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What Causes Lightheadedness While Treating High Blood Pressure?

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Posted on Wed, 4 May 2016
Question: I'm 58 black female. I take medication for high blood pressure. I get very light headed when I stand up after sitting. I normally last a minute or so and I also just feel strange. What is causing this? I recently got over a severe cold that lasted 8 weeks. Is this something I should see a doctor about? My BP with mess is normally 117/75 but recently it has been 127/80 to 130/84.
doctor
Answered by Dr. Ilir Sharka (48 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello,

Welcome on HCM!

Regarding your concern, I would like to explain that light headed feeling while standing up from a sitting position is most likely an expression of some kind of orthostatic hypotension.

Coming to this point, I recommend you to monitor (measure) you BP values when sitting and then after standing up (within seconds to minutes).

If a fall in systolic blood pressure of at least 20 mmHg or in diastolic blood pressure of at least 10 mmHg is present when assuming the upright position, then orthostsatic hypotension seems a rationale explanation.

In such case, it is recommended performing a more specific test, like Head Up Tilt testing, which could reveal a possible orthostatic intolerance.

Such a phenomenon (orthostatic hypotension) may be also triggered by several health conditions like hypovolemia/dehydration (body fluids loss), illnesses leading to prolonged bed rest, anemia, etc.

Now returning to your concrete situation, you are taking antihypertensive medications and seems that your BP is controlled (all the referred BP values seem acceptably controlled; they are less than 140/90 mmHg).

But, if your light headed feeling becomes problematic (it is pronounced and lasts more than a few seconds), then it is necessary to:

- closely monitor your BP values in different positions,
- discuss with your doctor about an eventual review and optimization of anti-hypertensive therapy, and
- a possible Tilt test.

So, to conclude, if your actual complaints become disturbing enough, you need to discuss with your attending physician on the above mentioned issues.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (43 minutes later)
This is very helpful, thank you. What I noticed is that my diastolic number went up 10 when I stood and my systolic number dropped. I will keep monitoring and get in to see my physician. Now I know how to articulate to him what I am feeling. The light headedness feels like tension or sinus pressure. It can get severe but goes away in a minute or less. I have been on a diuretic also as part of my hypotension therapy and I've been sick (taking a lot of cold meds) but not in bed more than a day or two over 8 weeks. This is just scary. And well worth the fee.
doctor
Answered by Dr. Ilir Sharka (9 hours later)
Brief Answer:
You are welcome!

Detailed Answer:

Hi again,

Diuretic treatment may be a reason for a possible relative dehydration leading to your current symptomatology (light headedness).

Nevertheless, I recommend to exclude other possible reasons, like anemia (by complete blood count testing), etc.

My advice is to follow the above mentioned strategy and discuss with your attending doctor to exclude orthostatic hypotension.

Wishing you a good health!

Regards,

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9534 Questions

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What Causes Lightheadedness While Treating High Blood Pressure?

Brief Answer: I would explain as follows: Detailed Answer: Hello, Welcome on HCM! Regarding your concern, I would like to explain that light headed feeling while standing up from a sitting position is most likely an expression of some kind of orthostatic hypotension. Coming to this point, I recommend you to monitor (measure) you BP values when sitting and then after standing up (within seconds to minutes). If a fall in systolic blood pressure of at least 20 mmHg or in diastolic blood pressure of at least 10 mmHg is present when assuming the upright position, then orthostsatic hypotension seems a rationale explanation. In such case, it is recommended performing a more specific test, like Head Up Tilt testing, which could reveal a possible orthostatic intolerance. Such a phenomenon (orthostatic hypotension) may be also triggered by several health conditions like hypovolemia/dehydration (body fluids loss), illnesses leading to prolonged bed rest, anemia, etc. Now returning to your concrete situation, you are taking antihypertensive medications and seems that your BP is controlled (all the referred BP values seem acceptably controlled; they are less than 140/90 mmHg). But, if your light headed feeling becomes problematic (it is pronounced and lasts more than a few seconds), then it is necessary to: - closely monitor your BP values in different positions, - discuss with your doctor about an eventual review and optimization of anti-hypertensive therapy, and - a possible Tilt test. So, to conclude, if your actual complaints become disturbing enough, you need to discuss with your attending physician on the above mentioned issues. Hope to have been helpful to you! In case of any further uncertainties, feel free to ask me again! Kind regards, Dr. Iliri