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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 enough 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 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. Other drugs, such as pyridostigmine (Mestinon), nonsteroidal anti-inflammatory drugs (NSAIDs), caffeine and epoetin (Epogen, Procrit), are sometimes used, too, either alone or with other drugs for people who aren't helped with lifestyle changes or other medications.
- Orthostatic hypotension. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec07/ch069/ch069d.html. Accessed May 13, 2011.
- Hypotension. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hyp/hyp_all.html. Accessed May 13, 2011.
- Kaufmann H, et al. Mechanisms, causes, and evaluation of orthostatic and postprandial hypotension. http://www.uptodate.com/home/index.html. Accessed May 13, 2011.
- Low blood pressure. The American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure...re_UCM_301785_Article.jsp. Accessed May 13, 2011.
- Bradley JG, et al. Orthostatic hypotension. American Family Physician. 2003;68:2393.
- Low PA, et al. Management of neurogenic orthostatic hypotension: An update. Lancet Neurology. 2008;7:451.
- Kaufmann H, et al. Treatment of orthostatic and postprandial hypotension. http://www.uptodate.com/home/index.html. Accessed May 13, 2011.
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