Postural hypotension emergency department leaflet

• You may have been diagnosed as having postural hypotension by your doctor. This is a drop in blood pressure due to a change in body position, most commonly when standing up.

• This drop in blood pressure causes a temporary reduction in blood flow to the brain. It can cause lightheadedness, nausea, palpitations and faints.

• It is a common problem affecting older people but can also affect younger people.

• Many conditions can lead to postural hypotension, including Parkinson’s disease and Diabetes.

• Other factors that may contribute include: not drinking enough; warm temperatures; over-exertion; anxiety, and an ongoing infection.

• Some of your medications can also cause this as a side-effect and your GP may need to review these to decide if any of your medications may need to be stopped or changed.

• This article is designed to give you some information and guidance on how to selfmanage this condition with some simple advice and exercises.

• If simple measures do not help improve your symptoms, your GP may consider medications to help your symptoms.

Postural hypotension is a drop in blood pressure due to a change in body position, most commonly when standing up. This drop in blood pressure causes a temporary reduction in blood flow to the brain.

Symptoms.

Symptoms are most common after standing up and can include

• Dizziness.
• Light headedness.
• Weakness.
• Fainting.
• Nausea.
• Heart palpitations.

These situations can make your symptoms worse:

• Dehydration.
• Drinking alcohol.
• Hot temperatures.
• Infection or illness.
• Straining on the toilet.

Symptoms may be worse in the morning.

Symptoms may be worse after standing still, sitting or lying down for a long time.

The following actions may help improve your symptoms:

• Try to drink a large glass of cold water before standing up and ensure you are drinking enough during the day.
• Try not to bend over when reaching for something. You should squat with your knees to recover it or obtain a grabber device.
• Try sleeping in a more upright position in bed, with more pillows.
• Avoid excessive alcohol and large meals.
• Exercises can reduce your symptoms.

If your symptoms are severe, talk to your doctor about increasing the amount of salt in your diet.

Exercises to do while sitting, before you stand up.

Toe tapping

Sitting with your feet flat on the floor, lift your toes up with your heel still on the ground, then ‘tap’ them back onto the ground. Do this for 10 seconds, 3 times.

Heel lifts

Sitting with your feet flat on the floor, lift your heel off the floor onto your ‘tiptoes’, then lower your heels back to the ground. Do this for 10 seconds, three times.

Marching on the spot

Sitting down, march your legs briskly on the spot. Repeat this for 10 seconds, three times.

Leg extensions

Sitting down with both feet flat on the floor. Lift one foot off the floor until your knee is straight. Hold for 10 seconds, then slowly lower your foot back to the floor. Repeat three times, then repeat the exercise on the other leg.

You should see your GP if:

• Advised by the doctor in the Emergency department.
• Symptoms do not settle after your review.

For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.

• The NHS website provides online health information and guidance.

• NHS 111 phone line offers medical help and advice from trained advisers supported by nurses and paramedics. Available 24 hours a day. Calls are free from landlines and mobile phones.
• There are walk-in and urgent treatment services at Brighton Station, in Crawley and at Lewes Victoria Hospital.
• Patient Advice and Liaison Service (PALS) can be contacted with your comments and concerns, and to provide general support.

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

This information is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.