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Treatments and drugs
By Mayo Clinic staff
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. There are usually several options for treating orthostatic hypotension, including:
- Lifestyle changes. Drinking plenty of fluids, such as water; drinking little to no alcohol; avoiding walking during hot weather; and standing up slowly are things your doctor may suggest. Your doctor may also suggest exercise programs that strengthen your calf muscles. If you don't also have high blood pressure, your doctor might suggest increasing the amount of salt in your diet.
- Compression stockings. The same elastic stockings and leotards commonly used to relieve the pain and swelling of varicose veins 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 your amount of blood, which raises blood pressure. Doctors often use the drug midodrine to raise standing blood pressure levels. It works by limiting the ability of your blood vessels to expand, which raises blood pressure. Other drugs, such as pyridostigmine, nonsteroidal anti-inflammatory drugs (NSAIDs), caffeine and epoetin, are sometimes used, too, either alone or with other drugs.
- Your high blood pressure questions answered: Low blood pressure. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3034848. Accessed April 14, 2009.
- Hypotension. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hyp/hyp_whatis.html. Accessed April 14, 2009.
- Sheps SG, ed. Mayo Clinic 5 Steps to Controlling High Blood Pressure. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008.
- Kaufmann H, et al. Mechanisms and causes of orthostatic and postprandial hypotension. http://www.uptodate.com/home/index.html. Accessed April 6, 2009.
- Kaufmann H, et al. Treatment of orthostatic and postprandial hypotension. http://www.uptodate.com/home/index.html. Accessed April 6, 2009.
- Krediet CTP, et al. Management of initial orthostatic hypotension: lower body muscle tensing attenuates the transient arterial blood pressure decrease upon standing from squatting. Clinical Science. 2007;113:407.
