Low blood pressure when standing up

Orthostatic hypotension

You get up too quickly in the morning and suddenly you feel dizzy or go black. Circulatory problems like this are not uncommon. They last a few seconds and are usually harmless. The cause is falling blood pressure (hypotension), because when you stand up, the blood can sink due to gravity.

If such circulatory problems occur frequently and improve as soon as you sit down, you may have orthostatic hypotension or dysregulation. Typical symptoms include dizziness, ringing in the ears, weakness in the legs, pain in the neck and shoulders, or even blacking out.

This means that blood pressure is lower than it should be when standing, which leads to temporary insecurity when standing. This also creates a risk of falls and broken bones. This form of hypotension becomes even more problematic when you have to stand for work or in certain situations. However, such symptoms can be alleviated early on with simple means.

Reflexes weaken with age

Blood pressure drops slightly when you stand up because more blood flows to your legs due to gravity when you stand. Normally, the body compensates for this fluctuation in blood pressure through circulatory reflexes, whereby the blood vessels in the legs contract and the heart beats faster. The autonomic nervous system is responsible for this and controls unconscious body functions such as heart rate, body temperature, blood pressure and digestion.

Unfortunately, with increasing age, the autonomic nervous system gradually loses the ability to compensate for gravity-related blood pressure fluctuations. Diseases, in which the cells of the autonomic nervous system are damaged, causing a lack of performance of the nervous system.

Finally, medications can also cause orthostatic hypotension, for example as a side effect when taking medications for Hypertension, prostate enlargement or depression.

Rapidly falling blood pressure often means that too little blood flows to the brain. Dizziness, dizziness and weakness, even confusion, blurred vision or fainting when standing up are typical symptoms of insufficient blood flow to the brain. In isolated cases, breathing problems, nausea, headaches and neck or chest pain when standing can also occur with orthostatic hypotension.

Not only do sufferers suffer from dizziness when standing up, but also when physically StressThese symptoms occur when there is a lack of fluids or after illness. Blood pressure can even drop more quickly after large meals.

The Doctor A typical drop in blood pressure associated with orthostatic hypotension occurs when blood pressure falls by more than 20-30 mmHg and/or the second value falls by at least 10 mmHg within three minutes of standing up.

Underlying diseases such as anemia or dehydration can be diagnosed through blood and urine tests. The doctor can get a comprehensive picture using a 24-hour blood pressure measurement or an analysis of the functioning of the autonomic nervous system.

Finally, the “tilt table test” can also be used to Diagnosis orthostatic hypotension can be determined. The patient is placed on a table with a footrest, which is then raised to an upright position. At the same time, blood pressure is continuously measured and the pulse rate is recorded.

Relieve symptoms of orthostatic hypotension

The first measures to be taken after the diagnosis of orthostatic hypotension, in consultation with the doctor, are to consume more fluids and salt and to adjust the dosage of medications in order to reduce side effects.

Further measures:

• change movement sequences
  Those affected know when the circulatory problems occur and can actively contribute to stabilizing their blood pressure. It is always important to get up slowly and gradually. If the symptoms seem too severe, sit or lie down again and only continue when you feel safe on your feet. If a drop in blood pressure is imminent, you should cross your legs while standing and press your thighs together. Alternatively, you can put one leg on a step or a chair and bend forward.
  Such exercises activate the muscles and promote blood flow from the legs to the heart.
  
  
• compression stockings
  You can stabilize your circulation by wearing compression stockings or an abdominal compression bandage. This prevents blood from pooling in the legs.
  
  
• Check medication dosage
  Complaints related to orthostatic hypotension should not be treated independently with additional medication, as new side effects may occur. The doctor knows which medications can be taken or discontinued.
  
  
• Some patients with orthostatic hypotension have high blood pressure when lying down. In these cases, blood pressure-increasing medications usually drive blood pressure even higher. Such problems can be prevented by sleeping with the head end elevated and by not taking any blood pressure medication at least five hours before going to bed.