Postural (Orthostatic) Hypotension

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Postural hypotension is a quick drop in blood pressure that happens when you sit up or stand up. This can be a drop in your systolic blood pressure by 20 mmHg (top number) or your diastolic blood pressure by 10 mmHg (bottom number). It can make you feel dizzy or lightheaded. The feeling is often mild and goes away after a few seconds or minutes. Sometimes, the drop in blood pressure can be more severe and even cause people to faint. Symptoms can include:

  • Feeling light-headed or dizzy
  • Blurry vision and seeing stars
  • Confusion
  • Weakness
  • Nausea
  • Fainting
Postural hypotension is a drop in your systolic blood pressure by 20 mmHg or your diastolic blood pressure by 10 mmHg.
Why does postural hypotension happen?

When you get up quickly, gravity causes your blood to go down into your legs. Usually your veins and arteries respond by squeezing the blood back to your head. If your body does not respond, your blood pressure drops. Not enough blood gets to your head which makes you feel dizzy.

People often have postural hypotension when they spend many days in bed. This can happen because of surgery or illness. During this time, your arteries and muscles get weak and don’t respond like they used to. When getting out of bed, you will need to first get used to sitting before you can stand. You will need to retrain your body. Postural hypotension caused by bed rest can last days or weeks.

Postural hypotension and spinal cord injury

After spinal cord injury, your body may not respond to posture changes like it did before. It might not act fast enough to pump the blood back to your head. When you have weakness in your leg muscles, they no longer help pump blood. Postural hypotension caused by spinal cord injury can last weeks or months. Some people will always have it and will need to find ways to reduce symptoms.

Postural hypotension is also called orthostatic hypotension.
How is blood pressure measured?

Blood pressure is the amount of pressure in your arteries. It is measured with a blood pressure cuff placed around your arm. The blood pressure in a healthy person is 120/80 mmHg. The first number (120) is the ‘systolic blood pressure’ and is the pressure during a heartbeat. The second number (80) is the ‘diastolic blood pressure’ and is the pressure between heartbeats.

After spinal cord injury, it is common to have resting blood pressure below 110/70 mmHg or even 100/60 mmHg.
Reducing Symptoms

If you feel dizzy when sitting up or standing up, try doing it slowly in stages. This gives your body time to respond. If dizziness lasts more than a few seconds, you will need to go back to your earlier posture for a few minutes. Practicing changes in posture every day trains your body to get used to it. Drinking plenty of clear fluids also helps keep your blood pressure normal.

Lie to sit: Do this slowly by raising the head of your bed or by placing pillows behind your back. Stay in this position for about 15-20 min before sitting up fully. If you feel dizzy, lay down again for a few minutes before trying again.

Bed to chair: Before transferring from your bed to chair, dangle your legs. Sit with your legs hanging over the edge of the bed for a few minutes. If you have a tilting wheelchair, you can use the tilt feature to slowly move to an upright position.

Sit to stand: When getting up, you can do it slowly by using a standing frame or a tilt-table. Using these devices often can help your blood pressure adjust over time.

Treatments

Abdominal binder: An abdominal binder is a tight piece of clothing worn on your belly and chest. It helps keep your blood pressure higher when standing.

Elastic stockings: Elastic stockings help keep pressure in your legs so that blood does not rush to them. They come in knee-high and thigh-high sizes.

Tilt-table or standing frame: A gradual standing program with a tilt-table or standing frame can help. Using these devices often can help train your body to have better blood pressure.

Medications: Some medications help maintain your blood pressure. Ask your doctor which medications are right for you.

Disclaimer: Information is provided for educational purposes only. Consult a qualified health professional regarding specific medical concerns or treatment. University Health Network does not assume and disclaims any liability to any party for any loss or damage caused by errors or omissions in this publication.