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Postural orthostatic hypotension: How is it treated?

Heart & Blood Health | Last Active: Sep 10 1:50pm | Replies (25)
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@taterjoy

Hello--my husband who is athletic, very fit at age 71, and never had high BP before, recently developed severe pain due a hip injury (not properly diagnosed as of yet, though he's been to ER when his BP rose to 178/110, and urgent care when it hit 165/113, and to his MD finally agreed to see him yesterday). He was not able to sleep more than a few hours per day/night for 12 days. They finally gave him tyl/codeine and told him "not to get addicted to it" so he only takes it in the middle of the night if he can't sleep. Meanwhile his BP is very high when sitting but not standing. And once it was normal when sitting. And his MD does not want to treat it until we "observe" it for a while. We've done some research, but can't determine what might be causing the erratic elevations. My husband does not think he has sleep apnea. Is it safe to "wait" and observe? It was 148/95 after waking up this AM. What questions can I/he ask his MD? Thank you for any input

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Replies to "Hello--my husband who is athletic, very fit at age 71, and never had high BP before,..."
John, Volunteer Mentor | @johnbishop | Oct 7, 2020

Hello @taterjoy, From your description of your husbands symptoms it sounds like Orthostatic Hypotension. Mayo Clinic has some information that might answer some of your questions - Orthostatic hypotension (postural hypotension) Symptoms & causes: https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548

@cehunt57 @that_girl and @predictable may be able to provide some information on your husbands symptoms.

Although this conversation is in the Brain & Nervous System group on Connect, you may wish to read some of their posts:
– Is there anyone else out there with pure autonomic system failure? https://connect.mayoclinic.org/discussion/is-there-anyone-else-out-there-with-pure-autonomic-system-failure/

Here’s an informative journal article with some great information about managing orthostatic hypotension, including diet recommendations:
– Preventing and treating orthostatic hypotension: As easy as A, B, C https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888469/

There is another site with some good ideas on planning your conversation with your doctor: https://patientrevolution.org/visit-tools. If it were me, I might want to ask the doctor what he is looking for when he wants to observe your husband. Another question might be does your husbands symptoms fit the diagnosis of Orthostatic Hypotension. You might want to write a list of questions you have to take them with you to make sure they all get answered.

How is your husband feeling about waiting until the doctor makes some observations?

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