How Does Blood Pressure Change When Standing After Lying Down?

Posture and Blood Pressure

Hello, what is the change in blood pressure when transitioning from lying down to standing up? In healthy adults, should it increase or decrease? What is the reason for this? Thank you!

fuyi, 30~39 year old female. Ask Date: 2013/01/02

Dr. He Dongjin reply Cardiology

Orthostatic hypotension is defined as a decrease in systolic blood pressure greater than 20 mmHg or a decrease in diastolic blood pressure greater than 10 mmHg when standing up from a lying position.
Symptoms may include dizziness, headaches, blurred vision or temporary vision loss, weakness, drowsiness, and even fainting.
Orthostatic hypotension is a manifestation that can occur in various diseases.

1.
Medication-related: Many medications can cause orthostatic hypotension, including diuretics, vasodilators, alpha-blockers that lead to autonomic reflex failure, and some psychiatric medications.

2.
Inadequate blood volume: Conditions such as severe bleeding, significant vomiting or diarrhea, and excessive sweating leading to severe dehydration can result in low blood volume.

3.
Autonomic nervous system issues: Orthostatic hypotension is one of the most common causes of symptomatic hypotension in the elderly.
In healthy individuals, the body’s mechanisms to regulate blood pressure activate when transitioning from a lying to a standing position to maintain normal blood pressure.
However, in older adults, the degradation of autonomic nervous system function can prevent the timely regulation of blood pressure, making them more susceptible to orthostatic hypotension.
Other factors such as diabetic neuropathy, alcohol-related neuropathy, spinal nerve damage, or neuropathy following viral infections can impair autonomic function, leading to orthostatic hypotension.

4.
Cardiac issues: Sudden orthostatic hypotension can be seen in cases of myocardial infarction or arrhythmias.
In general, asymptomatic hypotension does not have clinical significance and does not require further investigation or treatment.
However, symptomatic hypotension necessitates medical evaluation to identify potential underlying causes.
The treatment principle is to first address any known causes and provide treatment accordingly, followed by considering the use of medications to raise blood pressure.
Changhua Hospital cares about your health.

Reply Date: 2013/01/02

More Info

When a person transitions from lying down to standing up, blood pressure typically experiences a decrease, a phenomenon known as orthostatic hypotension. This condition is defined as a drop in blood pressure of more than 20 mmHg in systolic pressure or more than 10 mmHg in diastolic pressure upon standing. The symptoms associated with this drop can include dizziness, lightheadedness, blurred vision, weakness, fatigue, and in severe cases, fainting.

In healthy adults, the body has mechanisms in place to counteract the effects of gravity when standing. When a person stands, gravity causes blood to pool in the lower extremities, which can lead to a temporary decrease in blood return to the heart and subsequently a drop in cardiac output. To compensate for this, the autonomic nervous system activates reflexes that constrict blood vessels and increase heart rate, thereby maintaining blood pressure. However, in some individuals, especially the elderly or those with certain medical conditions, this compensatory mechanism may not function effectively, leading to orthostatic hypotension.

Several factors can contribute to the occurrence of orthostatic hypotension:
1. Medications: Certain medications, such as diuretics, vasodilators, and some psychiatric medications, can interfere with the body’s ability to regulate blood pressure upon standing.

2. Dehydration: Conditions that lead to decreased blood volume, such as severe vomiting, diarrhea, or excessive sweating, can result in lower blood pressure.

3. Autonomic Nervous System Dysfunction: Conditions that affect the autonomic nervous system, such as diabetes (which can cause neuropathy), Parkinson's disease, or other neurological disorders, can impair the body's ability to regulate blood pressure.

4. Heart Conditions: Cardiac issues, such as heart failure or arrhythmias, can also lead to inadequate blood pressure regulation upon standing.

In healthy individuals, the drop in blood pressure upon standing is usually transient and resolves quickly as the body adjusts. However, if someone experiences significant symptoms or recurrent episodes of orthostatic hypotension, it is advisable to seek medical evaluation to rule out underlying conditions.

In summary, when a healthy adult stands up after lying down, blood pressure generally decreases due to the pooling of blood in the lower body and the body's compensatory mechanisms. If symptoms arise, they should be taken seriously, and further evaluation may be warranted to ensure there are no underlying health concerns. Regular monitoring of blood pressure, especially in individuals with risk factors, can help manage and mitigate potential complications associated with blood pressure changes.

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