Postural hypertension, also known as orthostatic hypertension (OHT), is a condition where blood pressure regulation falters when an individual changes body position. This can impact daily activities as the body struggles to maintain stable blood flow to the brain and other organs.
Defining Postural Hypertension
Postural hypertension refers to an abnormal increase in blood pressure that occurs when transitioning from a lying or sitting position to standing. Normally, the body’s autonomic nervous system adjusts blood pressure to counteract gravity, ensuring adequate blood flow to the brain when upright. This involves mechanisms like blood vessel constriction and an increase in heart rate.
In individuals with postural hypertension, this regulatory process does not function as it should, leading to a noticeable rise in systolic blood pressure by 20 mmHg or more upon standing. This condition is distinct from orthostatic hypotension, which is a sudden drop in blood pressure upon standing and can cause dizziness or fainting.
Underlying Causes
Various factors and underlying medical conditions can contribute to postural hypertension. Autonomic nervous system dysfunction, which controls involuntary bodily functions like blood pressure, is a primary disturbance. This dysfunction can prevent the body from properly adjusting blood vessel tone when standing.
Certain medical conditions are associated with an increased risk of postural hypertension, including essential hypertension, diabetes mellitus, and some neurological disorders. For instance, postural tachycardia syndrome (POTS) often shows a pressor response to standing. Age is a significant factor, with higher prevalence in older individuals. Dehydration can temporarily lead to postural hypertension by affecting blood volume.
Identifying Symptoms
Identifying the symptoms of postural hypertension can be challenging because, similar to essential hypertension, it often does not present with noticeable signs. When symptoms do occur, they appear upon standing or shortly after. Common symptoms include dizziness or lightheadedness, which can make individuals feel unsteady.
Headaches may also occur. Some individuals report heart palpitations, a sensation of a rapid or irregular heartbeat. Other possible symptoms include nausea, general discomfort, and persistent fatigue. Fainting is a rare occurrence.
Diagnosis and Treatment
Diagnosing postural hypertension typically involves measuring blood pressure in different body positions. A common diagnostic approach includes an active standing test, where blood pressure is measured while lying down and then again within three minutes of standing. An increase in systolic blood pressure of 20 mmHg or more upon standing suggests postural hypertension.
Treatment strategies for postural hypertension are tailored to the individual and aim to manage blood pressure and address any underlying causes. While standard treatments are still evolving, doctors monitor blood pressure closely. In some cases, medications may be prescribed to help regulate blood pressure or manage related conditions.
Managing Through Lifestyle
Lifestyle modifications can play a significant role in managing postural hypertension and reducing symptom severity. Rising slowly from a seated or lying position is a simple yet effective strategy, allowing the body more time to adjust blood pressure. Maintaining adequate hydration by drinking enough water supports overall blood volume and pressure stability.
Regular physical activity can strengthen the cardiovascular system, which in turn improves the body’s ability to regulate blood pressure. Managing sodium intake can be part of a broader blood pressure management plan. Avoiding rapid position changes and incorporating compression garments can also help. Managing stress through various techniques may also contribute to overall well-being.