What should you know about orthostatic hypertension?

Standing shifts blood into the legs, and the nervous system normally adjusts heart rate and blood-vessel tone. In orthostatic hypertension, the measured pressure rises rather than following the expected pattern. One reading is not enough to establish a diagnosis because stress, caffeine, pain, recent activity and measurement technique can affect results. Your clinician may compare readings after resting and after standing, while also reviewing conditions such as [Hypertension](/conditions/hypertension/), kidney disease, obesity or sleep apnoea.

Arrange a medical review if home or clinic readings repeatedly rise after standing. Use a validated cuff, sit quietly before measuring, keep the arm supported, and record the time, posture, reading and symptoms. Do not change blood-pressure medicine on your own. Your clinician may review medicines, hydration, sleep, kidney health and cardiovascular risk, and may request home monitoring or further tests.

Seek urgent help for chest pressure, severe breathlessness, fainting, sudden weakness on one side, trouble speaking, new confusion or a sudden severe headache. These can signal emergencies such as a heart or brain event and need immediate assessment. Contact your clinician soon if readings remain high or you develop repeated headaches, visual changes or palpitations.

Ask how to measure at home, whether your medicines could affect standing readings, whether ambulatory monitoring is useful, and which symptoms should trigger urgent care. Ask how your overall cardiovascular and kidney risk will be assessed.