How to Diagnose Orthostatic Hypotension

Orthostatic hypotension is a type of low blood pressure that occurs when your blood pressure drops significantly when you stand up after sitting for a while.^{[1]XResearch source} The mild form is common and can happen to just about anyone, especially if you stand up too fast or sit for long periods of time. However, it can be a serious condition that needs medical attention. To treat orthostatic hypotension, determine if you feel dizzy, lightheaded, or weak after standing, decide if you are at risk because of a preexisting condition or medication, and undergo tests at the doctor’s office.

Method 1

Method 1 of 3:

Recognizing the Symptoms

1
Notice dizziness when you stand. The most common symptom of orthostatic hypotension is being dizzy when you stand up. This can happen after sitting or lying down for a time. The dizziness or lightheadedness generally only lasts for a few seconds.^{[2]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- You may find that the world spins around you and you need to grab onto something or sit back down for a moment.
2
Monitor for blurred vision. Another symptom of this condition is blurry vision. When you stand, you may experience blurry or unclear vision. This may linger for a few seconds after the dizziness or lightheadedness has passed.^{[3]XTrustworthy SourceAmerican Academy of Family PhysiciansOrganization devoted to improving the health of patients, families, and communitiesGo to source}
- Your head may also begin to hurt.^{[4]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
3
Watch for any weakness. You may feel weak after standing and feeling dizzy. Your body may suddenly feel fatigued. In more severe cases, you may faint due to the lightheadedness and weakness.^{[5]XTrustworthy SourceAmerican Academy of Family PhysiciansOrganization devoted to improving the health of patients, families, and communitiesGo to source}
- You may start to tremble, and you may feel some heart palpitations.^{[6]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
4
Check for other symptoms. The other symptoms of orthostatic hypotension are confusion. This generally occurs in conjunction with the dizziness. While feeling light headed, or right after, you may be monetarily confused.^{[7]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- After standing and being dizzy, you may feel nauseous.
- Sometimes, you may feel chest pain or cold in your extremities.^{[8]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
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Method 2

Method 2 of 3:

Determining the Risk Factors of Orthostatic Hypotension

1
Check for dehydration. Dehydration is a common cause for orthostatic hypotension. This dehydration may be caused from bleeding, diarrhea, or vomiting. Elevated blood sugar levels can also cause it.^{[9]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Taking medication that are diuretics can also cause dehydration.
2
Determine if you have a preexisting related condition. A risk factor for orthostatic hypotension is a preexisting condition that can cause it. There are multiple conditions that can cause your blood pressure to drop suddenly when you stand up. These include:^{[10]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Pregnancy
- Anemia
- Parkinson's
- Diabetes
- Adrenal problems
- Thyroid conditions
- Any heart conditions
Orthostatic hypotension is likely to occur after long periods of bed rest. If you have been on bed rest for any medical condition, be careful standing or rising for the first time.^{[11]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
Drinking alcohol can increase the likelihood of orthostatic hypotension. Alcohol can cause dehydration, which also increases your risk of orthostatic hypotension. Limit how much you drink, or avoid alcohol entirely.^{[12]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
Heat may cause you to sweat, which can cause you to become dehydrated. It can also lower your blood pressure. These can all cause orthostatic hypotension, so be careful when you are in hot environments.^{[13]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
6
Determine if you have a heart condition. Heart conditions can lead to this sudden drop in blood pressure because of the irregularity of the way the heart works due to the condition. Heart attacks and heart failure may put you at risk.^{[14]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Irregular heart rhythms can cause this drop in blood pressure, as can valve disease.
7
Decide if your medication puts you at risk. Different medications can cause this condition. Beta blockers, ACE inhibitors, nitrates, and other blood pressure medication can lead to this condition. You are more at risk if you take these medications with a preexisting condition that puts you at risk.^{[15]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Anxiety and depression medications can also increase your risk.
- Medications for erectile dysfunction and Parkinson’s can also cause this condition.
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Method 3

Method 3 of 3:

Diagnosing Orthostatic Hypotension

1
Visit your doctor. Orthostatic hypotension can range from mild to severe. If you have a mild case of it, you probably don’t need to go to the doctor. However, if you experience the symptoms frequently, or you are at risk, you may want to visit your doctor.
- Mild cases are when you feel the occasional dizziness after standing after sitting in a hot tub or sitting for a long period of time. A moderate case is when you experience it almost every time you stand up.
- When you go to the doctor, try to let your doctor know what symptoms you’ve experienced, how often they occur, and how long they lasted.
- They will also ask you for a medical history.
2
Have your blood pressure checked. The first thing your doctor will do is measure your blood pressure. They will take your blood pressure while you are lying down and while standing. Generally, your BP will be taken after 3 minutes lying down, 1 minute after standing, and then 3 minutes after standing.^{[16]XResearch source}
- Your heart rate will be measured at the same time as your blood pressure.
- Orthostatic hypotension may be diagnosed if your systolic blood pressure drops 20 mm Hg or your diastolic blood pressure drops 10 mm Hg within 3 minutes after standing up.^{[17]XTrustworthy SourceAmerican Academy of Family PhysiciansOrganization devoted to improving the health of patients, families, and communitiesGo to source}
3
Get blood tests. Blood tests may be needed to determine the cause of the condition. Blood tests can check for electrolyte imbalances, low blood sugar and anemia. These two conditions can lead to orthostatic hypotension.^{[18]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Skin tests may be done to determine if you are dehydrated.^{[19]XResearch source}
4
Undergo heart tests. An electrocardiogram (ECG) and echocardiogram can be done to check your heart. Both of these tests are noninvasive tests. An ECG tests the rhythm of your heart. It looks for any irregularities to that or the structure of your heart. It will also monitor the blood and oxygen supply in your heart.^{[20]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- An echocardiogram is an ultrasound of your heart. This test produces an image of the heart. This test is used to look for structural problems or heart disease.
5
Undergo other tests. If the doctor needs more evidence, you will go through other tests. A stress test monitors your heart rate while you are exercising, like walking on a treadmill. This is done sometimes in conjunction with an ECG or echocardiogram.^{[21]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- A valsalva maneuver test is when you take deep breaths as the doctor monitors your blood pressure and heart rate.
- A tilt table test is given if you faint due to the condition. This test monitors your body’s response when you are put into an upright position after lying down for a while. You lie on a table that gradually goes from horizontal to vertical. The doctor monitors your blood pressure during this test.
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