Postural Hypotension or Orthostatic hypotension is the process of drop in body blood pressure, when people stand up from sleeping or sitting position.  Medically it is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing compared with blood pressure from the sitting or supine position. Alternatively, the diagnosis can be made by head-up tilt-table testing at an angle of at least 60 degrees.

People develop various symptoms due to drop in blood pressure in the form of mild dizziness, blackout and loss of consciousness.  Postural hypotension may be acute or chronic. Patients may present with light-headedness, blurred vision, dizziness, weakness, and fatigue, or with syncope (in the acute care setting).  Less commonly, they may present with neck and shoulder pain, orthostatic dyspnea, and chest pain. Outlines the differential diagnosis of orthostatic hypotension, which may be caused by a number of things, including dehydration, blood loss, medication, or a disorder of the neurologic, cardiovascular, or endocrine system.

Various parkinsonism syndromes can have postural hypotension.  Among these Multiple system atrophy (MSA) patients have more commonly these symptoms.

The treatment of Postural hypotension includes non-pharmacological (without medications) and Pharmacological (with medications).   Your doctor will suggest you what treatment you need to follow.  In this page, we are providing some of the non pharmacological treatments to manage postural hypotension.

Home Management of Postural Hypotension
(Non-pharmacological treatments)

Increase Salt Intake

Increase salt intake in the food. Add extra salt in most of the diet. OR you can also take Salt tablets (Seek your doctor)

Simple exercies

Simple exercises, especially of lower back and abdomen / pelvis will help. Avoid sternous activities / exercises.

Avoid Sudden Position changes

Avoid sudden position changes. Take time to move from one position to other, especially from sleeping and sitting position. Move your legs like marching or cycling for few seconds before you get up

Head end elevation

Keeping your head end of the bed elevated will help to some extent to avoid sudden blood pressure changes
Indian meals

Avoid Large Meals

Avoid large / big meals. Take small quantity and more frequent meals. Suggestions would be to have small meals/snacks once in 3-4 hours.

Avoid Hot Water Bath

Avoid very hot water bath. Hot water bath affects the blood flow pattern, leading to BP fluctuations.

Use Abdominal Binders

Use abdominal binders and compression stockings. This will help to reduce the blood pressure drop during sudden posture changes

Crossed leg standing

Simple postures like crossed leg standing, toe raises, contracting abdominal muscles / legs will help

Drink more water

Drink lot of water. Atleast 1.5 to 2.5 liters of water to be consumed in a day. If dizzy, quick gulping of 400-500ml of water will also help to increase blood pressure

Avoid Alcohol

Avoid alcohol and alcoholic breverages. It adds to BP changes and more symptoms,

Check you Medications

Everytime you visit your doctor, show all your prescription and non prescription medications. Some medications may be affecting your postural hypotension. It's better to get it cross checked on every visit

Monitor Postural BP

Monitor your postural BP changes and maintain a records. This will help your doctor to take decisions on your next visit. Check your BP after sleeping for atleat 5 minutes and on standing at 1min, 3min and 5mins.