Post orthostatic hypotension: what to know

Standing shifts blood toward the legs. Normally, blood vessels tighten and the heart adjusts to keep blood flowing to the brain. If that response is delayed or insufficient, symptoms may appear after getting out of bed, rising from a chair, or standing after a meal. Dehydration, illness, prolonged bed rest, some medicines, and nervous-system or heart problems can contribute. A clinician may compare blood pressure and pulse while you are lying down and standing.

Rise in stages: sit first, pause, move your feet, then stand while holding a stable surface. If symptoms begin, sit or lie down promptly. Drink fluids if your clinician has not restricted them, avoid sudden heat exposure, and ask before changing blood-pressure medicines. Keep a record of triggers, position, symptoms, and any fainting. Arrange a GP consultation for repeated episodes, falls, or unexplained symptoms.

Seek urgent care after fainting, an injury, chest pain, severe breathlessness, a new irregular heartbeat, sudden weakness, trouble speaking, or a severe headache. Emergency assessment is also needed if dizziness is persistent, occurs while exercising, or comes with confusion. Recurrent but milder episodes still warrant a medical review because the cause and medicine plan may need checking.

Could any of my medicines or health conditions be contributing? How should my blood pressure be monitored? Are fluids or compression garments suitable for me? What should I do if I feel faint? Which symptoms mean I should seek emergency care?