Dizziness To The Point Of Falling, Low BP

Hello,

Thanks for posting your query.

What you are probably experiencing is postural hypotension, a form of low blood pressure.

Orthostatic hypotension, also known as postural hypotension, and colloquially as head rush or dizzy spell, is a form of hypotension in which a person's blood pressure suddenly falls when standing up or stretching. The symptom is caused by blood pooling in the lower extremities upon a change in body position. It is particularly prevalent among the elderly, and those with low blood pressure.

Considering your age, health i.e. no known illness, and sitting blood pressure which is lowest limit of normal (below 100/60 is hypotension), I would advise you to get yourself evaluated for Orthostatic Hypotension (OH).

There is a simple test for OH which measures the person's blood pressure while seated or reclining at rest, and again upon standing up. A sudden, significant fall in blood pressure (>20 mmHg) between 2 and 5 minutes after standing from the supine position indicates orthostatic hypotension. In addition, the heart rate should also be measured for both positions. This and certain other clinical examination findings can help your physician to confirm the diagnosis.
The treatment includes lifestyle changes in milder cases and medications in severe cases.

You should try the following lifestyle changes only after confirmation of diagnosis by your physician.

1.     Standing up more slowly .This can help avoid incidents of syncope (fainting).

2.     Breathing deeply and flexing the abdominal muscles while rising helps maintain blood and oxygen flow to the brain. Alternatively you can"dangle" legs before rising from bed to decrease the likelihood of dizziness. The dangling is done by sitting on the side of your bed for about a minute so you do not have the sudden dizziness.

3.     Maintaining an elevated salt intake, through sodium supplements or electrolyte-enriched drinks can reduce incidence of orthostatic hypotension. A suggested value is 10g per day; overuse can lead to hypertension and should be avoided.

4. Maintaining proper fluid intake helps prevent the effects of dehydration factor.

5.     Eating more, smaller meals can help; as digestion lowers blood pressure more when eating larger meals. Taking extra care when standing after eating.

If your symptoms still persist then your doctor might start medications like fludrocortisone , erythropoetin etc to aid fluid retention and blood pressure maintenance.

So please do not worry and do get yourself evaluated.

Hope I have answered your query.

Regards

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Hello,

Thanks for the follow up.

The blood pressure is not fixed but rather a continuously dynamic entity subject to many influencing factors both inside and outside the body. It constantly changes to suit the flow requirements of the various parts of the circulation and the circulation as a whole.

Yes you have heard it right when you say that most probably the blood pressure decreases in the night.

It also varies across the day being highest in the morning and lower towards evening and this is called the "diurnal variation." Some decrease does occur during sleep.

That is precisely why I request you for an evaluation as other factors like neurological or labyrinthine causes of postural hypotension can be ruled out.

Still what you have described can be as a result of venous pooling of blood in legs which is more in the sitting position than in the lying down position.

So hope this answers your query.

Regards

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