Many of us are familiar with orthostatic hypotension or postural low blood pressure, a condition that usually triggers dizziness after suddenly changing positions, typically from lying down to standing up. Interestingly, we also have orthostatic hypertension, although it is less studied and appreciated. Here’s what you need to know about this kind of high blood pressure.
What is Orthostatic Hypertension?
The fact that orthostatic hypertension is understudied makes it hard for experts to assign it with a standard definition. Currently, the basic definition of orthostatic hypertension is an increase in the normal blood pressure when a person assumes an upright posture.
The details surrounding that definition vary depending on the study you choose to look into.
For instance, some papers checked how much both the systolic and diastolic numbers increased from lying down to standing position. In other reports, they only checked how much the systolic reading (number on top) increases when the person changes position.
Due to the lack of a standard definition, it’s quite difficult to diagnose orthostatic hypertension. The hallmark, perhaps, is the consistent and significant increase in BP when the patient sits or stands.
Symptoms of Orthostatic Hypertension
It’s still unclear if orthostatic hypertension presents with physical symptoms other than increased blood pressure; after all, hypertension usually does not result in any symptoms unless the reading becomes dangerously high.
One case presentation about orthostatic hypertension noted a 58-year old patient who experienced the following symptoms:
- During the emergency room visit: Intense, throbbing headache which got worse upon sitting or standing up. The headache appeared to slightly get better when lying down.
- Weeks before: The patient noticed milder episodes of intermittent headaches, blurry vision, and occasional palpitations.
Please note that upon admission to the ER, the patient was already experiencing a hypertensive crisis. This indicates a systolic BP of 180 mmHg or higher OR a diastolic BP of 120 mmHg or higher.
Upon checking, her blood pressure reading while lying down was at 196/94 mmHg. Interestingly, the reading went up to 208/98 mmHg when she was sitting up, and it increased further to 236/118 when she was standing.
Management Strategies
To date, there is still no specific treatment recommendation for orthostatic hypertension. Reports say management strategies should be individualized and other factors like symptoms and comorbidities must be considered.
If you’re worried about orthostatic hypertension or high blood pressure in general, consider the following steps.
