What Causes Orthostatic Hypotension?

Orthostatic Hypotension

Orthostatic hypotension, also known as postural hypotension, is a condition characterized by a sudden drop in blood pressure when a person stands up from a sitting or lying position. Several factors can contribute to orthostatic hypotension, including:

  • Dehydration: Inadequate fluid intake or fluid loss from factors such as vomiting, diarrhea, excessive sweating, or certain medications can lead to reduced blood volume and lower blood pressure, predisposing individuals to orthostatic hypotension.
  • Medications: Certain medications, particularly those used to treat high blood pressure (antihypertensives), diuretics, antidepressants, antipsychotics, and medications for Parkinson’s disease, can cause orthostatic hypotension as a side effect. These medications can affect blood pressure regulation or fluid balance in the body.
  • Age-related changes: As people age, the body’s ability to regulate blood pressure and respond to changes in position may decline. Age-related changes in blood vessel elasticity, autonomic nervous system function, and baroreceptor sensitivity can increase the risk of orthostatic hypotension in older adults.
  • Prolonged bed rest or immobility: Spending extended periods in a supine or seated position, such as during hospitalization or convalescence, can lead to blood pooling in the lower extremities and reduced venous return to the heart. This can result in orthostatic hypotension when the person attempts to stand up.
  • Pregnancy: Changes in blood volume, hormonal fluctuations, and pressure on blood vessels due to the growing uterus can contribute to orthostatic hypotension during pregnancy, particularly in the later stages.
  • Autonomic nervous system disorders: Conditions that affect the autonomic nervous system, such as diabetes mellitus, Parkinson’s disease, multiple system atrophy, pure autonomic failure, or amyloidosis, can disrupt blood pressure regulation and lead to orthostatic hypotension.
  • Neurological conditions: Neurological disorders or damage to the nerves controlling blood pressure regulation, such as peripheral neuropathy, spinal cord injuries, or autonomic neuropathies, can cause orthostatic hypotension.
  • Volume redistribution: Conditions that cause blood to pool in the lower extremities, such as varicose veins or venous insufficiency, can reduce venous return to the heart and predispose individuals to orthostatic hypotension when standing up.
  • Acute blood loss: Acute hemorrhage or significant blood loss, such as from trauma, surgery, or gastrointestinal bleeding, can lead to orthostatic hypotension due to reduced blood volume.

Orthostatic hypotension can cause symptoms such as dizziness, lightheadedness, blurred vision, weakness, fatigue, or fainting upon standing. Treatment may involve lifestyle modifications (such as increasing fluid and salt intake), adjusting medications, wearing compression stockings, and implementing strategies to prevent sudden changes in position. In some cases, further evaluation and management by a healthcare professional may be necessary to address underlying causes or complications associated with orthostatic hypotension.

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