Tilt test and orthostatic hypotension: what to know

Orthostatic hypotension, also called postural hypotension, is a drop in blood pressure after moving from lying down to sitting or standing. It can cause light-headedness, blurred vision, weakness, or fainting. A tilt-table assessment starts with you lying safely on a supported table. The table is then raised while clinicians monitor your blood pressure, pulse, and symptoms. The pattern matters: symptoms with a blood-pressure fall, a heart-rate change, or both can help guide the next assessment.

A result does not explain every episode of dizziness by itself. Dehydration, medicines, prolonged bed rest, heart rhythm problems, nervous-system conditions, and other causes may be considered alongside your history and examination.

Follow the test team’s instructions about eating, drinking, and medicines before the appointment. Tell them about fainting, palpitations, pregnancy, and every medicine or supplement you take. Until the cause is clearer, rise slowly, pause at the edge of the bed, and sit or lie down when warning symptoms begin. Fluids may help some people, but increasing salt or changing medication should be discussed with a clinician first.

Keep a brief record of when symptoms occur, what you were doing, recent illness, fluid intake, and whether symptoms improve when lying down. A [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) can help review the pattern and arrange suitable tests. Read more about [Dizziness](/symptoms/dizziness/).

Seek urgent help for fainting during exercise, chest pain, severe breathlessness, a new irregular heartbeat, one-sided weakness, trouble speaking, severe headache, or an injury after a fall. Get prompt medical advice if dizziness is repeated, worsening, or stopping you from walking safely. Do not drive while you feel close to fainting.

Could my medicines, dehydration, anaemia, heart rhythm, or another condition be contributing? What should I do if symptoms start? Do I need a tilt test or another form of blood-pressure monitoring? Should I change exercise, fluids, salt, or compression clothing?