Postural Hypotension

Postural hypotension is a sudden fall in blood pressure that occurs when changing position from lying or sitting position to standing.

What are the symptoms of postural hypotension?

The condition causes reduced blood flow to the brain and muscles, causing a variety of symptoms:

Feeling dizzy and light-headed
Visual blurring or double vision
Loss of consciousness, such as a faint (this is uncommon)
Feeling vague or confused
Pain across the back of shoulders and neck
Weakness and fatigue.

When might the symptoms occur?

Changing from lying or sitting positions to standing
Early mornings
After large meals
After excess alcohol
After any prolonged period when on your feet.

Certain factors can worsen your symptoms:

Dehydration
Anaemia
Illness that causes you to have prolonged period of immobility
Increased body temperature e.g. in an overcrowded room, warm weather or after a hot bath
Medications – e.g. blood pressure tablets and Parkinson’s medications.

What to do when you get symptoms

Symptoms are a warning that your blood pressure is too low. The only way to improve this is:

STOP what you’re doing
SIT down or LAY if possible
DRINK some water – 2 glasses of water will usually bring your blood pressure up within 15 minutes
THINK about what has triggered your symptoms.

What to do if you faint

Your family or those around you need to:

Lie you down flat
Raise your legs up, if possible, to help blood flow to the brain
If no response to these measures, urgent medical attention is needed.

Can exercise help postural hypotension?

Some exercises might improve symptoms by helping blood flow to the correct place in the body.

You could try these before you stand up:

Hand grips – clench hands into a fist
Leg crossing
Arm muscle tensing – as shown opposite.

Management of postural hypotension

Avoid dehydration – drink at least 2 litres of fluid each day – a large glass of water early in the morning before you get out of bed.
Keep your head up in bed – can use a foam wedge under mattress to help this or extra pillows.
Prepare for mornings – take blood pressure medications before you get out of bed, sit up slowly and sit on side of bed before slowly standing up.
Keeping cool.
New medications – read information leaflet, ask pharmacist or doctor if these can affect your blood pressure. Do NOT STOP medications without consultation with your doctor.

Some things to try

Two large glasses of water in the morning before you get out of bed (if symptoms worse in the morning) might help. Try smaller meals at regular intervals. Long support stockings can help – they should be worn all day and as directed by your doctor.