Postural Hypotension May Also Be a Sign of Disease

Squatting down and suddenly standing up, all of a sudden, your eyes are blurry, you can’t stand still, and some people even faint, this is postural hypotension.I’m sure many people have heard of its great name and have even experienced it themselves.

These symptoms usually come back quickly and don’t seem to be a big deal, but a sudden fainting spell can induce other dangers and can even be life-threatening if not treated in time.

Today we’ll talk about how to prevent and manage postural hypotension so that it occurs less often, if at all.

What is postural hypotension?

Postural hypotension, a clinical phenomenon in which there is a sudden and significant drop in blood pressure when a person stands up quickly from a lying, sitting, or squatting position.

Specifically, a drop in systolic blood pressure of at least 20 mmHg or a drop in diastolic blood pressure of 10 mmHg, usually within 3 minutes.When this drop in blood pressure occurs, it can cause a range of discomfort, including dizziness, blackouts, and in extreme cases, temporary loss of consciousness.

This condition deserves our attention not only because it can cause you sudden discomfort while you’re standing, but also because it can point to other potential health problems.In short, postural hypotension is a warning that certain bodily functions may need to be examined and adjusted in more depth.

Why does postural hypotension occur?

The occurrence of postural hypotension can be confusing to many people; it can seem like a simple movement from sitting to standing, yet it can cause such a big reaction.

Much of this is due to an imbalance in the autonomic regulation of the cardiovascular system in response to changes in body position.

Normally, when we stand up quickly from a lying or sitting position, approximately 300 to 800 milliliters of blood accumulates in the veins of the lower extremities and spleen due to the effects of gravity.This process temporarily reduces venous return, which leads to a reduction in the heart’s output per beat and total cardiac output by as much as 40%, ultimately causing a drop in blood pressure.

In the face of this change, our bodies respond through a complex series of blood pressure regulatory responses.

Pressure receptors in the carotid sinus and aortic arch are activated to stimulate a sympathetic nervous system response while suppressing the parasympathetic nervous system to increase heart rate, venous return, cardiac contractility, and vascular tone in an effort to restore blood pressure to normal levels.The increase in peripheral vascular resistance becomes the primary force in restoring blood pressure, while the increase in heart rate aids in this process.

Often these compensatory responses will stabilize blood pressure within seconds and maintain it in the normal range for a short period of time.

Postural hypotension occurs when the autonomic nervous system is not adequately regulated, but the presence of postural hypotension is not always due to a single cause and can be categorized into three main groups: drug-induced, related to (overall or effective) intravascular volume deficit, and neurogenic:

1. Certain medications (e.g., antihypertensive, antidepressant, and antiparkinsonian) may cause postural hypotension by impairing autonomic responses;

2. Blood volume deficits may impede compensatory responses even when the autonomic nervous system is structurally normal;

3. Neurogenic postural hypotension is defined as a condition in which patients who meet the criteria for postural hypotension and who have impaired autonomic nervous system function as a result of structural damage to the erectilecannot adequately increase vasoconstriction and heart rate after standing upright, thereby causing postural hypotension.Diseases such as diabetes mellitus, chronic kidney disease, autoimmune disorders, endocrine disorders, increased alcohol intake, and paraneoplastic syndromes may lead to impaired autonomic nervous system function.

In addition, the risk of postural hypotension increases accordingly with age and is particularly common in the elderly.

Aging leads to decreased α-1 adrenergic receptor sensitivity, diminished heart rate response, decreased reflex sensitivity, and a general decline in autonomic nervous system function.These physiologic changes may contribute to the development of postural hypotension by causing a decrease in intravascular volume, a decrease in per-pulse output, and a diminished heart rate and vasoconstrictor response to uprighting.

In summary, postural hypotension occurs as a result of a multifactorial and multimechanistic approach, especially in the context of an inadequately regulated autonomic nervous system and an inadequate cardiovascular response to postural changes.

How to manage and relieve symptoms of postural hypotension?

There are multiple ways to effectively manage and relieve symptoms of postural hypotension.From simple lifestyle modifications to medications, there are a variety of ways to effectively manage and relieve symptoms of postural hypotension and improve the quality of life for patients.

Correcting Aggravating Factors

Certain diseases and medications have the potential to predispose to postural hypotension, so when beginning management for postural hypotension, one should first attempt to correct the aggravating factors.

Lifestyle Adjustments

Lifestyle modification is the most basic and important step and involves all aspects:

1. In terms of diet: patients are advised to increase water and salt intake to increase blood volume and blood pressure; at the same time, coffee, alcohol and other diuretic and vasodilator beverages should be limited, and limiting high-sugar foods is also necessary.

2. In terms of daily activities: patients are advised to do more horizontal exercise (e.g. stationary bicycle, rowing machine) or in the swimming pool, stand slowly when getting up, tense the buttocks during the process, and stand on tiptoe when standing straight.

3. In terms of clothing: Consider compression stockings to compress the lower extremities and reduce the amount of blood that stays in the veins of the lower extremities while standing; for some patients, special tights may also be needed to increase abdominal pressure to aid in blood return.

Medication

Doctors may prescribe medications, such as angiotensin-converting enzyme inhibitors or other medications that regulate blood pressure, depending on the patient’s specific situation.These medications can help regulate blood pressure and prevent significant drops in blood pressure due to changes in body position.

When should I seek medical help?

If the symptoms of postural hypotension are frequent or cause a significant decrease in quality of life, such as frequent dizziness or fainting, these are signs that a doctor should be consulted.Especially when postural hypotension is accompanied by other symptoms such as chest pain, palpitations or severe breathlessness, immediate medical attention should be sought.

For patients who have already been diagnosed with postural hypotension, it is also important to return to the doctor if symptoms suddenly worsen or treatments no longer seem to be effective.Regular checkups and evaluations can help adjust the treatment plan to ensure optimal results.

In summary, with these precautions and a clear understanding of when to seek medical help, we can better manage postural hypotension and reduce its impact on our daily lives.And maintaining good and timely communication with your healthcare provider in the event that you feel uncomfortable is all key to ensuring your health and safety.