Postural hypotension:
It is a condition in which blood pressure decreases, causing a significant decrease in the level of blood flow to the brain when standing up quickly and suddenly. It may also lead to dizziness, falls and fainting. Symptoms may occur when:

• Sudden standing after sitting.
• Sudden sitting after lying down.
• Getting up in the morning.
• After eating a big meal.
• While doing sports.
• Feeling anxious or panicked.

Causes:

• Diabetes, heart failure or atherosclerosis.
• Take certain diuretics, antidepressants or medicines to lower your blood pressure.
• Neurological diseases (such as: Parkinson's disease and some types of dementia).
• Dehydration.
• Vitamin B12 deficiency or anemia.
• Alcoholism (Alcohol addiction).
• Prolonged bed rest.

Symptoms:
Orthostatic hypotension occurs more frequently with more severe symptoms in the morning because blood pressure is at its lowest in the morning. It can vary from person to person and may include:

• Dizziness when standing.
• Feeling faint or falling.
• Headache and blurred vision.
• A feeling of pressure across the back of the shoulder or neck.
• Feeling nauseous or sweating.
• Weakness or tiredness.

Complications:
People with orthostatic hypotension may be more likely to have:

• Broken bones or concussions from a fall when you feel dizzy or faint.
• Postprandial hypotension, low blood pressure 30 minutes to 2 hours after eating (especially a carbohydrate-rich meal).
• Shock or organ failure if blood pressure remains too low.
• Stroke or heart disease caused by fluctuations in blood pressure.

Diagnosis:
Your blood pressure will be checked while lying down, sitting, and upright. Your doctor will also perform a physical exam in order to find a medical condition that may be causing your low blood pressure. He may order certain tests, including the following:

• Blood test.
• Electrocardiogram.
• Ultrasound examination of the heart.
• ECG stress test, where your heart rate is monitored while you exercise.
• Other tests to see how susceptible a person is to fainting.

Treatment:
It is determined whether the patient has another condition or disease that causes this, as in many cases the disease that causes orthostatic hypotension is treated, or the dose of the drug causing orthostatic hypotension is adjusted, and treatment is sometimes by conducting some Changes in daily life, which include:

• Drink more fluids when dehydrated.
• Get up slowly from a chair, and don't stand for long periods of time.
• Do not sit cross-legged.
• When staying in bed for medical reasons, it is best to sit for short periods of time.
• When getting out of bed, it is preferable to get up slowly and sit on the edge of the bed for several minutes before standing up.
• Special exercises (such as squeezing a rubber ball or a towel for a few minutes) can raise blood pressure and may prevent a significant drop in blood pressure when standing.
• Raise the head of the bed, and compression stockings can also be worn.

Prevention:

• Tell your doctor about any symptoms, and discuss whether you should reduce or stop any of your medications.
• Get out of bed slowly, first sitting on the side of the bed and then standing.
• Take time when changing position (e.g.: when getting up from a chair).
• Try to sit when showering, getting dressed or working in the kitchen.
• Do the exercises gently before getting up (e.g.: moving the feet up) or after standing.
• Make sure you have a firm object to hold on to when standing.
• Avoid walking when feeling dizzy.
• Drink 6-8 glasses of water each day, unless your doctor tells you to limit your fluid intake.
• Avoid using hot baths.
• Try to sleep with extra pillows to raise the head.

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