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Orthostatic hypotension refers to the significant drop in blood pressure (defined as the drop in systolic pressure greater than 20 mmHg or the drop in diastolic pressure greater than 10mmHg). The symptoms produced include dizziness, headache, blurry vision or temporary vision loss, weakness, drowsiness, and even fainting.

Orthostatic hypotension is a sign of many diseases.

Medicine relevance

Many medicines could lead to orthostatic hypotension, including:

1. Diuretics will cause excessive water discharge and lead to hypotension.
2. Vasodilating agent causes excessive dilation of blood vessels that trigger relative lower blood pressure.
3. Alpha blocker causes autonomic dysreflexia
4. Some medicine prescribed by the psychiatrist could lead to orthostatic hypotension.

Insufficient blood output

In case of severe peptic ulcer bleeding, severe vomiting or diarrhea, excessive sweating that leads to serious dehydration, the blood flow will be insufficient in the body and orthostatic hypotension may occur.

Autonomic Nervous System Problems

Orthostatic hypotension is the most common symptoms of hypotension in seniors. When normal people stand up from lying position suddenly, the mechanism of adjusting blood pressure will activate to maintain normal blood pressure. Seniors’ regulation mechanism could not compensate the blood pressure drop in short period of time due to autonomic system degeneration. Hence seniors are more likely to have orthostatic hypotension.

Other causes such as diabetic neuropathy, chronic alcohol consumption, high-level spinal cord injury, or neuropathy related to virus infection, all lead to damaged autonomic nervous function and hence orthostatic hypotension.

Primary Orthostatic Hypotension

The lesion in such patients could lie on the deficiency of “norepinephrine” in peripheral sympathetic nervous system. Such patients are rare and are often complicated with autonomic dysreflexia that is difficult to heal.

Problems with Heart

Sudden orthostatic hypotension can be seen in myocardial infarction or arrhythmia. Additionally, serious cardiac failure, cardiomyopathy, aortic stenosis, pericarditis will restrict cardiac output and lead to orthostatic hypotension.

Diagnosis and Treatment

In general, asymptomatic hypotension does not need further examination or treatment. On contrary, hypotension with symptoms will require further medical diagnosis to find out the cause, and possibly be treated.

The principle of treatment is to remove known cause, followed by taking consideration of using agent that will boost blood pressure. Additionally, patients could wear elastic stocking to promote peripheral circulation and thereby improve the symptoms.