Dizzy When Standing? Why Your Blood Pressure Drops & Medical Next Steps

Feeling dizzy when you stand up can be unsettling. You may notice lightheadedness, blurred vision, weakness, or even a brief blackout sensation. One of the most common reasons for this is orthostatic hypotension — a drop in blood pressure that happens when you move from sitting or lying down to standing.

While occasional mild dizziness can be harmless, frequent or severe episodes deserve medical attention. Here's what you need to know about orthostatic hypotension, why it happens, and what to do next.

---

What Is Orthostatic Hypotension?

Orthostatic hypotension (also called postural hypotension) occurs when your blood pressure falls significantly within three minutes of standing.

Doctors define it as:

• A drop in systolic blood pressure (top number) of 20 mm Hg or more
• Or a drop in diastolic blood pressure (bottom number) of 10 mm Hg or more

When you stand, gravity pulls blood into your legs and abdomen. Normally, your nervous system quickly signals your heart and blood vessels to:

• Increase heart rate
• Tighten blood vessels
• Maintain steady blood flow to your brain

If this response is too slow or ineffective, your brain temporarily receives less blood — and that's when dizziness occurs.

---

Common Symptoms of Orthostatic Hypotension

Symptoms usually happen within seconds to a few minutes of standing and may include:

• Lightheadedness
• Dizziness
• Blurred or dim vision
• Weakness
• Nausea
• Feeling faint
• Confusion
• Fainting (syncope)

Symptoms often improve when you sit or lie back down.

---

What Causes Orthostatic Hypotension?

Orthostatic hypotension has many possible causes. Some are mild and temporary. Others require medical treatment.

1. Dehydration

One of the most common causes. When you don't have enough fluid in your body, your blood volume drops.

Causes of dehydration include:

• Not drinking enough fluids
• Vomiting or diarrhea
• Fever
• Excessive sweating

2. Medications

Many medications can contribute to orthostatic hypotension, including:

• Blood pressure medications
• Diuretics (water pills)
• Antidepressants
• Parkinson's medications
• Certain heart medications
• Erectile dysfunction drugs

If symptoms began after starting a new medication, speak with your doctor before making any changes.

3. Heart Conditions

If your heart cannot pump enough blood quickly when you stand, dizziness may result. Conditions include:

• Slow heart rate (bradycardia)
• Heart valve problems
• Heart failure

4. Nervous System Disorders

Some neurological conditions affect the body's ability to regulate blood pressure, such as:

• Parkinson's disease
• Multiple system atrophy
• Diabetic neuropathy

5. Aging

Orthostatic hypotension becomes more common with age. Blood vessels may become less responsive, and many older adults take medications that affect blood pressure.

---

Is It the Same as Vasovagal Syncope?

Not exactly. While orthostatic hypotension involves a blood pressure drop when standing, Vasovagal Syncope is a reflex that suddenly lowers heart rate and blood pressure in response to triggers like stress, pain, or standing for long periods.

If your dizziness sometimes leads to fainting and you're wondering whether it could be related to this condition, checking your symptoms can help you understand what might be happening and prepare you for a more informed conversation with your doctor.

However, any repeated fainting should be evaluated by a medical professional.

---

When Is Orthostatic Hypotension Serious?

Occasional mild dizziness that resolves quickly may not be dangerous. But repeated or severe episodes can lead to:

• Falls
• Injuries
• Fractures
• Reduced quality of life

More importantly, orthostatic hypotension can sometimes signal:

• Heart disease
• Significant dehydration
• Blood loss
• Nervous system disorders

Seek urgent medical attention if dizziness is accompanied by:

• Chest pain
• Shortness of breath
• Severe headache
• Weakness on one side of the body
• Slurred speech
• Irregular heartbeat
• Repeated fainting

These symptoms could indicate a life-threatening condition.

---

How Doctors Diagnose Orthostatic Hypotension

Your doctor may:

• Measure blood pressure while lying down, sitting, and standing
• Review your medications
• Ask about fluid intake
• Check heart rate response
• Order blood tests (to check for anemia, dehydration, diabetes)
• Perform an ECG (heart tracing)
• In some cases, recommend a tilt-table test

Diagnosis is usually straightforward when blood pressure changes are clearly documented.

---

Treatment for Orthostatic Hypotension

Treatment depends on the underlying cause. The goal is to improve blood flow to the brain and prevent falls.

Lifestyle Adjustments

Many cases improve with simple changes:

• Stand up slowly, especially in the morning
• Sit on the edge of the bed for a minute before standing
• Drink adequate fluids
• Increase salt intake (only if your doctor approves)
• Avoid alcohol
• Eat smaller, more frequent meals
• Avoid standing still for long periods
• Wear compression stockings (if recommended)

Medication Adjustments

If medications are contributing, your doctor may:

• Lower the dose
• Change the timing
• Switch to an alternative

Never stop medications on your own.

Prescription Treatments

In more persistent cases, doctors may prescribe medications that:

• Increase blood volume
• Constrict blood vessels
• Help regulate nervous system responses

These are typically used when lifestyle changes are not enough.

---

Practical Tips to Prevent Dizziness When Standing

Here are easy habits that can reduce episodes of orthostatic hypotension:

• Pump your ankles and clench your leg muscles before standing
• Cross your legs while standing to increase blood return
• Stay hydrated throughout the day
• Avoid very hot showers
• Elevate the head of your bed slightly

Small daily adjustments can make a noticeable difference.

---

Who Is at Higher Risk?

You may be more likely to develop orthostatic hypotension if you:

• Are over age 65
• Have diabetes
• Have Parkinson's disease
• Take multiple blood pressure medications
• Have chronic dehydration
• Have heart disease

If you fall into a higher-risk category, regular monitoring is especially important.

---

Can Orthostatic Hypotension Be Cured?

Sometimes, yes — especially if it's caused by:

• Dehydration
• Medication side effects
• Temporary illness

Chronic forms related to nervous system disorders may not be fully reversible but can often be managed effectively.

Early evaluation improves outcomes.

---

When to Speak to a Doctor

You should speak to a doctor if:

• Dizziness happens frequently
• You have fainted
• You've fallen
• Symptoms are getting worse
• You have other concerning symptoms
• You have heart disease or neurological conditions

Even if symptoms seem mild, recurrent orthostatic hypotension deserves medical evaluation. Some causes are serious and require prompt treatment.

Do not ignore symptoms that could indicate something life threatening. If you experience chest pain, neurological symptoms, or repeated fainting, seek immediate medical care.

---

The Bottom Line

Orthostatic hypotension is a common cause of dizziness when standing. It happens when your blood pressure drops too quickly, reducing blood flow to the brain.

In many cases, it's manageable with:

• Hydration
• Careful movement
• Medication review
• Simple lifestyle changes

But sometimes, it signals a deeper issue involving the heart, nervous system, or overall health.

If you're unsure what's causing your symptoms, consider starting with a symptom check and then speak to a doctor for a full evaluation. Your safety — especially preventing falls or serious complications — is worth taking seriously.

Dizziness may be common, but it should never be ignored.