Should You Be Concerned about Dizziness When Standing?

September 8, 2019

Alright, our next question comes from one of our Twitter followers. Our viewer Tweets, I don’t have low blood pressure, but if I get up after sitting for a long period, I get really dizzy. What could be happening, should I be concerned? It sounds like it could be postural hypotension, which means low blood pressure upon standing. Now it’s important to figure out what other conditions are going on in your life. This person said that they don’t have low blood pressure normally. I don’t know how old this person is, but as we get older, we become more susceptible to these changes in blood pressure. Because what happens, when you’re seated, your blood pressure drops a little bit, and your body doesn’t need to create enough pressure to get the blood going to your brain. But when you stand up, your body has to react very quickly, because the baroreceptors, which are the pressure receptors in your legs, say oh my god, we’re not getting enough pressure, let’s get more pressure, and they respond. As you get older, that response worsens, and you’re more likely to experience this dizziness upon standing. And obviously, other conditions, how hot it is in the room, what other activities you’re doing, what other illnesses you have, like diabetes, can all contribute to this. Now my opinion as a physician, if you’re having any kind of instance of lightheadedness, dizziness, when you’re feeling about to faint, you should get that checked out, not just say, oh I probably have low blood pressure. That’s not a good way to go about it. The one thing that I will say, medications are often– Yes. The factor here, and that’s one of the first questions I ask my patients. Recently, they’ve been some proposed changes to blood pressure guidelines, and we’ve become more aggressive in treating high blood pressure, and that’s dangerous in older adults, because if we lower the blood pressure too low, you can have instances of this orthostatic hypotension, and you have an increased risk of falls, which are very dangerous. So a lot to keep in mind, but to make that situation simpler, talk to your family medicine doc and figure out what’s right for you. That’s really good. (audience clapping) They get you in pregnancy, too. Yes. They get you in pregnancy. You can tell people, when you’re lying down, then first just sit up for a little bit, and then stand up. Pregnancy, varicose veins, dehydration, certainly medications, like you mentioned. But I don’t know if you guys got this very much in your clinic. I get this all the time after procedures. Where people have been sitting or lying down, and all that blood has pooled– Has pooled.
Together in their legs, in their abdomen, and they just can’t get the blood to their head fast enough. And then they get up and they sort of feel very woozy. So definitely get it checked out if it’s worsening. I’ve even, that’s a common situation. I’ve seen even athletes who are very well trained, they’ll run a marathon, and I’ve worked some of the tents in the marathons. They pass out from the same reaction, because the blood pools in their legs, so our first thing is to get them on their backs and pick up their legs, so the blood returns to their brains, and that’s really what it’s about. It’s about making sure your brain is well-perfused with blood.

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