Orthostatic Hypotension

What is Orthostatic Hypotension?

Orthostatic hypotension describes a drop in blood pressure sufficient to cause inadequate blood supply to the brain. This results in symptoms of dizziness, falls and blackouts. The fall in blood pressure may occur quickly and may happen at any time after getting up from the lying or sitting positions. You will usually feel better if you lie down.

There are some simple things that you can do to improve your symptoms. This leaflet contains advice that will help you.

There are many causes of orthostatic hypotension. It can occur at any age, but is more common in older people. Some medications can make the condition worse. Your doctor will advise you.

What should I do if I feel dizzy?

• Sit down immediately
• If possible, lie down flat
• Put your legs in the air, for example against a wall
• When you feel well again, get up cautiously. However, if you have further symptoms you may need to lie down again.

How can I prevent the symptoms occurring? 

• Take particular care in the morning. Blood pressure tends to be lowest in the morning and your symptoms are likely to be worst then.
• Get out of bed in stages. Perform arm and leg exercises before sitting up and again before standing. Cross and uncross your legs firmly. Be prepared to sit down again promptly if you have symptoms at any time.
• Avoid sudden changes in posture. Bending or stooping suddenly may make your symptoms worse. Try to pause in between changes in position.
• Avoid sitting or standing for long periods. If you do have to stand still, then clench and unclench your calves or rock forward on the balls of your feet to encourage blood flow.
• Raise the head of your bed with blocks. Use bricks or heavy books to raise the head of the bed by about six inches. This will help with morning dizziness.
• Wear support stockings or tights. This will help to return blood to the heart. Take them off before going to bed.

Does what I eat and drink affect my symptoms?

• Increase your fluid intake. You need to drink 3-4 pints (1.5-2 litres) of noncaffeinated fluids in the first few hours of the day. Then take sufficient fluid throughout the day to keep your urine clear.
• Drink strong tea or coffee. This will help keep your blood pressure up. Drink up to five cups per day.
• Take small, frequent meals. Some patients have large drops in blood pressure one or two hours after meals. Small meals help prevent this problem.
• Avoid excess alcohol. Alcohol will make your symptoms worse. You may find that you can tolerate a small drink, but avoid taking large amounts in one go.
• Increase your salt intake. Only do this after discussion with your doctor. Do not increase your salt intake if you are receiving treatment for high blood pressure.

Are there any other treatments for Orthostatic Hypotension?

It is always preferable to avoid using medication if possible. Please try to stick to the advice given above as this may relieve your symptoms entirely. However, some people may need medications for orthostatic hypotension. The doctor will discuss this with you if necessary.

If you have any questions about this advice sheet,
Contact Falls and Syncope Service
Telephone 0191 282 5237
Hours Monday to Friday 9.00am – 5.00pm