Common Cause Of Dizziness May Spell Heart Trouble
Blood Pressure That Falls When You Stand May Be a Clue to Coming Heart Failure
March 19, 2012 — Blood pressure that drops when a person stands up may signal a higher risk for heart failure, a new study shows.
If further research supports the studyâs findings, a simple test that measures blood pressure change as a person gets to their feet may one day help doctors spot heart failure early, when it is most manageable.
The study followed more than 12,000 middle-aged adults for nearly two decades.
At the start of the study, researchers measured blood pressure while people were lying down and then several times over a two-minute period after they stood.
âIf the top number, the systolic number, fell by 20 or more points, or the bottom number, the diastolic blood pressure, fell by 10 or more points, then it was defined as orthostatic hypotension,â says Christine D. Jones, MD, an internist and resident in preventive medicine at the University of North Carolina at Chapel Hill.
In orthostatic hypotension, the blood pressure drops when the body is in an upright standing position, as compared to a reclining position. Sometimes the sudden dip causes a brief dizzy spell or head rush. In severe cases it may cause a person to faint.
âSometimes people can have it and not feel a thing,â Jones says.
Are Orthostatic Hypotension And Postural Tachycardia Syndrome The Same Condition
Postural tachycardia syndrome, or POTS, causes symptoms similar to orthostatic hypotension. Both cause dizziness or fainting upon standing. Along with a drop in blood pressure, POTS causes a heart rate increase of 30 to 40 beats per minute within 10 minutes of standing. POTS is less common than orthostatic hypotension.
Diagnosis Of Orthostatic Hypotension
- Medical history, including medical conditions and drugs taken on a regular basis
- Physical examination
- Measuring blood pressure when lying down versus standing up
- Blood tests to check, for example, blood sugars or adrenal hormones
- Echocardiography, an imaging scan of the heart, to check for certain heart conditions
- Other tests, depending on individual factors.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- Why did I get orthostatic hypotension?
- What is the best treatment for orthostatic hypotension?
- Could medications be causing my symptoms? Should I change medications?
- What changes should I make to manage symptoms?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Orthostatic hypotension symptoms can be unsettling. They may even be dangerous if you lose your balance, fall or pass out. Symptoms often improve when you change how you move into a standing position. Tell your healthcare provider about your symptoms. You may need to change your medications to reduce or prevent symptoms. In more severe cases, your provider may prescribe medicine to improve blood flow and pressure.
Should Blood Pressure Be Taken Lying Down
Some people have inquired about taking blood pressure lying down. Every muscle can be fully relaxed in that position, so why not? In addition, it might make the reading lower. Therefore, lets answer the question, should blood pressure be taken lying down?
Blood pressure should not be taken lying down. The American Heart Association and the American College of Cardiology recommend taking blood pressure sitting down. Blood pressure should only be measured lying down if a condition makes it too difficult to sit down.
This article will explain every aspect of why lying down should not be your first choice. Although there are times when its appropriate. Ill inform you when and tips on how to perform it correctly.
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How To Take Your Own Blood Pressure Effectively
When taking your own blood pressure, its important to take it the right way to get accurate results. When and how you take your own BP can affect your results. Blood-pressure monitoring tips include:
- Take it easy before taking your BP. Rest for at least five minutes before your first measurement. Dont smoke, drink caffeinated beverages or exercise for 30 minutes before taking your BP. Dont talk while taking your BP.
- Take your BP with an empty bladder.
- Sit correctly. Sit with your back straight and well-supported make sure not to cross your legs and keep your feet flat on the floor.
- Position your arm correctly. Keep your upper arm at heart level. The way to do this will be a little different depending on whether youre using a wrist or upper-arm monitor, so follow the instructions for your device. Dont place blood pressure cuffs over your sleeves
- Measure at the same time every day. Many doctors will recommend taking your BP in the morning and evening. Dont take your BP right after you wake up.
- Take more than one reading and track your results. Take two or three readings about one minute apart. Some OMRON devices do this automatically and then give you an average of your readings. Take your monitor with you to doctor appointments. Some monitors called, wireless or connected, will allow you to store, track and share your results with your doctor from your mobile device.
What To Do When Your Blood Pressure Drops Too Low
So, what to do when your blood pressure drops too low? If you are experiencing symptoms of very low blood pressure, for example, dizziness or fainting, it is always advisable to seek medical opinion. As there are various factors that can be the reason why your blood pressure drops too low, the condition should be properly evaluated. It is important to assess the situation and rule out any related serious cause like sudden dehydration, internal bleeding, serious infection or an allergic reaction.
