Orthostatic hypotension: Symptoms, Causes, Treatment

The Orthostatic hypotension , Also known as postural hypotension, or in its shortened form, orthostasis, occurs when a person's blood pressure drops suddenly when standing from a sitting or lying position.

Ortostasis means upright posture, and hypotension means low blood pressure. Orthostatic hypotension is usually mild and may last from a few seconds to a few minutes after standing up.

Orthostatic hypotension

If orthostatic hypotension lasts longer than mentioned, it can be a sign of more serious problems and requires a consultation with the doctor as soon as possible. Even more so if the person often feels stunned when standing up.

The loss of consciousness (even for a brief period) is considered an emergency that requires the attention of a health professional immediately.

Orthostatic hypotension, if mild, is not a cause for concern and usually does not require treatment. Many people occasionally feel dizzy or dizzy when changing positions, for example when standing up or going to bed abruptly. For the most severe cases requiring treatment, it is imperative to investigate the cause.

Scientific definition of orthostatic hypotension

Orthostatic hypotension is a physical finding defined by the American Autonomic Society and the American Academy of Neurology as a decrease in systolic blood pressure of at least 20 mm Hg or a decrease in diastolic blood pressure of at least 10 mm Hg within Of the three minutes of standing. The condition may be symptomatic or asymptomatic.

In healthy people, muscle contraction increases the venous return of blood to the heart through unidirectional valves that prevent blood from collecting in dependent parts of the body.

He autonomic nervous system Responds to changes in position by narrowing veins and arteries and by increasing heart rate and cardiac contractility. When these mechanisms are defective or if the patient has suffered hypovolemic shock, the picture of orthostatic hypotension may occur.

In people with orthostatic hypotension, gravitational opposition to venous return causes a decrease in blood pressure and threatens cerebral ischemia. Several potential causes of orthostatic hypotension include medications, non-neurogenic causes such as impaired venous return, hypovolemia and heart failure, and neurogenic causes such as multisystemic atrophy and diabetic neuropathy .

Treatment is usually directed at the underlying cause, and a variety of pharmacological or non-pharmacological treatments may alleviate symptoms.

Orthostatic hypotension has been observed in all ages, but it occurs more frequently in the elderly, especially in the sick and fragile.

It is associated with several diagnoses, conditions and symptoms, including dizziness shortly after stopping, increased rate of falls and history of myocardial infarction or transient ischemic attack. It may also be predictive of ischemic stroke.

symptom

The most common symptom of orthostatic hypotension is dizziness or lightheadedness when standing from a sitting or lying position. This sensation, along with other symptoms, usually lasts only a few seconds. Signs and symptoms of orthostatic hypotension include:

  • Sensation of numbness
  • Dizziness
  • Blurry vision
  • Weakness
  • Fainting ( syncope )
  • Confusion
  • Sickness

Symptoms that often accompany orthostatic hypotension include chest pain, difficulty retaining urine, impotence, and dry skin from loss of sweating.

Causes

Orthostatic or postural hypotension occurs when something disrupts the body's natural process to counteract low blood pressure for various reasons.

The function of the heart is to pump blood. If there is little blood volume the pressure decreases and then the blood vessels contract to raise blood pressure.

If this action is inhibited or blocked for some reason, the blood vessels dilate and blood pressure drops.

The nervous system detects and responds to regulate blood pressure. If something is wrong with this control system, blood pressure may fluctuate.

Then, orthostatic hypotension can be caused by many different causes:

  • Dehydration: from fever, vomiting, not drinking enough fluids, severe diarrhea and strenuous exercise with excessive sweating. When dehydrated, the body loses blood volume. Mild dehydration can cause symptoms of orthostatic hypotension, such as weakness, dizziness, and fatigue.
  • Paintings of anemia .
  • Heat: produced by fever, a hot bath, unventilated places.
  • Dialysis.
  • Medicines:

-Psicropharmaceuticals

-Medication to calm heart pains

"Alpha blockers. Medications that are mainly used to treat hypertension - high blood pressure and prostate problems in men. Side effects that may occur are mild drowsiness, Headaches And dizziness, which disappear after the first few weeks of treatment.

  • Autonomic neuropathy is a group of symptoms that appear when there is damage to the nerves that control everyday body functions such as blood pressure, heart rate, perspiration, bowel and bladder evacuation and digestion.

When to consult a medium?

Occasional dizziness or shortness of breath may occur due to mild dehydration, low blood glucose, too much time in the sun or by immersion in a hot tub.

Dizziness or dizziness (in addition to what is already mentioned) can also occur when you are indoors for a long time, at a concert, at a church, or at a conference.

Obviously, if these symptoms occur only occasionally, there is usually no reason to worry. Consultation with the physician is important if the individual experiences frequent symptoms of orthostatic hypotension, in different places and circumstances.

In these cases, it may be helpful to keep a record of the symptoms, when they occurred, how long they lasted, and what the person was doing at that time. Taking into account the degree of danger that could mean to the patient or others.

