Brief Answer: Agree but can do more Detailed Answer: Dear Mr XXXX, Thanks for the query. It appears clear by the repeated episodes that you are suffering from orthostatic hypotension, likely exacerbated by medications. It is a disorder that happens more frequently as we age, since the body is unable to make the necessary adjustments to keep blood pressure up when we change positions suddenly. Some medications can make it worse. Agree that tamsulosin and atenolol can contribute. Simple but effective measures to help in your case as you are waiting for the atenolol levels to stabilize will be to increase both your salt and fluid intake, and use graded compression stockings or self-fitted ACE bandages on both legs, which are proven methods to increase the return from the veins and increase blood pressure during these changes. Also, if you are sitting for prolonged periods of time, try crossing your legs, calf over shin, and press them hard so that you increase the venous return to the heart; alternate between the legs. Also, doing hand grip exercises while sitting down helps. Hope that is useful, wish you the best, Dr. Brenes-Salazar MD Mayo Clinic Cardiology

---