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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How to treat Orthostatic hypotension?

Hello, I am a 27 year old male. I was diagnosed with Orthostatic Hypotension with a tilt test by a cardiologist about a year ago. I ve been very interested in monitoring my blood pressure so I bought a home kit that I use. My average blood pressure is at about 130/85 when sitting. I am aware that my blood pressure drops when standing. When I test myself standing, the readings puzzle me because I do not know how to interpret the results. There is also very little information online about this - readings such as 113/87 HR 85, 115/85 HR 84. I find the lack of disparity between the Systolic and Diastolic reading puzzling I am also aware that my HR should go when I stand up to compensate for the pooling of blood in my legs, however, it seems to slow to 65 BP from 90 BP or so, before jumping to about 98 BP after standing. When this happens, I get a sensation in my stomach similar to gagging (I don t gag, just the stomach pressure) and pressure building behind my ears from my neck. I replicated the slowing of the HR by utilizing my gag complex successfully. I m curious if this is related to the odd blood pressure reading or if any of this is part of the Orthostatic Hypotension I was diagnosed with...
Thu, 12 Jan 2017
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Cardiologist 's  Response
Hi,

Normally heart rate should go up with response to decrease in BP but sometimes due to pooling of blood in legs, blood coming to heart decreases and heart contacts rapidly and vigourously. So when empty hearts contracts vigorously then there other reflex is activated called as bezold jarish reflex which leads to slowing of heart beat. Have plenty of oral fluids and avoid standing abruptly. Use measure like crossing of legs, bed rest during episodes.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Sagar Makode
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