Orthostatic Hypotension

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is the treatment for orthostatic hypotension?

The treatment for orthostatic hypotension depends upon the underlying diagnosis. If the cause is dehydration, then fluid replacement will resolve the symptoms. If it is due to medication, then an adjustment of the dose or change in the type of medicine taken may be required.

Compression stockings may be considered to help prevent fluid from pooling in the legs when a person is sitting or lying down. This allows for more blood flow to be available to the brain when changes in position occur.

Medications may be of use, again depending upon the underlying cause of the orthostatic hypotension. For those who are otherwise healthy and have no specific illness that must be treated, increased salt and fluid intake may be recommended. Caffeine and nonsteroidal antiinflammatory medications for example, ibuprofen may also be suggested.

Some patients may be a candidate for fludrocortisone (Florinef) to increase the volume of fluid in the blood vessels. Fludrocortisone is an adrenergic (adrenaline-mimicking) drug, which stimulates the sympathetic nervous system. This medication does have significant side effects, including lowering magnesium and potassium levels in the blood, headache, swelling, and weight gain.

What are the complications of orthostatic hypotension?

Falling is the most important complication of orthostatic hypotension. Most often, the symptoms are transient and self- limiting, giving the patient a chance to sit down, but when the drop in blood pressure causes syncope (fainting) or near syncope, it is the trauma that is sustained in the fall that causes the most damage.

Medically Reviewed by a Doctor on 5/14/2015

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