Thứ Hai, 13 tháng 1, 2014

Postural Hypotension

Postural Hypotension When a person suddenly gets up after sitting or lying down for long time, he may feel slightly dizzy. This condition is called postural hypotension. It is a mild elevated blood pressure observed when a person stands up after extended time of sitting. Some people may feel lightheaded or even faint for sometime during this episode. Postural hypotension occurs only for few seconds after standing up. Also called as orthostatic hypotension this blood pressure is not serious and does not require to be treated. But if the dizziness lasts for minutes then you need to consult your physician.


Symptoms :


Some of the common signs of postural hypotension are feeling dizzy, lightheaded or confused when a person stands up suddenly after sitting. He may have blurred vision or may feel suddenly weak, and sometimes he may faint. There will be slight confusion of thoughts for some minutes and on rare cases there can be nausea followed by vomiting. It is not a matter of concern when you get these symptoms only for few seconds. It is quite common for many adults to experience such symptoms after sitting for a lecture or after listening to concert or after prayer hours in the church.


Causes :


Postural hypotension can be caused due to diabetes and more particularly due to peripheral neuropathy. There is loss of sensation for few seconds or minutes due to lack of blood supply to the nerve. This is largely seen on aged people when they try to get up from the bed after hours of sleep. This condition is also observed on people with Parkinson’s disease and anemia.


This process can be explained as follows. As one gets up there will be increased flow of blood to the legs. This would automatically decrease the blood circulation in the heart. There are special cells in the heart for sensing the blood pressure and these cells become alert due to fall in blood pressure. This in turn will trigger more of blood to the heart giving rise to increased blood pressure.


Dehydration can cause postural hypotension since you will lose excess of fluids when you get dehydrated. You will feel weak and dizzy which would cause hypotension.


Certain heart related problems like bradycardia (low heart beat) or any other valve problems in your heart can trigger hypotension. Actually elevated blood pressure happens for preparing the body to respond rapidly thus pumping more of blood to the heart and sending it to your legs when you stand up. Diabetes and nervous system disorders can cause this problem.


Who are at risk?


Aged people or individuals above 70 can get postural hypotension. The special cells will naturally slow down to pump enough blood to the heart as one grows old. The heart will also become weak and would beat faster for compensating the reduced blood pressure causing hypotension.


Intake of certain powerful drugs like diuretics, beta blockers and benign prostatic hyperplasia can cause this problem. Certain diseases like Parkinson’s syndrome will pose risk to the heart thus lowering the blood pressure. People who are in bed rest for long time will obviously become weak and will experience hypotension when they suddenly get up. The stage of pregnancy can also cause hypotension thus dropping the blood pressure.


Diagnoses :


Your doctor would monitor your blood pressure continuously making you to sit and stand to find out if you have postural hypotension. He may request for complete blood culture, ECG and echo test for studying the heart function fully. For some people stress test is to be taken asking them to walk rapidly on treadmill thus making the heart to work harder. Your doctor will monitor the BP simultaneously.


Treatment :


Underlying cause has to be found out before giving any treatment for postural hypotension. For many people, there is no need for any treatment since it is quite common.


Treatment is given by reducing the dosage of blood pressure medications gradually. The affected person should make necessary changes in his lifestyle. He should drink plenty of water or fluids and avoid going out in hot sunlight. He should stand up slowly without making sudden movements. As per the instructions of the doctor, he should reduce or increase salt content in his diet.


It is recommended to use compression stockings for regularizing the blood flow to the legs so that the symptom of postural hypotension is reduced.


Drugs like fludrocortisones are prescribed for treating hypotension which would increase the fluid content in your blood. Midodrine is given for regularizing the blood pressure and reducing the level of blood vessels from expanding. NSAID, pyridostigmine or mestinon is given with other medicines for reliving the symptoms of hypotension.


Home Remedies :


You can add more salt in the diet after monitoring your blood pressure with your doctor. Drink plenty of fluids and keep the body hydrated. Do not get up suddenly from the sitting position. Do regular exercises and wear stockings to prevent accumulation of blood in the legs. Streamline your activities and slow down the pace of your activity while standing up after sitting for long hours.


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