Postural hypotension is also known as upright hypotension, drug treatment is not the main treatment, non-pharmacological treatment is the current first-line treatment, including stop taking the drugs that cause upright hypotension, increase salt and water intake, lifestyle changes, etc., the effect of the improvement is not obvious, can be followed by the doctor’s instructions to add medication, such as fludrocortisone, midodrine, drospirenone and so on.
Upright hypotension is defined as a decrease in systolic blood pressure of ≥20mmHg or a decrease in diastolic blood pressure of ≥10mmHg after standing for 2-5 minutes compared to before.
1. Non-pharmacologic treatment. The main causes of upright hypotension are taking certain drugs (such as antihypertensive drugs), changing position too quickly, insufficient blood volume, pressure receptor disorder, etc. Therefore, the treatment should be to identify the causative drug and stop using it, consume more salt and water, avoid walking for a long time under high temperature, use compression stockings and other measures.
2. Medication. If the improvement is not obvious by the above non-pharmacological treatments, pharmacological treatments should be initiated, such as the use of fludrocortisone to increase blood volume, but this drug has a higher likelihood of hypokalemia, supine hypertension, and ankle edema, and should be closely monitored.
Or use Midodrine, Droxidopa to regulate sympathetic excitability, but the former is prohibited to be used in patients with severe heart disease, patients with uncontrolled supine hypertension, patients with urinary retention, the latter is prone to supine hypertension, headache, nausea and other adverse reactions.
Warm reminder: when upright hypotension occurs, it should go to the regular hospital in time, to clarify the cause of the disease, the treatment plan varies from person to person, do not take drugs without authorization.