Feeling Dizzy After Standing or Eating? It Might Be Low Blood Pressure

Podcast Introduction 0:00

Many of us have a sense of dizziness or lightheadedness, and as I mentioned, this can even lead to a loss of consciousness and or falling from being minimally conscious. Some people will describe just kind of weird visual sensations, changes in their hearing, changes in speech or language, and just cognition, their thinking changes. Have you made it past menopause, or are you going through it now? I'm Dr.

What Low Blood Pressure Is 0:31

Pat McShane, and on the Women's Health Span Voices podcast, I'll guide you through the health challenges of the menopausal years and beyond, guiding the way to thriving in this powerful era of your womanhood. Hello and welcome. Our subject for this recording is low blood pressure. Most of us are quite familiar with the concept of high blood pressure, but low blood pressure also affects a number of people, especially when they stand up or when eating after eating. So what, again, is blood pressure?

It's the pressure that is exerted against the arteries in your body by the pumping of the blood from the heart. And the top number when you get your blood pressure taken is called the systolic blood pressure. And that one should be between 90 and 120. Once we get up into 120 plus, it starts to be high blood pressure.

Common Causes and Medications 1:32

But below 90 can be low blood pressure. And then the bottom number, the diastolic blood pressure, is the pressure in between the beats of the heart. So the kind of constant steady pressure on your arteries. And that number should be above 60. So 60 to 80 is considered normal. So if your blood pressure is below 90 over 60, that's considered low blood pressure. Some people have low blood pressure on a frequent basis and that can be due to a number of medications, particularly the ones that are given for high blood pressure, but also other medications such as diuretics that might be given for heart problems or venous insufficiency in your lower extremities, in your legs.

And vasodilators is another category and that can be given for a number of reasons. Some of the antidepressant drugs, SRIs in particular, can cause low blood pressure and also diabetes drugs. So If you think you might have low blood pressure on a chronic basis and you're taking some of these medications, this is something you might discuss with

Symptoms and Orthostatic Hypotension 2:50

your doc or your nurse practitioner. Other causes for low blood pressure in people who are healthy otherwise, who are just walking around, they're not in the hospital, they're not undergoing an acute event, can be just sensitivity of their body to different stimuli. And dehydration is another big one. People who are not getting enough fluid, especially in hot weather or with exercise. And then after eating, and we're going to talk about that a little bit more. So why do we care about low blood pressure?

Well, often, certainly, episodes of low blood pressure can give a person a sense of dizziness or lightheadedness or even passing out and falling. So this can be a background for some major medical traumas in your life. And so it's definitely worth being aware of and talking with your practitioner. It's estimated that about 25% of older adults will have what is called orthostatic hypotension or postural hypotension, and that's when your blood pressure drops upon standing. So you're lying down or seated, you stand up, and your blood pressure drops.

Sometimes right away, sometimes there's a little bit of a delay. There's several different flavors of this condition. Some people, their blood pressure drops and they have no awareness of it, but many of us have a sense of dizziness or lightheadedness.

Treatment and Lifestyle Strategies 4:22

And as I mentioned, this can even lead to a loss of consciousness and or falling from being minimally conscious. Some people will describe just kind of weird visual sensations, changes in their hearing, changes in speech or language, and just cognition, their thinking changes. So it can be pretty significant as far as symptoms. Sometimes this is just due to aging. Sometimes it's a sign of something that is going to happen in the future. Sometimes neurological diseases can have this as their first symptom, but often it just is something that you kind of live with.

So what's the treatment of these different conditions? Certainly if you tend to run low blood pressure on a frequent basis or a chronic basis and you're on any of the medications that we talked about earlier, this might be an opportunity to reduce those medications. There are medications that can be given for low blood pressure, but if possible to try other means before adding yet another medication to the list of the things that many of us are taking. If you're having low blood pressure after eating, probably the first thing to try is to anticipate the low blood pressure and have some water before eating to make sure that you're not dehydrated.

Avoiding carbohydrates and sticking more with protein and fat is a useful strategy for a lot of people. And just being aware of it and eating smaller meals more frequently often will be useful as well. Certainly, if you're having significant side effects and these kinds of minor adaptations don't make a difference, it's something that you should discuss

A Personal Example and Closing 6:25

with your providers because there are some additional tests that might need to be done. Because of the seriousness of this condition, it's definitely something that you don't want to ignore and end up with some kind of a fall or other event that's very, very significant. So the take-home message here is that blood pressure is dependent upon a lot of things that some of which we can control and some of which we can't. And if you're having some of these symptoms and you think it could be low blood pressure, definitely convey this to your physician.

I'll tell you a little anecdote. I had a friend who was feeling lightheaded and ended up with a whole big workup of her heart, including a coronary artery study that turned out to be normal. And when she told me about that she was going to have a coronary artery study because she was feeling dizzy after meals, I, who was totally naive about this, looked it up and basically said, friend, you have postprandial hypotension. That means low blood pressure after eating. And indeed, that is what she had.

And she ended up doing some of the things that we just discussed with some success. So she was able to get out of bed without feeling so dizzy and weak after eating. So I hope this information is useful for some of you at the very least, or you have, as I did, a friend with this situation. And I hope to have you again on my podcast. Thank you. Thanks for listening to the Women's Health Span Voices podcast. If today's episode spoke to you, follow the show and share it with a friend ready to take charge of her health and please leave a review.

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