Orthostatic Hypotension Causes, Symptoms, and Treatment by
Orthostatic Hypotension
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
- What is orthostatic hypotension?
- What causes orthostatic hypotension?
- What are the risk factors for orthostatic hypotension?
- What are the symptoms of orthostatic hypotension?
- When should I call the doctor for orthostatic hypotension?
- How is orthostatic hypotension diagnosed?
- What is the treatment for orthostatic hypotension?
- What are the complications of orthostatic hypotension?
- How can orthostatic hypotension be prevented?
- Orthostatic Hypotension At A Glance
- Patient Discussions: Orthostatic hypotension: Effective Diagnosis
- Find a local Cardiologist in your town
Orthostatic Hypotension and Yoga
Author: Richard Weil, MEd, CDE
Medical Editor: Jay W. Marks, MD
Viewer Question: I sometimes feel dizzy while doing some yoga stretches where the head is lower than the heart (like downward facing dog). What types of exercise should you avoid when you have low blood pressure?
Fitness Expert’s Response: The medical term for your condition is orthostatic hypotension. It typically occurs in situations like you are describing when there is a sudden change in posture, particularly so when the head rises from below the heart, but it can also happen from a supine or prone position when the head is level with the heart. The reason it happens is that circulation (blood pressure) isn’t forceful enough to return adequate blood to the brain and so there is a moment of dizziness. The danger is that you can pass out, and so you need to take precautions to avoid the problem.
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What is orthostatic hypotension?
When a person stands up from sitting or lying down, the body must work to adjust to that change in position. It is especially important for the body to push blood upward and supply the brain with oxygen. If the body fails to do this adequately, blood pressure falls, and a person may feel lightheaded or even pass out. Orthostatic hypotension is the term used to describe the fall in blood pressure when a person stands (orthostatic= upright posture of the body; hypo= less + tension=pressure).
Adequate blood supply to the body’s organs depends upon three factors:
- a heart strong enough to pump,
- arteries and veins that are able to constrict or squeeze, and
- enough blood and fluid within the vessels.
When the body changes position, a variety of actions occur involving all parts of the cardiovascular system as well as the autonomic nervous system that helps regulate their function.
The autonomic nervous system can be considered to “run in the background” of the body, regulating body processes that we take for granted. There is a balance between the sympathetic system (adrenergic nerves), that speed things up, and the parasympathetic system (cholinergic nerves) that slow things down. These names are based on the type of chemical that is used to transmit signals at the nerve endings.
- Adrenaline (from the sympathetic nervous system) allows the body to respond to stress. Imagine seeing a bear in the woods; your heart beats faster, your palms get sweaty, your eyes dilate, and your hair stands on end.
- Acetylcholine is the chemical that is the anti-adrenaline and is involved in the parasympathetic nervous system.
These two systems are in balance, and yet need to respond to routine changes in the body that happens throughout the day.
- When the body moves to a standing position, pressure monitors (baroreceptor cells) located in the carotid arteries and the aorta sense a subtle drop in blood pressure because of gravity, which causes blood to flow towards the legs.
- Almost immediately, the sympathetic system is stimulated, causing the heart rate to increase, the heart muscle to contract or squeeze more forcefully, and blood vessels to constrict or narrow.
- All of these actions serve to increase the blood pressure so that an adequate amount of blood can still be pumped to the brain and other organs.
- Without these changes, gravity would cause the blood to remain in the lowest part of the body and away from the brain, causing symptoms of lightheadedness or even passing out.
Orthostatic hypotension is not a disease or a complaint from an individual; it is an abnormal change in blood pressure and heart rate associated with an illness.
Next: What causes orthostatic hypotension?
Orthostatic hypotension: Effective Diagnosis
How was your orthostatic hypotension diagnosed?
The following Patient Discussions have not been medically reviewed. See additional information.
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