How to prevent Orthostatic Hypotension? [6 simple steps]

When you get up suddenly from a chair or bed, your blood rushes into your legs.

This can cause a drop in Blood pressure. You may become light-headed & fall.

This is called Orthostatic Hypotension. It is very common in Parkinson’s disease.

We can prevent this with 6 measures.

Prevent Orthostatic Hypotension
1. Avoid medications that may worsen this problem.

2. Drink enough water

3. If your doctor agrees, slightly increase salt in your diet

4. Stand up gradually

5. Exercise & develop better muscle tone

6. Ask your doctor for medications.

Let us read more about these 6 things.

Avoid medications that may worsen this problem:

Certain medications can make it difficult to maintain adequate blood pressure on standing up.

Medications that can cause/worsen a drop in BP on standing up

Some psychiatric medications, particularly medications belonging to a class called Tricyclic antidepressants Examples: Imipramine, Trazodone
Some antihypertensives, particularly those that produce marked relaxation of blood vessels or cause excessive urination leading to dehdration Examples: Nitrates, Prazosin, hydralazine, Frusemide (Lasix) etc
Some other vascular relaxants Example: Sildenafil, Tadalafil
Medications given for Prostrate problems Examples: Terazosin, Doxazosin, Prazosin
Antiparkinsonian medications themselves! Examples: Levodopa, Bromocriptine, MAO-inhibitors (rasagiline and selegiline)

Drink enough water

Unless you have been advised water restriction by your doctor (e.g. due to a bad kidney or a bad heart) drink at least 7-8 glasses of water per day.

Drink 7-8 glasses of water daily.

Slightly increase salt in your diet

Do this only after talking with your physician first.

Salt causes retention of fluid inside the body, therefore helping to maintain blood pressure.

Stand up gradually

Standing gradually gives your body time to adjust your blood pressure.

If you are lying down, sit in your bed first and wait for a full minute. Then stand up and wait for one more minute before you start walking.

Especially after sleeping, sit by the side of the bed for a minute instead of jumping out of bed.

Exercise

Exercise can maintain good muscle tone.

Good muscle tone of your abdomen and legs and prevent pooling of blood in these areas. This prevents a drop in blood pressure.

Gentle exercise such as walking helps to maintain your leg muscles.

Medications

If all else fails, medications such pyridostigmine, midodrine and fludrocortisone can be used to stabilize your blood pressure when you get up suddenly.

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Caution:
This information is for educational purposes. It is not a substitute for professional medical diagnosis & treatment. Do not change your medications, supplements or other treatments without your doctor's permission.

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Dr. Siddharth Kharkar

Dr. Siddharth Kharkar is a board certified (American Board of Psychiatry & Neurology certified) Neurologist. He is a Epilepsy specialist & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

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