Here are some immediate steps that guide on how to raise the blood pressure if it is too low. These include
- Drink plenty of fluids
- Lie with the feet above heart
- Avoid standing for long as it acts as a trigger for hypotension
- Consume salt or salty food
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Getting Blood Pressure Help
You should get your blood pressure checked during your routine doctor visits, or at least once every two years, according to the American Heart Association. “Blood pressure is called the silent killer because there may be no symptoms until damage is already being done,” Pacold says. “You can prevent that damage by getting early diagnosis and treatment.” Here are some takeaway tips:
- Blood pressure readings from 120 to 139 or from 80 to 89 are considered to be pre-hypertension. You may need to have your blood pressure checked more frequently.
- If your blood pressure readings stay at or above 140 and 90 over time, your doctor may start you on a treatment program.
- Any time you have a blood pressure reading of over 180 systolic or over 110 diastolic, check it again. If it is still that high, you need to get emergency blood pressure help right away.
Your blood pressure readings can tell you and your doctor a lot about your current health and may even predict future problems. If you are concerned about PAD or if you have episodes of feeling dizzy when you stand up, talk to your doctor. Checking your blood pressure, both sitting and standing and in both arms, is a great way to learn more about what’s going on inside your arteries.
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How Is Orthostatic Hypotension Diagnosed
Your healthcare provider will check your blood pressure while youre seated, lying down and standing. You may also get one or more of these tests:
- Blood tests to check for conditions like diabetes and anemia.
- Echocardiogram to check the hearts pumping action.
- Electrocardiogram to test for heart rhythm changes.
- Exercise stress test to measure heart rate during physical exertion.
- Portable EKG devices to measure heart rhythm.
- Tilt table test to safely measure blood pressure, heart rate and heart rhythm while you lie on a table that moves from horizontal to vertical.
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Living With Low Blood Pressure
Medicines and lifestyle changes can help you live safely with chronic low blood pressure. Your doctor can recommend steps you can take to manage your low blood pressure. These actions can help control the condition:
Drink more water. This can help avoid dehydration.
Medicines and lifestyle changes can help you live safely with chronic low blood pressure.
Avoid alcohol. Alcoholic beverages are dehydrating, and alcohol changes how medicines work in your body.
Slow down. Take your time when standing up. If lying down, sit up first. Then wiggle your feet and move your legs. This will increase circulation and get your heart rate up so that you dont feel lightheaded when you stand up.
If your medicine and lifestyle changes do not reduce your low blood pressure symptoms, talk with your doctor about other changes you can make.
Does Blood Pressure Drop Before A Heart Attack
Blood pressure is not an accurate predictor of a heart attack. Sometimes a heart attack can cause an increase or in blood pressure, but having a change in blood pressure reading doesnt always mean its heart-related. Instead, a better strategy for gauging a heart attack is to look at your overall symptoms.
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What To Do When Your Blood Pressure Drops Too Low & How To Raise It
Maintaining ideal blood pressure can be a difficult task for some. As very high as well as low blood pressure levels can be dangerous, it is necessary to maintain the normal range. So, while a healthy routine and medications are important for high blood pressure, it is also essential to know about the symptoms of very low blood pressure. Let us understand what to do when your blood pressure drops too low and how to raise it.
Ask The Doctor: Should I Worry About Low Nighttime Blood Pressure
Q. My systolic blood pressure is high in the morning , but in the evening it drops to below 100. I am taking two blood pressure medications daily and still experiencing seriously low blood pressure at night. What would you suggest?
A. Everyone’s blood pressure changes throughout the day, and it’s often highest in the morning and lowest at night. You seem worried about the low pressure at night, but that would concern me only if it’s accompanied by symptoms such as dizziness or fainting. A systolic pressure below the normal of 120 is usually not worrisome. In fact, studies show that low blood pressure while you are sleeping predicts low cardiovascular risk.
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Blood Pressure Measurement Part : Lying And Standing Blood Pressure
15 July, 2007
VOL: 103, ISSUE: 20, PAGE NO: 24
Phil Jevon, PGCE, BSc, RN, is resuscitation officer/clinical skills lead, Manor Hospital, Walsall, and honorary clinical lecturer, University of Birmingham Medical School
John Holmes, MA, Cert Ed, DPNS, RMN, RN, is senior lecturer, pre-registration adult nursing, University of Wolverhampton
In healthy patients there is normally little difference between lying and standing blood pressure.
