Faint on standing from sitting or lying down? Know about Postural Hypotension
Fainting on standing from sitting or lying down position due to drastic fall in blood pressure is called Postural Hypotension or Orthostatic Hypotension. Here's what doctors have to say about the commonest cause of fainting called ‘Common Faint’.
When the blood pressure drops, less blood can go to the organs and muscles which can make one more likely to fall which is why one may faint or experiences Postural hypotension (orthostatic hypotension) when one goes from lying down to sitting up, or from sitting to standing. This is the commonest cause of fainting hence called ‘Common Faint’.
What is postural hypotension or orthostatic hypotension?
In an interview with HT Lifestyle, Dr Deepak P, Consultant – Cardiac Electrophysiology, explains, “Orthostatic hypotension is a condition characterised by a sudden drop in blood pressure when the patient stands up from a seated or lying position.
Dr Muqshith Quadri, Senior General Physician and Diabetologist at Kamineni Hospitals in Hyderabad, calls it, “A drop in the systolic pressure (the upper value in BP) of more than 20mm of hg or a drop in diastolic pressure (the lower value) by more than 10mm of hg after 2-3 minutes of standing.”
Dr Deepak P shared, “It is common in the elderly population, pregnant women and in people who have been on bed rest for a long time. Several disease conditions such as heart problems, nervous system disorders, dehydration, the use of alcohol and certain medications such as anti-depressants, heart medications, etc can also cause this condition. If you are experiencing a frequent bout of orthostatic hypotension, it is important to see a doctor to prevent the risk of falls, stroke and heart diseases.”
According to Dr Muqshith Quadri, other common causes are recent change or increase in BP medication causing decrease in BP, some medication for other disease may also cause postural hypotension. Hence, first thing he recommends is to go to your physician and review all the medications you are taking.
He highlighted that it can also be due to a problem in our autonomic nervous system and listed other non-nervous system causes as, “Heart - related to pump failure, alcohol, medications, dehydration, diarrhoea and vomiting, straining or heavy lifting.”
According to Dr Deepak P, some patients might experience dizziness, weakness confusion, blurry vision or vomiting sensation due to the sudden BP drop. It may also cause fainting. Dr Muqshith Quadri revealed, “The symptoms before the fall are generally sweating, blurring of vision, decreased hearing or light headedness.”
Dr Subhash Chandra, Chairman and HOD Cardiology at BLK Max Super Speciality Hospital added to the list and said, “Preceding symptoms of dizziness, black out, sweating and nausea, vomiting may accompany frank fainting. Prolonged standing, dehydration, underlying heart problems, nervous system disorders, blood loss (especially in female during menstrual phase) precipitate common faint.”
Serious complications like injury in elderly can occur due to postural hypotension. Anti-hypertensive drugs can also cause postural fall in BP and serious injuries in elderly patients.
Dr Darshan, Consultant – Cardiac Electrophysiology at Manipal Hospitals, advised, “Lifestyle changes such as drinking enough water to prevent dehydration and quitting alcohol are helpful. Avoiding stepping out in the hot sun during summers and hot showers, keeping your head in an elevated position while resting, standing up slowly from a sitting or lying position and avoiding crossing your legs while sitting are some important steps in avoiding orthostatic hypotension. You can increase the amount of salt in your food if you do not have hypertension. If your blood pressure falls after food, try eating small, low carbohydrate meals.”
He added, “Your doctor may recommend the use of compression stockings or abdominal binders to reduce symptoms. Diabetes and amyloidosis have to be ruled out before managing the disease. Medications may be prescribed if lifestyle changes fail to reduce symptoms. While immediate recovery is good, there is a need of evaluation to ensure there are no sinister reasons for orthostatic hypotension. The recent HrS paper, has shown how to manoeuvres recovery and need of evaluation.”
As per Dr Muqshith Quadri, “A few basic test done are heart beat variation on deep breathing and Valsalva response. Once we come to a cause of the disease - nervous, metabolic, cardiac, etc., then the patient is treated accordingly.” Echoing the same, Dr Subhash Chandra stressed that the prevention of common faint includes adequate hydration, avoiding prolonged standing and titration of blood pressure medications. Concluding, Dr Deepak P suggested that if you are experiencing a frequent bout of orthostatic hypotension, it is important to see a doctor to prevent the risk of falls, stroke and heart diseases.