Orthostatic Hypertension Causes, Symptoms, and Treatment (2024)

Orthostatic hypertension is a type of high blood pressure. It occurs when a person goes from sitting or lying down to standing.

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The body has automatic processes that regulate blood pressure when moving from positions like lying down to standing. In people with orthostatic hypertension (OHT), blood pressure rises despite those processes. This can cause a sensation of lightheadedness or nausea.

OHT is not a well-studied condition. In fact, medical experts do not even currently have a standard definition for it.

Recent proposals suggest that OHT should be defined as an increase in systolic blood pressure greater than or equal to 20 millimeters of mercury (mm Hg) when going from lying down to standing.

It is also not a well-understood condition, and it is often undiagnosed. But there are signs and symptoms that could indicate you have it.

Plus, research does suggest that possible complications are associated with it. That makes diagnosis important.

Like essential hypertension, OHT often does not cause any symptoms. That can make detecting and diagnosing the condition difficult.

If symptoms of OHT do occur, they may include:

• lightheadedness upon standing
• dizziness
• heart palpitations
• nausea
• sweating

Fainting is possible, but it is rare.

Alternatively, orthostatic hypotension is the opposite of OHT. It is low blood pressure that happens when someone stands up quickly. Symptoms of this condition include weakness, leg buckling, and blurred vision.

Temporary OHT could be the result of a condition like dehydration. When the body is not properly hydrated, it can cause issues. In this case, the elevated blood pressure will pass once the underlying condition is treated.

For others, OHT may be the result of a more long-term condition or problem. These include:

• Prolonged bed rest: People who are lying down for extended periods of time may experience OHT.
• Older age: OHT appears to be more common in older people. The automatic nervous system may not regulate blood pressure as well with age.
• Medication: Some medications may cause high blood pressure as a side effect.
• Existing hypertension: People with high blood pressure may experience these sudden increases in blood pressure more frequently, even if they take medication.

Occasional lightheadedness when standing isn’t uncommon, and it’s rarely anything to be concerned about. But if the condition continues or worsens, it’s worth talking with your doctor.

OHT is not always easy to diagnose, especially during a standard appointment. But certain tests can help with diagnosis. These may be done at home or in a clinic.

For example, your doctor may ask you to wear a blood pressure monitor so they can see blood pressure changes as you move from lying down to standing. This test can help them see whether your blood pressure changes and, if so, by how much.

Additionally, a tilt-table test may be used. This allows a doctor to slowly raise you from lying flat to a specific angle. During the test, you will wear a blood pressure monitor.

A systolic blood pressure reading that increases by 20 mm Hg may be adequate to diagnose this condition for most doctors. Yet because there are currently no official guidelines, doctors may differ on their personal opinion of what measurements define OHT.

Currently, there are no treatment guidelines for OHT, either. Most treatments are based on limited studies.

For some people, changes to how they sit up after lying down may help. Slowing down the process might give the body’s nervous system more time to respond.

Your doctor won’t prescribe blood pressure medication unless they find that you do have high blood pressure. In fact, your doctor may choose to closely monitor your blood pressure for signs that you have developed essential hypertension.

One report from 2019 suggests that young people with an increase in systolic blood pressure as small as 5 mm Hg when standing were at risk for developing essential hypertension.

It’s unclear, however, if OHT is a type of prehypertension, or if it should be considered a subtype of essential hypertension. If it is, it should be closely monitored so that further complications like organ damage and heart disease are detected early or avoided entirely.

Orthostatic hypertension is a type of high blood pressure that occurs when someone goes from lying down to standing. Typically, the body can regulate blood pressure during movements, but in people with OHT, this regulation fails. Instead, the blood pressure rises.

For most people, the condition will not cause any symptoms. Others may experience lightheadedness. Fainting is even possible, though rare.

OHT is not well-researched, so there are no standard treatments. Doctors typically determine treatment on a case-by-case basis, but almost all people will be monitored for high blood pressure. Research does suggest that OHT may be an early sign or type of hypertension.