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Postural Hypotension

Summary:


Postural hypotension is a drop in blood pressure that happens when changing into an upright position, e.g. moving from lying to sitting or sitting to standing.




Contents

What is Hypotension?

Blood pressure is the pressure exerted by circulatory blood upon the walls of blood vessels. It varies between a minimum (diastolic) and maximum (systolic) pressure. A blood pressure of 100 (systolic) over 60 (diastolic) and lower is classified as hypotension. This means that the blood pressure is lower than usual and may cause symptoms such as dizziness.

What is Postural Hypotension?

Postural hypotension is a drop in blood pressure of more than 20mmHg systolic and 10mmHg diastolic when changing into an upright position, e.g. moving from lying to sitting or sitting to standing.


What are the common causes?

  • Dehydration
  • Artherosclerosis
  • Parkinson’s disease
  • Cardiac impairment
  • Certain medications (such as anti-hypertensives)

What are the signs and symptoms?

The signs and symtoms generally occur after position change, they include:

  • Dizziness
  • Palpitations
  • Light headedness
  • Nausea
  • Blurred vision
  • Syncope (fainting)
  • Pain or pressure along the neck and shoulders
  • Weakness

Symptoms vary from person to person and people may experience any combination of these symptoms

What are the risk factors?

  • Incidence increases in the elderly
  • Diabetes Mellitus
  • After prolonged bed rest

What types of treatment are available?

Advice and Education

Management of patients with postural hypotension is focused on advice and education, to help decrease the risk factors associated with this condition

Medication

There are some medications which can help to control postural hypotension

What can I do to help myself?

There are lifestyle changes that can be made to help manage postural hypotension:

  • Sleeping with your head elevated 20-30 degrees
  • Avoid sudden postural change. Try to change position slowly and in stages, sit on the edge of the bed for a few minutes before standing
  • Sit back down if you feel symptomatic after position change
  • Do simple lower limb exercises, such as moving your ankle up and down before and after changing position
  • Avoid bending down to pick things up
  • Avoid eating large meals
  • Avoid hot baths or showers
  • If possible, sit down to do washing, showering and dressing
  • Maintain proper fluid intake


References

  1. Lahrmann, H. et al (2006) EFNS Guidelines on the diagnosis and management of orthostatic hypotension European Journal of Neurology 13 pp.930-936 [Online] http://www.efns.org/fileadmin/user_upload/guidline_papers/EFNS_guideline_2006_management_of_orthostatic_hypotension.pdf
  2. Bray, J. et al ‘Lecture Notes on Human Physiology’ 3rd ed. Blackwell Scientific Publications
  3. Sherwood, L. (2010) 'Human Physiology: From Cells to Systems' 7th ed. 'The Bloods Vessels and Blood Pressure'. Brooks/Cole: USA
- Last updated 14 Nov 2011,12:08 pm




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