However, a significant fall can occur in older people, patients with diabetes and those with symptoms suggesting postural hypotension . It is advisable to measure both lying and standing blood pressure routinely in these patients.
Blood pressure measurement in the presence of atrial fibrillation, particularly when the ventricular rhythm is extremely irregular, is unreliable and may be improved with repeated measurements. Some automated devices may provide unreliable readings in the presence of atrial fibrillation . Auscultation using a mercury device may provide a more accurate reading.
The Lowdown On Low Blood Pressure
“In a healthy person, low blood pressure is a sign of good health as long as the systolic pressure is above 80,” explains Dr. Pacold. “Very low blood pressure in a person with heart disease could be a sign of heart failure.”
One type of low blood pressure that could predict future heart problems is called orthostatic hypotension. In this type of low blood pressure, “there is a drop of 10 to 20 points of blood pressure when a person moves from a sitting or supine position to a standing position,” Pacold says. “It causes a sudden sense of lightheadedness and can be due to a heart that is starting to have trouble compensating.”
A recent study on orthostatic hypotension published in the journal Hypertension followed more than 12,000 adults for about 17 years. None of them had heart failure at the start. People who had episodes of orthostatic hypotension during the study period, especially between the ages of 45 to 55, were more likely to develop heart failure by the end.
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What Are Everyday Ways To Help Manage Pots
Diet and nutrition
Taking and writing down your vital information can give you insight and better control over your POTS, and helps your doctor fine tune your treatment.
Check blood pressure and pulse at the same time daily . Its very helpful to do this for the first few months of your diagnosis. Also check blood pressure and pulse when you aren’t feeling well.
Measuring heart rate can give you insight as you deal with POTS. Other facts about heart rate and POTS:
- A normal heart rate is between 60 to 100 beats per minute.
- A fast heart rate over 100 beats per minute can be a condition called tachycardia.
- A slow heart rate under 60 beats per minute is called bradycardia.
- High or low rates can cause symptoms of POTS.
Blood pressure is the pressure of the blood in the blood vessels in the circulatory system. Blood pressure is related to the heart beating and the diameter and elasticity of the artery walls.
Exercise and physical activity
Exercise and physical activity are key to managing POTS. Here are important things to know as you undergo an exercise program such as cardiac rehab, as well as other physical activities. Talk with your healthcare provider for specific instructions on these exercises.
As you do better with your POTS, more fitness and exercise regimens may be started.
Dropping Blood Pressure And Heart Failure
About 600 people had the telltale blood pressure shift at the start of the study.
Researchers found that those with orthostatic hypotension were about 50% more likely than those who didnât experience the changes to go on to develop heart failure.
Some of that extra risk appeared to be explained by high blood pressure.
People with orthostatic hypotension were also more likely to have high blood pressure, which is known to contribute to heart failure.
The risk appeared to be highest for younger adults. Those who were younger than 55 when they were diagnosed with the positional change in blood pressure were nearly twice as likely as those with steady blood pressure to go on to develop heart failure.
Researchers caution that their study can only show associations. It doesnât prove that falling blood pressures cause heart failure or even explain how the two problems may be linked.
âMaybe this is an of early atherosclerotic disease,â Jones says.
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Orthostatic Hypotension Blood Pressure When You Stand Up From Sitting Or Lying Down
If you stand up from a sitting or lying down position and experience orthostatic hypotension, it is likely that your systolic blood pressure has decreased at least 20 mm/HG or your diastolic blood pressure has decreased at least 10 mm/HG within three minutes of standing. It is not uncommon to feel a slight drop in blood pressure and, perhaps, experience a slight lightheaded feeling, but when the feeling lasts for a few minutes and when it happens on a regular basis, you should see a doctor. Orthostatic hypotension or postural hypotension can be a sign of a serious health problem.
Blood Pressure Differences Between Arms
Has your doctor ever measured your blood pressure in both arms? “Not a bad idea,” says Pacold. “Finding blood pressure differences between one side of the body and the other can be a warning sign for atherosclerosis in the main blood vessel leaving the heart or elsewhere in the body. It is a signal that you need to look further.”
Research published in the British medical journal The Lancet found that a blood pressure difference of 10 to 15 points between arms increases the risk for dying from a stroke or from heart disease. Having a difference of 15 points or more was found to double the risk for peripheral artery disease , a condition that affects more than 12 million Americans. Researchers concluded this after reviewing 20 studies that recorded blood pressure differences between arms.
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