Postural hypotension (orthostatic)

General or Other | General Practice | Postural hypotension (orthostatic) (Disease)


Orthostatic hypotension, also known as postural hypotension and colloquially as head rush or dizzy spell, is a form of hypotension (a persons BP – blood pressure - suddenly falls when standing up or stretching).

Causes and Risk factors

The symptom is caused by blood pooling in the lower extremities upon a change in body position. It is quite common and can occur briefly in anyone, although it is particularly prevalent among the elderly, and those with low blood pressure.

When orthostatic hypotension is present, the following symptoms can occur after sudden standing or stretching (after standing): dizziness, euphoria or dysphoria, bodily dissociation, distortions in hearing, lightheadedness, nausea, headache, blurred vision( or dimmed) possibly to the point of blindness, generalized or extremity numbness, fainting, pain centered in the neck and shoulders and in rare cases, vasovagal syncope, which is a specific type of fainting. They are consequences of insufficient blood pressure and cerebral perfusion.

Diagnosis and Treatment

Tests to determine the cause of the disorder are done including: blood tests, tilt table test, and imaging studies. Lifestyle changes such as drinking plenty of fluids and standing slowly. Medications include: fludrocortisone, midodrine, pyridostigmine, nonsteroidal anti-inflammatory medications(ibuprofen, naproxen), pain medications such as acetaminophen, caffeine and epoetin. ...