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Orthostatic hypotension, also known as orthostatic hypotension, is the difference in blood pressure that occurs when you reposition your body. Blood pressure is not always the same, but it fluctuates with the activities you do every day. When a sudden change in the position of our body is accompanied by dizziness, then we may be dealing with orthostatic hypotension.

Blood pressure and body position

When standing, most of our blood is found in the lower body or the lower part of significant organs (e.g. the lungs). Changing the position to lying causes the effect of gravity to change, and thus a more even distribution of blood in our body. The change of position may be accompanied by a temporary change in the pressure level.

The regulation of pressure in the body depends on the amount of plasma, baroreceptor reflexes and the level of tension regulation in the blood vessels. Most often, orthostatic hypotension occurs when there is an insufficient amount of plasma (hypovolaemia).

In a properly functioning human organism, the carotid sinuses and the aortic arch regulate the fluctuations in arterial pressure. When a person changes the position of their body and their blood pressure drops, baroreceptors increase the heart rate and raise the blood pressure. Thus, they increase the level of tension in the walls of blood vessels. When the baroreceptor reflex is disturbed, orthostatic hypotension may develop, and with it may be hypertension when lying down. Daily, natural pressure fluctuations may also be deregulated.

The causes of orthostatic hypotension

The most common causes of postural hypotension include:

  1. taking diuretics,
  2. taking vasodilators,
  3. excessive, regular consumption of alcohol.

Chronic orthostatic hypotension is caused by:

  1. hypertension,
  2. improper work of baroreceptors,
  3. diastolic dysfunction,
  4. central nervous system failure (including brain stem damage, stroke, Parkinson’s disease, myelopathy, multiple system atrophy, dementia),
  5. peripheral nervous system failure (diabetes mellitus, alcoholism, pruritus, pernicious anemia, autonomic dysfunction, amyloidosis).

Acute orthostatic hypotension is caused by:

  1. dehydration,
  2. myocardial infarction,
  3. sepsis,
  4. bradycardia,
  5. tachycardia,
  6. the use of certain drugs (alpha-blockers, beta-blockers, diuretics, antidepressants, antipsychotics, bromocriptine, levodopa, sildenafil).

Symptoms of orthostatic hypotension

The most common symptoms of postural hypotension include a tendency to unconsciousness in the following situations:

  1. sudden upright positioning,
  2. after a long rest in a lying position,
  3. after a heavy meal,
  4. in the morning, after waking up.

In addition, there are symptoms such as:

  1. dizziness,
  2. problems with maintaining balance,
  3. lack of control over your own body,
  4. “Spots” in front of the eyes,
  5. inability to maintain an upright position,
  6. pain in the back of the head and neck
  7. feeling weak
  8. short-term visual disturbances,
  9. pain in the chest area.

If the above symptoms persist for a long time, please report this fact to your doctor. They may be evidence of worsening of orthostatic hypotension.

Diagnosis of orthostatic hypotension is made with a 3-minute tilt test. This test is performed to assess cardiovascular function. During it, the systolic and diastolic pressure is checked while staying in different positions. Healthy patients should have the same blood pressure regardless of their position: lying or standing.

Treatment of orthostatic hypotension

If orthostatic hypotension is suspected, tests are performed to confirm or exclude the neurological causes of the disease, diabetes, amyloidosis or vitamin B12 deficiency.

There is also a reduction in the number of doses or discontinuation of drugs, the intake of which lowers the level of blood pressure. In people who do not suffer from hypertension, it is recommended to consume a large amount of water every day (even 2,5 liters a day or more), as well as to increase the consumption of table salt.

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