Orthostatic Hypotension
1 medicine
Orthostatic hypotension is a sudden fall in blood pressure that happens within minutes of standing up, causing dizziness or fainting. Lifestyle measures come first, with midodrine used when they are not enough.
Key facts
- Orthostatic hypotension is a sudden fall in blood pressure within a few minutes of standing up, briefly reducing blood flow to the brain.
- It causes lightheadedness, blurred vision or fainting, and is more common in older adults and people with diabetes, Parkinson's disease or autonomic nerve disorders.
- Dehydration, prolonged bed rest, heat and standing up too quickly are common triggers; some blood-pressure and diuretic medicines can cause it too.
- Rising slowly, staying hydrated and wearing compression stockings help most people; midodrine is used when lifestyle measures are not enough.
What is actually going on
Orthostatic hypotension is a sudden fall in blood pressure that occurs within a few minutes of standing up. The body normally tightens blood vessels and raises heart rate to keep blood flowing to the brain against gravity; when that reflex is sluggish or blunted, the brain briefly receives less blood, causing lightheadedness, blurred vision or fainting. It is more common in older adults and in people with diabetes, Parkinson's disease or other autonomic nerve disorders, and can also be a side effect of certain blood-pressure or diuretic medicines.
Why it happens
The most common triggers are dehydration, prolonged bed rest, heat and standing up too quickly. Fluid loss through sweating or inadequate fluid intake can make symptoms noticeably worse, and medicines that lower blood pressure or increase urination can compound the effect.
How it is managed
Simple steps help most people: rising slowly, drinking enough water, adding a little extra salt to the diet where the heart allows, and wearing compression stockings. When lifestyle changes are not enough, midodrine is the primary medicine used to raise blood pressure in the standing position. It works by tightening blood vessels and belongs to the broader heart and blood pressure group of treatments.
When to see a doctor
See a doctor promptly if you experience fainting, chest pain or repeated falls, so any underlying cause can be identified and treated.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.