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Orthostatic hypotension, or orthostatic hypotension, is associated with dizziness, a feeling of weakness after getting out of bed quickly. Although these symptoms pass, they are often disturbing, and if severe, they can be bothersome. What are the causes of orthostatic hypotension? What might its effects be? What is an Orthostatic Test? What is the treatment of orthostatic hypotension?

Contents:

  1. Orthostatic hypotension - what is it?
  2. Orthostatic hypotension - symptoms
  3. Orthostatic hypotension - causes
  4. Orthostatic hypotension - orthostatic test
  5. Orthostatic hypotension - treatment

Orthostatic hypotension , otherwiseorthostatic hypotension , is a pressure drop caused by a change in body position. Blood pressure is constantly fluctuating and is influenced by countless factors, including body position, especially its changes.

This is mainly due to the action of gravity. This effect is minimized by the tension of the vascular walls and the work of the heart, but it cannot be completely eliminated.

Orthostatic hypotension - what is it?

In the standing position, a little more blood is found in the lower body or lower parts (segments) of the lungs, when we think of the so-called circulation. small, so where there is more blood, there is also a higher blood pressure.

It is a completely normal state and our body is adapted to this state of affairs. This effect of blood displacement and hence increased blood pressure is also the reason why the cuff of the blood pressure monitor should be placed at the level of the heart during measurement.

When we lie down, the blood pressure throughout the body is the same, the effect of gravity is eliminated, and measurements can be made anywhere. What happens when we change the position of the body?

According to the laws of physics, when we get out of bed, the blood flows to the legs, the amount of blood decreases, so the pressure in the rest of the body, especially in the head, drops.

Such changes in blood pressure and blood quantity are read by baroreceptors and properly neutralized by the body: the autonomic nervous system stimulates the heart through the so-called beta receptors to temporarily speed up the work to pump blood and ensure the right amount reaches the brain -smaller volumes of blood are pumped, but delivered more frequently.

This way - even though the pressure is lower - the total amount of blood remains the same or only slightly decreases. In addition, the acceleration of the heartbeat also serves to remove the excess blood that has appeared in the lower parts of the body. Once this has happened and the pressure in your brain has risen, your heart rate is back to normal.

In addition, the entire process is accompanied by slight changes in the diameter of the vessels - contraction of the arteries in the legs, thus reducing the volume of blood supplied to them. If the entire mechanism of acceleration of the heart rate and vascular activity is working efficiently, orthostatic hypotension is absent or very weak.

Orthostatic hypotension - symptoms

Orthostatic hypotension is caused by a temporary decrease in blood supply to the brain and eyes, sothe symptoms of orthostatic hypotensionrelate to these organs.

Symptom may be fainting typically upon standing up. In a slightly different mechanism than the one described earlier, and less frequently, it occurs after standing for a long time or staying in a crowded, hot room, or after exercise.

Here, the drop in blood pressure in the brain is related to the expansion of blood vessels in the skin, which means that more blood flows through them and heat is released more easily, the body prevents overheating, but thus exposes the brain to temporary ischemia. Other common symptoms include:

  • dizziness
  • feeling weak
  • sometimes spots in front of eyes
  • temporary disturbance of vision and balance
  • do chest pain

All these symptoms usually appear after standing, but of course they can also be so-called pre-emptive symptoms preceding fainting.

If these symptoms are more prolonged, it is worth reporting it to the doctor, because the cause may be different or the severity of the hypotension is so great that treatment should be started. Loss of consciousness should always be consulted with a doctor who will decide whether it is necessary to diagnose it.

Orthostatic hypotension - causes

Orthostatic hypotension is the result of low blood pressure or inadequate heart response (failure of the heart to accelerate). Low blood pressure is observed in people who are dehydrated, e.g. as a result of taking drugs that stimulate diuresis or simply consuming too little fluid.

Similarly, vasodilators lower blood pressure, such as nitroglycerin, some diuretics, and sildenafil (Viagra).

No heartbeat is usualcaused by taking drugs that block the receptors that stimulate its work (beta receptors). These drugs, such as metoprolol (Metocard, Beto), are used in diseases of the cardiovascular system, ischemic heart disease, arterial hypertension and others.

Therefore, orthostatic hypotension sometimes appears after the initiation of treatment of arterial hypertension or after its intensification, because in this case both mechanisms are disturbed - on the one hand, drugs stimulating diuresis, but also drugs blocking beta receptors are used.

Due to the disturbance of the nervous reflex, hypotension may be a symptom of Parkinson's disease or vegetative neuropathy. Of course, it is not always possible to establish the cause of the ailments.

Important

Orthostatic hypotension - diagnosis. Orthostatic test

The so-called upright test ( orthostatic test ), which consists in measuring the pressure lying down and standing at appropriate intervals. A positive result, i.e. allowing the diagnosis of hypotension, is present in three cases:

  • when systolic blood pressure drops by at least 20 mmHg
  • when systolic blood pressure drops below 90 mmHg
  • when diastolic blood pressure drops by at least 10 mmHg

Orthostatic hypotension - treatment

Orthostatic hypotension itself is not dangerous to he alth and life, but it can cause falls, and thus - injuries.

Therefore, measures should be taken to minimize the severity of the ailment, such asorthostatic hypotension , especiallyin the elderlywho are especially prone to such injuries, and in whom they can have very serious consequences (e.g. long hospitalization or bed rest).

Orthostatic hypotension is not serious, but can be very bothersome. It can be reduced by simple methods, It is rarely necessary to modify the current treatment or to include appropriate medications.

First of all, avoid situations in which it occurs, e.g. avoid stuffy rooms or high temperatures. In addition, the simplest activities help, such as sitting for a while before getting out of bed or using a footrest if hypotension occurs even in a sitting position.

Secondly, it is worth learning to recognize the symptoms that occur before fainting (examples are described above), if they occur, and if they occur, lie down or sit down, cross your legs or squeeze a ball in your hand.

Third, you should take care of the correct amount of water in the bodyand avoid dehydration - consume about 2.5 liters of fluid a day. Sometimes drinks with an increased amount of electrolytes also help, but they can only be used by people without high blood pressure. Sometimes it helps to drink coffee and the caffeine it contains.

If medical intervention is required, it is sometimes recommended to wear a belly belt, compression stockings, which reduce blood build-up in the legs, abdomen and increase blood flow to the heart. If possible, conditions that may cause fainting (e.g. coughing) are treated.

Sometimes the treatment changes - specific drugs or their doses, if a person with hypotension is taking preparations that may cause it.

Orthostatic training is also possible, consisting in adopting a standing posture with a back against a wall for a gradually extended time, up to 20-30 minutes a day.

Pharmacological treatment is primarily midodrin, a vasoconstrictor, and fludrocortisone, a mineralocorticoid that causes sodium and water retention in the body. However, oral medications are used very rarely if the hypotension is very bothersome. In extreme cases, it may be necessary to implant a pacemaker, but this is preceded by a thorough and long-term diagnosis of syncope.

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Category:

Cardiology