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What You Need To Know About Orthostatic Hypertension

What You Need To Know About Orthostatic Hypertension

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 blood pressure when a person assumes an upright posture.

The details surrounding that definition vary depending on the study you choose to look into.

orthostatic hypertension

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 or higher OR a diastolic BP of 120 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.

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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.

Get in touch with your doctor

Orthostatic hypertension is linked to masked or future hypertension, which many consider a “silent killer” because it doesn’t typically result in symptoms until the reading becomes threateningly high. For this reason, it’s crucial to consult your doctor even if you do not have symptoms.

Showing up for wellness check-ups help ascertain if you have elevated blood pressure or hypertension. From there, the doctor can help create an individualized management plan for you.

Make lifestyle changes to control your blood pressure

Left untreated, high blood pressure might progress into hypertensive crisis, which can damage the organs and even result in death.

But, even if it doesn’t reach that stage, keeping your blood pressure within the normal range should still be a priority. This is because hypertension increases your risk of developing cardiovascular diseases like heart attack and stroke.

The following practices can help you achieve normal blood pressure levels:

  • A healthy diet; focus on fruits and vegetables, whole grains, and lean meat
  • Regular exercise
  • Achieve a healthy weight
  • Avoid or quit smoking
  • Reduce sodium intake
  • Manage your stress levels
  • Cut back on caffeine
  • Monitor your blood pressure regularly

And, of course, if the doctor prescribes you BP-lowering medicines, you need to take them as ordered.

Watch out for warning symptoms

Unchecked, hypertension (including orthostatic hypertension), can be life-threatening. If you experience the following warning signs of a hypertensive crisis, seek medical help right away to receive appropriate intervention:

  • Severe chest pain
  • Intense headache, especially if accompanied by confusion and blurry vision.
  • Nausea and vomiting
  • Shortness of breath
  • Severe anxiety

Other warning signs include seizures and unresponsiveness.

Key Takeaways

Orthostatic hypertension is understudied, that’s why we still don’t have a standard definition for it. However, receiving treatment for it should be a priority because hypertension puts the patient’s health and life at risk.

Learn more about Hypertension here.


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Orthostatic hypertension: Recognizing an underappreciated clinical condition
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Orthostatic hypertension: From pathophysiology to clinical applications and therapeutic considerations
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Written by Lorraine Bunag, R.N. Updated Apr 30, 2021
Fact Checked by Hello Doctor Medical Panel