What Is Orthostatic Hypotension?

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Orthostatic hypotension is a drop in blood pressure that occurs when standing up and can cause dizziness, unsteadiness and sometimes fainting, especially in older adults.

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What Happens in the Body?

When we stand up, gravity causes blood to pool in the legs. Normally, the body quickly compensates by:

• Constricting blood vessels

• Increasing heart rate

• Stabilizing blood pressure

In orthostatic hypotension, this regulatory response is impaired. As a result, the brain temporarily receives too little blood, leading to symptoms.

Medically, the condition is defined as a drop in blood pressure of at least:

• 20 mmHg systolic

• or 10 mmHg diastolic

within three minutes of standing [1].

Common Symptoms

• Dizziness

• Blurred or darkened vision

• Unsteadiness

• Weakness

• Fainting

Symptoms often last seconds to minutes, but even brief dizziness can lead to a fall [2].

How Common Is It?

Orthostatic hypotension affects:

• About 5% of middle-aged adults

• Up to 20% of people over 70

• A high proportion of residents in long-term care facilities

It is particularly common in people with:

• Parkinson’s disease

• Diabetes with neuropathy

• Heart disease

• Previous stroke

Common Causes

Aging

Blood vessels become less elastic and the nervous system responds more slowly.

Medications

Commonly associated with:

• Antihypertensive drugs

• Diuretics

• Antidepressants

• Parkinson’s medications

Dehydration

Low fluid intake reduces blood volume.

Neurological Conditions

Diseases affecting the autonomic nervous system impair blood pressure regulation [3].

Link to Fall Risk

Orthostatic hypotension is a common underlying cause of sudden falls in older adults.

Risk increases when:

• Standing up quickly

• Getting up at night

• Multiple medications are combined

• Balance is already impaired

Research shows the condition is associated with recurrent falls and hip fractures [2].

Treatment and Prevention

Treatment depends on the underlying cause and may include:

• Adjusting medications

• Standing up slowly

• Increasing fluid intake

• Compression stockings

• Balance and strength training

In some cases, medication may be prescribed to stabilize blood pressure.

When to Seek Medical Care

Recurrent dizziness when standing or unexplained falls should be evaluated. Blood pressure should be measured both lying down and standing.

More information is available via 1177 Vårdguiden (Sweden) or your local healthcare provider.

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