuretics, alpha-blockers for the prostate, antidepressants and Parkinson's drugs. Nerve conditions such as diabetes, Parkinson's disease and amyloidosis damage the reflex itself.

How doctors confirm it

The diagnosis is made by measuring blood pressure and pulse lying down and then after one and three minutes of standing. A tilt-table test, 24-hour monitoring, blood count, glucose and morning cortisol help find the cause.

Treatments and solutions

Reviewing every medicine with your doctor and removing or reducing the ones responsible, which alone solves many cases
Drinking two to two and a half litres of fluid daily, and adding salt if your doctor agrees and you have no heart failure
Getting up in stages: sit on the edge of the bed, flex the ankles, then stand
Compression stockings or an abdominal binder to stop blood pooling
Medicines such as midodrine or fludrocortisone when the measures above are not enough

Living with it day to day

Practical tricks help a lot: cross your legs and tense the thigh muscles when you feel it coming, avoid large carbohydrate-heavy meals and hot baths, raise the head of your bed slightly, and drink two glasses of cold water quickly before situations that usually trigger symptoms.

When to seek medical help

See a doctor if you faint completely, injure yourself in a fall, have chest pain or palpitations with the dizziness, or if symptoms appear suddenly over a few days.

This article explains general health information in simple language. It does not replace advice from your own doctor.

The words explained

Medical terms used above, in everyday language.

Symptom: A sign you can feel or see that something is wrong, like pain, tiredness or a rash.
Diagnosis: The moment a doctor identifies which illness is causing your symptoms.
Blood pressure: The force of blood pushing against your artery walls. Too high, over years, damages the heart and vessels.
Blood sugar: The amount of sugar circulating in your blood, your body's main fuel.

When should you see a doctor?

Your symptoms last more than a few weeks or keep coming back.
They get worse quickly, or stop you doing everyday things.
You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
You already take medication and want to change anything about it.

This article explains general health information. It does not replace advice from your own doctor.

Frequently asked questions

What is Orthostatic hypotension: dizzy when you stand up?: Why standing makes you light-headed, which medicines cause it, and simple measures that work.
What are the main symptoms or signs of Orthostatic hypotension: dizzy when you stand up?: Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
When should you see a doctor for Orthostatic hypotension: dizzy when you stand up?: See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.

#blood pressure #dizziness #falls