The treatment for orthostatic hypotension depends on the underlying cause. Your doctor will try to address the underlying health problem — dehydration or heart failure, for example — rather than the low blood pressure itself.
For mild orthostatic hypotension, one of the simplest treatments is to sit or lie down immediately after feeling lightheaded upon standing. Your symptoms of orthostatic hypotension usually disappear.
When low blood pressure is caused by medications, treatment usually involves changing the dose of the medication or stopping it entirely.
Orthostatic hypotension treatments include:
May 13, 2014
Lifestyle changes. Your doctor may suggest several lifestyle changes, including drinking enough fluids, such as water; drinking little to no alcohol; avoiding walking during hot weather; elevating the head of your bed; and standing up slowly. Your doctor may also suggest exercise programs to strengthen your leg muscles.
If you don't also have high blood pressure, your doctor might suggest increasing the amount of salt in your diet. If your blood pressure drops after eating, your doctor may recommend small, low-carbohydrate meals.
- Compression stockings. Compression stockings and garments or abdominal binders may help reduce the pooling of blood in your legs and reduce the symptoms of orthostatic hypotension.
Medications. Several medications, either used alone or together, can be used to treat orthostatic hypotension. For example, the drug fludrocortisone is often used to help increase the amount of fluid in your blood, which raises blood pressure. Doctors often use the drug midodrine (ProAmatine) to raise standing blood pressure levels. It works by limiting the ability of your blood vessels to expand, which in turn raises blood pressure.
Droxidopa (Northera) may be prescribed to treat orthostatic hypotension associated with Parkinson's disease, multiple system atrophy or pure autonomic failure.
Other medications, such as pyridostigmine (Regonol, Mestinon), nonsteroidal anti-inflammatory drugs (NSAIDs), caffeine and epoetin (Epogen, Procrit), are sometimes used, too, either alone or with other medications for people who aren't helped with lifestyle changes or other medications.
- Orthostatic hypotension. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/cardiovascular_disorders/symptoms_of_cardiovascular_disorders/orthostatic_hypotension.html?qt=orthostatic%20hypotension&alt=sh. Accessed Feb. 17, 2014.
- What is hypotension? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hyp/. Accessed Feb. 17, 2014.
- Kaufmann H, et al. Mechanisms, causes, and evaluation of orthostatic hypotension. http://www.uptodate.com/home. Accessed Feb. 17, 2014.
- Low blood pressure. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Low-Blood-Pressure_UCM_301785_Article.jsp. Accessed Feb. 17, 2014.
- Low PA, et al. Management of neurogenic orthostatic hypotension: An update. Lancet Neurology. 2008;7:451.
- What is an electrocardiogram? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/ekg/. Accessed Feb. 24, 2014.
- What is echocardiography? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/echo/. Accessed Feb. 24, 2014.
- Kaufmann H, et al. Treatment of orthostatic and postprandial hypotension. http://www.uptodate.com/home. Accessed Feb. 17, 2014.
- Figueroa JJ, et al. Preventing and treating orthostatic hypotension: As easy as A, B, C. Cleveland Clinic Journal of Medicine. 2010;77:298.
- FDA approves Northera to treat neurogenic orthostatic hypotension. U.S. Food and Drug Administration. http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm386311.htm. Accessed Feb. 24, 2014.