Sunday, June 9, 2013

Why You Feel Dizzy When You Stand Up

If you’re seeing stars when you get out of bed in the morning, there’s actually a name for that dizziness you sometimes get when you go from laying down or sitting to standing up: orthostatic hypotension (OH). What is Orthostatic Hypotension? Orthostatic hypotension is a condition of abnormal blood pressure regulation upon standing. The blood pressure dramatically decreases, more than 20/10 mm Hg, when rising from a lying down or sitting position to a standing position. A little momentary brain static might seem like nothing, but according to a new study from the University of North Carolina at Chapel Hill, OH is linked to heart failure. Could it be a danger sign for your health? What Causes Dizziness: OH happens when your blood pressure takes a dive. Usually, your body compensates when you go from sitting to standing by prompting your heart to beat a little faster (about an extra 10 beats per minute) and constricting your blood vessels, which force more blood back to your head and keep your brain on the up-and-up. This process is often so precise and automatic that you won’t notice any difference when you decide to go vertical. But for people with OH, dizziness is a sign that the system isn’t working as well as it could. Hidden Dangers: So should you be worried? Well, Messerli says, that depends. A bunch of benign reasons might cause OH, such as dehydration, taking medications like diuretics, ACE inhibitors, and beta blockers, or having naturally low blood pressure from being in great shape. (That last one actually lowers your risk of heart problems.) And then there’s a more sinister explanation: In the new study, researchers at UNC-Chapel Hill looked at data from a different, long-term study on heart disease risk factors. Part of that study involved taking volunteers’ blood pressure when they were laying down and when they stood up. Over the next 17 years, give or take, the researchers followed these participants to see which ones developed heart failure. Data showed that those with OH had a higher risk of developing heart failure than those without OH, even after accounting for other heart failure risk factors, such as overall high blood pressure, diabetes, and coronary heart disease. Study author Christine Jones, M.D., an internist and resident in preventive medicine at UNC-Chapel Hill, says that in some people, OH might be an early marker of atherosclerosis, or hardening of the arteries. Over time, that can cause the heart to pump harder and eventually fail. Are You at Risk? If you’ve always had a touch of dizziness upon standing, or you know you’re dehydrated or taking one of the meds that causes OH, then you’re probably safe, Jones says. “But if you’re having severe dizziness or this is something brand new and severe, you should seek medical care,” she explains. To rule out doom completely, have your doc check you for undiagnosed diabetes, hypertension, or early signs of atherosclerosis. The main message for people who do have OH is to optimize your management for other heart failure risk factors. Treating these problems now can help reduce the risk of heart failure in the future.

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