Studying Orthostatic Hypotension

 

 

Did this ever happen to you?

As you get out of bed or get up from a chair, you suddenly feel faint or dizzy.

When you get up, your head may spin since your blood pressure immediately falls.

You can experience tunnel vision, your eyesight might be blurry or faint. You might also feel confused and lightheaded, which would only make this already terrifying experience worse. Less frequently, you can experience a dull ache on the backs of your shoulders and neck. Rarely, you might faint or lose consciousness.

These are signs of orthostatic hypotension, a disorder that develops when blood pressure decreases significantly as a result of a  shift in position.

 What is Orthostatic Hypotension

An excessive drop in blood pressure (BP) when in an upright position is known as orthostatic (postural) hypotension.

A decline of more than 20 mm Hg systolic, more than 10 mm Hg diastolic, or both meet the mainstream definition. Within a few seconds to a few minutes of standing, fainting, light-headedness, dizziness, confusion, or blurred vision symptoms appear, and they  disappear quickly upon lying down.

Patients occasionally have generalized seizures, syncope, or even falls. A strenuous workout or a large lunch may make symptoms worse. The majority of additional symptoms and indicators are related to the reason.

Orthostatic hypotension is not a particular ailment but rather a symptom of poor BP regulation brought on by some circumstances. More and more evidence points to a link between postural hemodynamic control problems and an increased risk of cardiovascular disease and all-cause death. 

Pathophysiology of Orthostatic Hypotension

Blood (12 to 1 L) typically pools in the veins of the legs and trunk as a result of the gravitational tension of rapidly standing up.

The consequent brief reduction in venous return lowers cardiac output and subsequently blood pressure. Autonomic reflexes are triggered as a result, and the aortic arch and carotid sinus baroreceptors quickly restore normal blood pressure. 

The sympathetic nervous system raises the heart rate and contractility as well as the capacitance vessels' vasomotor tone. Heart rate is also raised by simultaneous parasympathetic (vagal) suppression. When people stand up, their blood pressure and heart rate fluctuate very little, and they usually don't experience any symptoms.

The renin-angiotensin-aldosterone pathway becomes activated with prolonged standing, and vasopressin (antidiuretic hormone [ADH]) release results in sodium and water retention as well as an increase in blood volume.

Pathogenesis of Orthostatic Hypotension 

If the afferent, central, or efferent portions of the autonomic reflex arc are compromised by diseases or medications, if myocardial contractility or vascular responsiveness is inhibited, if hypovolemia is present, or if hormonal reactions are flawed, homeostatic mechanisms may not be sufficient to restore low blood pressure.

Depending on whether symptoms are sudden or gradual, different causes apply.

Acute orthostatic hypotension's most frequent causes include

a.) Drugs

b.) Hypovolemia

c.) Prolonged bed rest

Chronic orthostatic hypotension's most typical causes include

a.) BP regulation alterations brought on by aging

b.) Drugs

c.) impaired autonomic function

Orthostatic hypotension following a meal is also typical. Blood pooling in the gastrointestinal system and the insulin response to high-carbohydrate meals are potential causes; alcohol use makes these conditions worse.

Orthostatic Hypotension Evaluation

When systolic blood pressure drops by 20 mm Hg or diastolic blood pressure drops by 10 mm Hg within 3 minutes of standing, orthostatic hypotension is suspected. A reason must be found after orthostatic hypotension has been identified.
 

A word from the team

Simply waiting a minute before getting out of bed will drastically cut down on orthostatic hypotension episodes since it gives your heart time to acclimatize. When you've been sleeping and wake up in the middle of the night, this is very important.

So, be mindful of your posture and any symptoms, and look after your heart.

Contact Us right away if you want to learn more about heart health.

Source: Studying Orthostatic Hypotension