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The Doctors Book of Home Remedies II: Low Blood Pressure

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Low Blood Pressure

If you've ever experienced low blood pressure after standing up, you probably know the symptoms: You climb out of bed feeling perfectly fine--and then, an instant later, you feel as though you might pass out.

This is because when you stand up suddenly, there's a brief period (about a minute or so) when your circulatory system has to adapt to a new body position and may not be sending enough blood to your brain. That's what accounts for the momentary light-headedness, which usually corrects itself after you've been on your feet and moving around a bit.

Low blood pressure symptoms sometimes can also occur after eating a meal or after standing for a long period of time. Under any of these circumstances, if you get light-headed, you are at risk for falls or fainting, according to Scott L. Mader, M.D., assistant professor of medicine at Case Western Reserve University in Cleveland. If this occurs frequently, you should definitely get a doctor's advice.

Another reason to see the doctor: If you're taking medications for other conditions, these drugs may be causing low blood pressure. "Tell your doctor about your symptoms," suggests Mark J. Rosenthal, M.D., associate professor of medicine and geriatrics at the University of California, Los Angeles, School of Medicine and a staff physician at the Geriatric Research, Education and Clinical Center at the Veterans Administration Medical Center in Sepulveda. It may be possible to reduce your dosage or to switch to a drug with fewer side effects.

In the meantime, here are some other ways to get the pressure up.

Fill 'er up with water. Dehydration reduces blood volume, which can lead to a drop in blood pressure. "I tell my patients to drink liberally," Dr. Rosenthal says. He recommends drinking about one glass (eight ounces) per hour; other doctors suggest eight glasses a day.

Pump your calves. When your blood pressure is low, gravity gets the upper hand. There's too much blood pooling in the lower part of your body. How can you keep it moving?

"If you're standing or sitting for long periods of time, keep blood from pooling in your legs by flexing and pointing your toes, stepping in place and rhythmically contracting and relaxing your calf muscles," Dr. Rosenthal suggests.

Adopt a flex stance. Standing at attention for a long time seems like an invitation to lower blood pressure. So why don't the guards at Buckingham Palace keel over?

Maybe it's because they don't lock their knees. Dr. Mader suggests keeping your knees slightly flexed rather than locked. "If you flex your knees slightly, you maintain muscle tension in your leg muscles to help pump blood back up to your heart."

Take time to cool down. When you've been exercising vigorously and you suddenly stop, there may be a dizzying drop in blood pressure. "For the next ten minutes or so following exercising, continue your activity at a slowed down pace," suggests John Duncan, Ph.D., associate director of the Exercise Physiology Department at the Cooper Institute for Aerobics Research in Dallas. That gives your breathing a chance to return to normal and your heart a chance to resume its regular pace.

When to See the Doctor

Since low blood pressure can contribute to falls, you should see the doctor if you have any blackouts or if you repeatedly feel faint and light-headed during the day. You should also see the doctor if you are taking any medication, since many drugs--especially those for high blood pressure--can affect the contraction and dilation of blood vessels. Usually you can be switched to a different medication that can still treat your condition without causing problems.

In some cases, low blood pressure may be one symptom of diabetes or nervous system diseases, according to Scott L. Mader, M.D., assistant professor of medicine at Case Western Reserve University in Cleveland.

Low blood pressure after standing can be treated. Often a change in diet or activity level will be enough. However, there are more potent therapies available if needed.

Stick with nonalcoholic drinks. Alcohol temporarily dilates blood vessels, causing a pleasantly warm flush. But those dilated vessels don't sustain their shape as well as normal, undilated vessels. So when your blood vessels dilate, your blood pressure can hit some dizzying new lows.

Don't restrict salt unless you need to. "I tell a lot of my patients with low blood pressure after standing up to lightly salt their food at each meal," suggests Dr. Mader. This is only for some people, however. If you've been put on a low-salt diet by your doctor, you shouldn't go off it without his permission.

Lie head-high. Sleeping with your head slightly elevated may help your body better adjust to an upright position, Dr. Rosenthal says. Try four-inch blocks under the legs at the head of the bed.

Rise and shine ... slowly. Take lessons from a cat. Stretch before getting up, contracting and relaxing the muscles in your legs, abdomen and arms. When you sit up, dangle your feet over the side of the bed and flex your calves and arms. "Squeeze your fists and pump your stomach in and out a few times," suggests Dr. Mader. "Arm exercises are particularly effective at raising blood pressure."

Of course, if dizziness is a problem, it's a good idea to keep a chair or handrail by the bed to grasp as you stand.

Eat like a bird, not a boa constrictor. If you feel woozy after a big meal, try eating smaller, more frequent meals, experts recommend. After a big meal, blood rushes to your digestive area, and as a result, there's less blood getting to your brain. By eating smaller, more frequent meals, you're more likely to maintain more constant blood flow.

Walk it off. In one study of older people with low blood pressure after meals, walking afterward restored their blood pressure to normal. "These findings support an old German proverb--'After meals, you should rest or walk a thousand steps,'" says researcher Lewis A. Lipsitz, M.D., director of medical research at the Hebrew Rehabilitation Center for the Aged and assistant professor of medicine at Harvard Medical School, both in Boston.

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