By John W. Watford, MD, LLC
Have you ever become unsteady standing from a lying or seated position? Has it happened more than once? An abnormal decrease in blood pressure while rising, or orthostatic hypotension, may be the cause.
When we stand up, particularly if we have been lying down, the pressure under which our blood is flowing in our brains can be significantly lower than the blood pressure at our feet or near our hearts. To compensate, the speed and force of our heartbeat may temporarily increase. The arteries in the periphery of our bodies may constrict to redirect more blood to our brains. If the pressure drops enough over a short period of time, we feel dizzy or may even faint and fall.
Pinpointing the cause of orthostatic hypotension can be challenging. Usually, more than one issue is present. If you are 60 years or older and have felt faint or lost consciousness, you should see your doctor or seek attention at an emergency department if symptoms are severe and persistent. Your doctor will ask you to retell the circumstances of your dizziness or fainting in some detail to help discern the most likely cause. He or she will also measure your blood pressure and heart rate when you are lying flat, seated, and standing. Orthostatic hypotension is present if your systolic blood pressure drops 20mmHg (millimeters of mercury) with concomitant drop of at least 10mmHg in diastolic blood pressure between lying and standing when measured over a few minutes. Usually, heart rate increases.
Your doctor will consider your age and details about your personal and family history to recommend some simple initial changes to your activity, fluid intake, and/or medications. Your doctor may order an electrocardiogram, ultrasound of your heart, and basic blood tests if warranted. A home heart rhythm monitoring device may be suggested. Finally, further investigation of your nervous system and reflexes, particularly if you are diabetic or have peripheral neuropathy, might be needed.
People with orthostatic hypotension can still have high blood pressure. Though challenging, your doctor can recommend adjustments to your diet as well as the type, dosing, and timing of medicine to mitigate the orthostatic pressure while still avoiding the negative effects of chronic high blood pressure.
Talk to you doctor about it. He or she can help to solve the problem.
ABOUT DR. WATFORD
My pursuit of a career in medicine began with natural curiosity about “how things work”. My early engineering interests later transformed into an interest in biology as I was inspired by my parents, several wonderful teachers in high school, and a general curiosity about physiology.
I believe curiosity helps us connect with each other. Curiosity drives lifelong learning, makes us better problem solvers, and nurtures our need to take on new challenges. It helps us to listen actively, inspires generosity to collaborate, and expands our empathy.
I grew up largely in Alabama and Florida and completed my undergraduate degree in Biomedical Sciences with Honors at Auburn University. There I founded the first inpatient shadowing program for health sciences students and was a charter member of the Auburn University Honors College. I earned my medical degree at the University of South Alabama in 2003 followed by internships in General Surgery at Carraway Methodist Medical Center, Birmingham, Alabama and then Internal Medicine at Providence St. Vincent Medical Center, Portland, Oregon.
My family and I settled in Naples in 2020 where I became part of the staff of Naples Community Hospital providing inpatient services. I opened my own practice in February of 2022.
Dr. John W. Watford is certified by the American Board of Internal Medicine and has been practicing since 2003. His concierge primary care medicine practice is now open and welcoming new patients. Reach Dr. Watford at 239-544-7440 or info@drwatfordnaples.com
John W. Watford
239-544-7440
www.drwatfordnaples.com
4085 Tamiami Trail North, Suite B103
Naples, FL 34103