
Physical inactivity and low fitness levels have been identified as risk factors for numerous metabolic and circulatory alterations that induce a variety of symptoms, including dizziness, particularly in the elderly.
Osteoporosis and muscle weakness associated with inactivity play a part in dizziness due to cervical muscle and bone structure weakening.
- Dizziness is one of the most common symptoms among the elderly. It is an extremely critical issue because it raises the chance of falls, which is a major risk factor for morbidity and mortality in the elderly.
- Lack of activity can result in orthostatic hypotension or low blood pressure with changes in body position, which can produce dizziness in inactive persons. This is due to the body's compromised vascular system or blood vessels, which become engorged with fluid, resulting in a lack of circulation to the brain.
- Muscles play a role in pumping blood back from the extremities when they contract and relax; thus, when activity levels are low or when the muscles get weaker, this does not happen.
- Reduced activity decreases the need for proper chest expansion, which is required when breathing hard during increased activity. With chest enlargement, lung cleansing and gas exchange are improved.
Physical inactivity is a major risk factor for a variety of aging-related disorders. A sedentary lifestyle may hasten the aging process. This is a compelling message that clinicians might utilize to promote the possible anti-aging effect of regular exercises and a healthy lifestyle.
16 symptoms of orthostatic hypotension
A prolonged reduction in systolic blood pressure of 20 mmHg or diastolic blood pressure of 10 mmHg within three minutes of standing from a seated or supine posture might result in orthostatic hypotension.
Orthostatic hypotension, also called postural hypotension, is a dip in blood pressure caused by shifting postures, such as sitting to standing.
In most cases, this is an asymptomatic disorder; however, the following symptoms have been observed in a few cases:
- Dizziness
- Lightheadedness
- Blurred vision
- Fatigue
- Nausea
- Palpations
- Headache
- Brain fog
- Confusion
- Excessive sweating above the level of injury
- Muscle weakness
- Syncope
- Dyspnea
- Chest pain
- Neck and shoulder pain
- Unexplained falls
Orthostatic hypotension is a frequent disorder, affecting at least 10 to 30 percent of the elderly population.

SLIDESHOW
Exercises for Seniors: Tips for Core, Balance, Stretching See Slideshow8 common causes of orthostatic hypotension
When a person sits or lies down, more blood pools in the blood veins of the legs. When standing, there is a systemic blood pressure drop because suddenly less blood is moving back to the heart (against gravity).
Usually, special sensors (baroreceptors) in the aorta and two carotid arteries detect this reduction in blood pressure and adjust in the peripheral small blood vessel caliber to maintain normal blood pressure by increasing the heart rate and constricting (narrowing) abdomen and leg blood vessels. When this normal physiologic process fails to regulate blood pressure appropriately, orthostatic hypotension ensues.
Orthostatic hypotension can additionally be caused by several factors, including:
- Dehydration: Lack of fluid ingestion increases the risk of orthostatic hypotension.
- Causes may include:
- Fever
- Vomiting
- Diarrhea
- Excessive sweating
- Excessive alcohol consumption
- Frequent or constant exposure to a hot environment
- Causes may include:
- Cardiac problems:
- Certain cardiac problems reduce the body’s ability to maintain blood pressure, such as:
- Low heart rate or bradycardia
- Structural or functional impairment of heart valves
- Heart failure
- Certain cardiac problems reduce the body’s ability to maintain blood pressure, such as:
- Endocrine problems:
- These conditions significantly disrupt blood pressure regulation by damaging the neuronal transmission:
- Thyroid-related problems
- Adrenal insufficiency
- Low or high blood glucose levels
- These conditions significantly disrupt blood pressure regulation by damaging the neuronal transmission:
- Neurodegenerative disorders:
- Some underlying nervous system disorders increase the risk of developing orthostatic hypotension, such as:
- Parkinson's disease
- Multiple system atrophy
- Lewy body dementia
- Amyloidosis
- Some underlying nervous system disorders increase the risk of developing orthostatic hypotension, such as:
- Aging:
- Orthostatic hypotension is related to extended-standing and other chronic medical disorders, and the risk increases with age and fragility.
- A reduction in blood pressure can occur because of increased intestinal blood circulation during food digestion.
- Medication: Medicines used for the treatment of high blood pressure anxiety, depression, and erectile dysfunction may cause orthostatic hypotension.
- Beta-blockers
- Calcium channel blockers
- Angiotensin-converting enzyme inhibitors
- Nitrates
- Angiotensin II blockers
- Diuretics
- Prostate medications
- Prolonged bed rest:
- The development of orthostatic hypotension is linked to impaired vestibular blood pressure regulation during movement and postural alterations caused by extended bed rest.
- Pregnancy:
- The pressure over the abdominal aorta due to rapid enlargement of the uterus circulatory contributes to orthostatic hypotension during pregnancy.
Orthostatic hypotension can be exacerbated by certain diseases, such as anemia and spinal cord problems (syringomyelia). Changes in sympathetic activity, impaired baroreflex, and salt and water imbalance are related to orthostatic hypotension caused by spinal cord diseases.
What are the treatment options for orthostatic hypotension?
The goal of orthostatic hypotension treatment is to return blood pressure to normal. This usually entails boosting blood volume, decreasing blood pooling in the lower legs, and assisting blood arteries to push blood throughout the body.
Treatment frequently focuses on the underlying cause, such as dehydration or heart failure, rather than the low blood pressure itself.
One of the simplest treatments for moderate orthostatic hypotension is:
- Hydration
- To sit or lie down soon after feeling lightheaded while standing
- When drugs produce low blood pressure, the treatment usually consists of adjusting the medication's dose or discontinuing it
Orthostatic hypotension treatments include:
- Lifestyle changes:
- Doctors may advise patients to make a few lifestyle modifications, such as:
- Drinking plenty of non-fizzy fluids
- Avoiding alcohol
- Avoiding being in overheated surroundings
- Raising the head of the bed
- Avoiding crossing legs when sitting, and standing up gently
- Take a small pause to ensure that it is safe to begin walking
- If a person does not have high blood pressure, the doctor may advise increasing the quantity of salt in the diet
- If blood pressure lowers after eating, the doctor may advise eating small, low-carbohydrate meals
- Doctors may advise patients to make a few lifestyle modifications, such as:
- Compression stockings:
- Compression stockings and garments, as well as abdominal binders, may help prevent blood pooling in the legs and alleviate the symptoms of orthostatic hypotension.
- Medications:
- Alpha-adrenergic agonists
- Mineral corticoids
- Nonselective alpha-and beta-receptor agonist
- Combination of these drugs
The doctor will monitor for side effects of the drugs and adjust the dose accordingly.
Exercise has been demonstrated to increase bone density in people of all ages and decrease the chance of dizziness, lightheadedness, and falls.
Inactivity, however, has been proven to reduce overall bone calcium, leading to various neuro and ortho complications. Try to be as active as possible. This will help stay and have better health even during the elderly age.
Bazoni JA, Mendes WS, Meneses-Barriviera CL, et al. Physical activity in the prevention of benign paroxysmal positional vertigo: probable association. Int Arch Otorhinolaryngol. 2014;18(4):387-390. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296996/#
Figueroa JJ, Basford JR, Low PA. Preventing and treating orthostatic hypotension: As easy as A, B, C. Cleve Clin J Med. 2010;77(5):298-306. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888469/
Better Health. Dizziness - orthostatic hypotension. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dizziness-orthostatic-hypotension
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