What is postural hypotension?

Postural hypotension (also known as orthostatic hypotension) is a drop in blood pressure when you stand up, from being seated or lying.

This drop causes a reduced blood supply to the brain. This can cause symptoms such as:

• dizziness or feeling light-headed
• unsteadiness
• changes in vision
• feeling vague or muddled
• weakness and fatigue
• pain
• feeling sick
• feeling hot or clammy
• sometimes blacking out.

It is linked to an increased risk of falls and can impact quality of life. There may be no symptoms and it may only be diagnosed when a medical professional checks your blood pressure.

What causes postural hypotension?

It can happen at any age but is more common in older people. Sometimes there is no obvious cause, but it can be caused by:

• not drinking enough fluid
• certain medicines
• being in bed for a long time
• heart conditions
• stress and/or anxiety
• damage to the nervous system, for example Parkinson’s disease or diabetes
• overheating or warm environments
• illnesses, such as an infections or virus.

How can I reduce or manage my symptoms?

• Take care when getting up, especially in the morning – stand up slowly.
• Avoid sitting and standing for long periods of time.
• Eat little and often, avoid larger meals.
• Keep as active as possible.
• Make sure you are drinking enough – six to eight glasses of water per day.
• If you suffer with constipation, speak to your pharmacist.
• Avoid alcohol.
• Avoid very hot baths and showers.

What should I do if I feel the symptoms coming on?

• Stop what you are doing.
• Sit or lie down.
• Once symptoms have settled, get up slowly
• If you are an inpatient, please let your healthcare professional know.

If symptoms happen often, please contact your GP for further advice. They may check your blood pressure when lying then standing or you may need a medicine review.

Please do not stop taking any medicines without discussing it with your GP first.

Exercises

Leg raises

• Sit tall with your back well supported.
• Slowly straighten the leg out in front of you for a count of two.
• Lower the leg for a count of four.
• Rest and repeat, build up to 10 times or more as you progress.
• Repeat on the other leg.

This exercise helps to:

• build up leg strength
• stay independent
• build up stamina.

You can also try:

• marching while sitting down.

Ankle loosener

• Sit tall at the front of the chair.
• Hold the sides of the chair.
• Place the heel of one foot on the floor then lift it, and put the toes down on the same spot.
• Repeat four times on each leg.

This exercise helps to:

• boost circulation
• prevent trips and falls.

More support

• If you have concerns about your blood pressure and/or symptoms, please speak to your GP.
• Speak to your community pharmacist or pharmacy team at your GP practice if you have any questions or concerns about medications, or are struggling to manage your medication.
• For additional information about falls prevention please read our steady on our feet leaflet: kentcht.nhs.uk/leaflet/steady-on-your-feet-beat-falls-trips-and-slips/
• For further falls prevention support visit kentcht.nhs.uk/service/falls-prevention-service for information about our Postural Stability Service, Falls Service or Community Rehabilitation Teams, or speak to your healthcare professional about other services we provide that may be able to help you.
• You may also find other services which could help at kentcht.nhs.uk

Other sources of information

• Age UK ageuk.org.uk
• NHS 111 nhs.uk
• Patient UK patient.info
• Community navigators kent.gov.uk/social-care-and-health/adult-social-care/care-and-support/help-to-live-at-home/care-navigators

Reproduced with permission from The Shrewsbury and Telford Hospital NHS Trust.