Treatment

The first steps in the treatment of orthostatic hypotension are diagnosis and treatment of the underlying cause. A patient with symptomatic orthostatic hypotension who has a specific disease or with treatment in process may benefit from alternative interventions, without pharmacological prescription.

Increased salt and fluid intake is often an early step if the patient does not suffer from severe heart failure.

In case of taking allopathic medication, non-steroidal anti-inflammatory drugs may be prescribed in order to increase and expand intravascular volume, but with caution to avoid additional side effects such as headache, edema, weight gain and supine hypertension.

Blood pressure

Blood pressure is called the force that exerts blood against the walls of blood vessels. The pumping action of the heart causes blood to flow into the arteries. The dilation of the vessels in response to this force and its subsequent contraction are important in maintaining blood flow through the vascular system.

When the heart pumps blood into the arteries, blood pressure is higher. This is called systolic pressure. When the heart is at rest, between heartbeat and heartbeat, the diastolic blood pressure decreases.

In humans, blood pressure is usually measured with a special bracelet over the brachial artery (in the arm) or the femoral artery (in the leg). Measurement of blood pressure is usually done with a sphygmomanometer.

The most commonly used are mercury and aneroid. They consist of a system to exert pressure around the arm and a scale that allows to know the pressure.

Two types of pressure are measured:

  1. Systolic pressure (The highest pressure and the first number recorded by the pressure gauge), which is the force that blood exerts on the arterial walls when the heart contracts to pump blood to the peripheral organs and tissues.
  2. Diastolic pressure (The lowest pressure and the second number recorded), which is the residual pressure exerted on the arteries when the heart relaxes between heartbeat and heartbeat. In healthy individuals, systolic pressure is normally between 100 and 140 millimeters of mercury (mmHg). The diastolic pressure is usually between 60 and 100 mmHg.

Reading Values:

  1. 119/79 is considered normal blood pressure.
  2. 140/90 or higher is considered high blood pressure.
  3. 130 and 139 for the highest number, and between 80 and 89 for the lowest number, prehypertension is considered. This means that high blood pressure could be triggered, so action should be taken.

Regulation of blood pressure

By the force of gravity, when a person is incorporated blood accumulates in the legs. This causes blood pressure to decrease because there is less blood flowing back to the heart to be pumped.

Baroreceptors or pressure receptors, formerly called presoreceptors, are simple and sensitive nerve endings found in the blood vessels of all vertebrates and that detect changes in blood pressure and transmit information to the brain.

The brain tells the heart to beat faster to pump more blood to stabilize blood pressure. These cells cause the blood vessels to narrow, offering resistance to blood flow to raise blood pressure.

They are found in abundance in the walls of the internal carotid artery (carotid sinus) and the aorta (aortic arch).

General recommendations

  • Avoid long periods of inactivity, sitting or lying down, or indoors.
  • Sit up slowly when you are sitting or lying down for a long time. In the case of getting out of bed in the morning, after sleeping all night, it is advisable, before getting up, incorporate the head with a complementary pillow and stay in that position for a few minutes. Afterwards, stay for a few moments sitting on the foot of the bed, until you get to stand up progressively.
  • Increase intake of salt and water: It is recommended to take between 1.5 and 2 liters of water a day and between 6 and 10 gr of salt daily. Salt can be incorporated into meals. Increased salt intake and / or decision to add supplementation will always be under the supervision of a physician as it may have serious cardiovascular complications.
  • Compression Stockings: The purpose of compression stockings is to reduce stagnation of blood in the legs and lower body area. There are several options: compression knee stockings, leg full or leg and lower abdomen. Although compression stockings, while not providing relief, can be difficult because it takes a lot of work to fit them.

References

  1. Orthostatic hypotension. Dorland's Medical Dictionary. Recovered at wikipedia.org.
  2. Orthostatic hypotension (postural hypotension). Mayo clinical staff. Retrieved from mayoclinic.org.
  3. Arterial blood pressure. Blood pressure. Physiology. Written by The Editors of Encyclopædia Britannica.Recovered on britannica.com.
  4. High blood pressure in primary health care. History of hypertension, chapter 2. VHL Cuba. Retrieved from engsdl.bvs.sld.cu.
  5. Baroreceptor. Retrieved on 02/02/2017 at en.wikipedia.org.
  6. Bradley, J. M. D., and Davis, K.R. Orthostatic Hypotension. Retrieved at www.aafp.org.
  7. Orthostatic hypotension (postural hypotension). Mayo clinical staff. Retrieved from mayoclinic.org.
  8. Discussion of positional changes in blood pressure using a diagram from the HeartPhys. Retrieved from /appstore.com.
  9. Patient. Trusted medical information and support. Alpha Blockers. © Patient Platform Limited. Registered in England and Wales. Retrieved on patient.info.
  10. Autonomic neuropathy. MedlinePlus. U.S. National Library of Medicine. U.S. Department of Health and Human Services National Institutes of Health. Retrieved at medlineplus.gov.
  11. Bradley, J. M. D., and Davis, K.R. Orthostatic Hypotension. Retrieved at aafp.org.


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