Tilt table test
You begin by lying flat on a table. Straps are put around your body to hold you in place. After lying flat for a while, the table is tilted to raise your body and head — simulating a change in position from lying down to standing up. During this test, your heart rate and blood pressure are monitored to evaluate your body's cardiovascular response to the change in position.
The goal in testing for low blood pressure is to find the cause. Besides taking your medical history, doing a physical exam and measuring your blood pressure, your doctor might recommend the following:
- Blood tests. These can provide information about your overall health as well as whether you have low blood sugar (hypoglycemia), high blood sugar (hyperglycemia or diabetes) or a low red blood cell count (anemia), all of which can cause lower than normal blood pressure.
Electrocardiogram (ECG). During this painless, noninvasive test, soft, sticky patches (electrodes) are attached to the skin of your chest, arms and legs. The patches detect your heart's electrical signals while a machine records them on graph paper or displays them on a screen.
An ECG, which can be performed in your doctor's office, detects irregularities in your heart rhythm, structural problems in your heart, and problems with the supply of blood and oxygen to your heart muscle. It can also tell if you're having a heart attack or have had one in the past.
Tilt table test. If you have low blood pressure on standing or from faulty brain signals (neurally mediated hypotension), a tilt table test can evaluate how your body reacts to changes in position.
During the test, you lie on a table that's tilted to raise the upper part of your body, which simulates the movement from horizontal to a standing position.
Compression stockings, also called support stockings, compress your legs, promoting circulation. A stocking butler may help you put on the stockings.
Low blood pressure that either doesn't cause signs or symptoms or causes only mild symptoms rarely requires treatment.
If you have symptoms, treatment depends on the cause. For instance, when medication causes low blood pressure, treatment usually involves changing or stopping the medication or lowering the dose.
If it's not clear what's causing low blood pressure or no treatment exists, the goal is to raise your blood pressure and reduce signs and symptoms. Depending on your age, health and the type of low blood pressure you have, you can do this in several ways:
Use more salt. Experts usually recommend limiting salt in your diet because sodium can raise blood pressure, sometimes dramatically. For people with low blood pressure, that can be a good thing.
But because excess sodium can lead to heart failure, especially in older adults, it's important to check with your doctor before increasing the salt in your diet.
- Drink more water. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension.
Wear compression stockings. The elastic stockings commonly used to relieve the pain and swelling of varicose veins can help reduce the pooling of blood in your legs.
Some people tolerate elastic abdominal binders better than they do compression stockings.
Medications. Several medications can be used to treat low blood pressure that occurs when you stand up (orthostatic hypotension). For example, the drug fludrocortisone, which boosts your blood volume, is often used to treat this form of low blood pressure.
Doctors often use the drug midodrine (Orvaten) to raise standing blood pressure levels in people with chronic orthostatic hypotension. It works by restricting the ability of your blood vessels to expand, which raises blood pressure.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.
Lifestyle and home remedies
Depending on the reason for your low blood pressure, you might be able to reduce or prevent symptoms.
- Drink more water, less alcohol. Alcohol is dehydrating and can lower blood pressure, even if you drink in moderation. Water, on the other hand, fights dehydration and increases blood volume.
Pay attention to your body positions. Gently move from a prone or squatting to a standing position. Don't sit with your legs crossed.
If you begin to get symptoms while standing, cross your thighs in a scissors fashion and squeeze, or put one foot on a ledge or chair and lean as far forward as possible. These moves encourage blood flow from your legs to your heart.
Eat small, low-carb meals. To help prevent blood pressure from dropping sharply after meals, eat small portions several times a day and limit high-carbohydrate foods such as potatoes, rice, pasta and bread.
Your doctor also might recommend drinking one or two strong cups of caffeinated coffee or tea with breakfast. Don't drink caffeine throughout the day because you will become less sensitive to caffeine, and caffeine can cause dehydration.
- Exercise regularly. Aim for 30 to 60 minutes a day of exercise that raises your heart rate and resistance exercises two or three days a week. Avoid exercising in hot, humid conditions.
Preparing for your appointment
No special preparations are necessary to have your blood pressure checked. Don't stop taking medications you think might affect your blood pressure without your doctor's advice.
Here's some information to help you get ready for your appointment.
What you can do
Make a list of:
- Your symptoms, including any that seem unrelated to low blood pressure, and when they occur
- Key personal information, including a family history of low blood pressure and major stresses or recent life changes
- All medications, vitamins or other supplements you take, including doses
- Questions to ask your doctor
For low blood pressure, basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- What are other possible causes?
- What tests will I need?
- What's the most appropriate treatment?
- How often should I be screened for low blood pressure?
- I have other health conditions. How can I best manage them together?
- Are there restrictions I need to follow?
- Should I see a specialist?
- Are there brochures or other printed materials I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, including:
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Do you have a family history of heart disease?
Sept. 22, 2020