Orthostatic hypotension occurs when blood pressure suddenly drops upon standing from a sitting or lying position. This reduces oxygen-rich blood flow to the brain, causing dizziness, lightheadedness, fatigue, or fainting. When standing, gravity temporarily pulls blood into the legs and abdomen, decreasing blood return to the heart. Pressure sensors in the carotid arteries and near the heart detect this change, triggering reflexes that increase heart rate and constrict blood vessels, pumping blood to the brain to maintain alertness and balance. In older adults or individuals taking antihypertensive medication, or those with chronic illnesses, this reflex is slower. Blood pressure remains lower than normal, increasing the risk of dizziness, loss of balance, and falls.

Orthostatic hypotension is diagnosed when systolic blood pressure drops by more than 20 mmHg or diastolic blood pressure drops by more than 10 mmHg within 3 minutes of standing. Beyond age, other factors contribute to this blood pressure reduction, including prolonged immobility, dehydration, reduced blood volume, and the use of medications such as diuretics or beta-blockers. Chronic illnesses like diabetes, heart failure, and neurological disorders also play a role. Therefore, maintaining adequate hydration, limiting alcohol consumption, exercising regularly, and managing chronic conditions help stabilize blood pressure and reduce the risk of dizziness upon standing.

To prevent orthostatic hypotension, individuals should slowly transition from lying or sitting to standing, especially after waking up or prolonged sitting. A diet rich in minerals like potassium, magnesium, and calcium, consuming several small meals, engaging in regular exercise, and avoiding sudden temperature changes also help balance blood pressure.

Beyond these basic preventive measures, older adults or those at high risk can wear compression stockings to support leg circulation. Using handrails or canes when standing up and performing gentle leg and ankle exercises can also improve circulation. If currently taking antihypertensive medication, diuretics, or cardiovascular drugs, consult a doctor to adjust dosages or timing, thereby reducing the risk of orthostatic hypotension.

Patients should seek medical attention for severe symptoms like severe headache, sudden vision changes, difficulty speaking, facial, arm, or leg paralysis, confusion, or seizures. Regular blood pressure checks enable early detection, timely lifestyle adjustments, and appropriate treatment, which protects long-term health and prevents serious complications.

Le Nguyen (According to Times of India, WebMD)