Brief Answer:
You are having postural hypotension. Lifestyle changes required

Detailed Answer:
Hello Dear. You migh be having a condition called postural hypotension or orthostatic hypotension.

When you stand up, gravity causes blood to pool in your legs. This decreases blood pressure because there's less blood circulating back to your heart to pump.

Normally, special cells (baroreceptors) near your heart and neck arteries sense this lower blood pressure and send signals to centers in your brain that in turn signal your heart to beat faster and pump more blood, which stabilizes blood pressure. In addition, these cells cause blood vessels to narrow, which increases resistance to blood flow and increases blood pressure.

Orthostatic or postural hypotension occurs when something interrupts the body's natural process of counteracting low blood pressure. Orthostatic hypotension can be caused by many different conditions, including:

1. Dehydration. Fever, vomiting, not drinking enough fluids, severe diarrhea and strenuous exercise with excessive sweating can all lead to dehydration. When you become dehydrated, your body loses blood volume. Mild dehydration can cause symptoms of orthostatic hypotension, such as weakness, dizziness and fatigue.

2. Heart problems. Some heart conditions that can lead to low blood pressure include extremely low heart rate (bradycardia), heart valve problems, heart attack and heart failure. These conditions may cause orthostatic hypotension because they prevent your body from being able to respond rapidly enough to pump more blood when needed, such as when standing up.

3. Endocrine problems. Thyroid conditions, adrenal insufficiency (Addison's disease), low blood sugar (hypoglycemia) and, in some cases, diabetes can trigger low blood pressure. Diabetes can also damage the nerves that help send signals regulating blood pressure.

4. Nervous system disorders. Some nervous system disorders, such as Parkinson's disease, multiple system atrophy, Lewy body dementia, pure autonomic failure and amyloidosis, can disrupt your body's normal blood pressure regulation system.

5. After eating meals. Some people experience low blood pressure after eating meals (postprandial hypotension). This condition is more common in older adults.

Orthostatic hypotension is common in those who are age 65 and older. As your body ages, the ability of special cells (baroreceptors) near your heart and neck arteries to regulate blood pressure can be slowed. Also, when you age, it may be harder for your heart to beat faster and compensate for drops in blood pressure.

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:

1. 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.

2. 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.

3. 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.

There are many simple steps to managing or preventing orthostatic hypotension. Your doctor may give you several suggestions, including:

1. Use more salt in your diet. This must be done with care, and only after discussing it with your doctor. Too much salt can cause your blood pressure to increase beyond a healthy level, creating new health risks.

2. Eat small meals. If your blood pressure drops after eating, your doctor may recommend small, low-carbohydrate meals.

3. Get plenty of fluids. Keeping hydrated helps prevent symptoms of low blood pressure. But avoid or limit the amount of alcohol you drink, because alcohol can worsen orthostatic hypotension.

4. Exercise. Exercise your calf muscles before sitting up. Also, when getting out of bed, sit on the edge of your bed for a minute before standing. Exercise regularly may help reduce symptoms of orthostatic hypotension.

5. Avoid bending at the waist. If you drop something on the floor, squat with your knees to recover it.

6. Wear compression stockings or abdominal binders. These may help reduce the symptoms of orthostatic hypotension.

7. Get up slowly. You may be able to reduce the dizziness and lightheadedness that occur with orthostatic hypotension by taking it easy when you move from a lying to standing position. Instead of jumping out of bed in the morning, breathe deeply for a few minutes and then slowly sit up before standing.

8. Elevate your head in bed. Sleeping with the head of your bed slightly elevated can help fight the effects of gravity.

9. Move your legs while standing. 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 maneuvers encourage blood to flow from your legs to your heart.

Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you.
All the best
With warm regards
Dr Sanjay Kini

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