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TRIBE TIPS - Managing Orthostatic Hypotension (Dizziness)

Updated: Mar 21

Written by Dr. Michael Braitsch PT, DPT via November 2022 Newsletter

Orthostatic hypotension is an unusually large decrease in blood  

pressure on standing that increases the risk of falls. 

  • Establish whether symptoms are  due to orthostatic hypotension by taking blood pressure: 

    • supine (laying down)  

    • upright (seated or standing)  

  • Management and prognosis vary according to the underlying cause,  (whether orthostatic hypotension is neurogenic or non-neurogenic). 

    • Neurogenic orthostatic hypotension (NOH) might be the  earliest clinical manifestation of Parkinson's disease and often  coincides with supine hypertension.  

    • NOH requires individualised, and primarily non-pharmacological  approach to the management.  

If you have NOH, talk with your doctor about possibly treating it  with: 

  • the cessation (or reduction) of blood pressure lowering  drugs adoption of lifestyle measures (eg, counterpressure manoeuvres) like ankle pumps before standing and more EXERCISE 

  • Use of compression stockings 

  • In some cases, use of other pharmacological interventions

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