Treating Dizziness Related to Blood Pressure Issues – Part III

The treatment of dizziness related to blood pressure abnormalities is not within the scope of Audiology practice, and is best managed by an Internist or Primary Care physician. None of the suggestions listed below should be attempted without first consulting with your physician.
As noted in the previous blogs, dizziness on rising from the sitting or supine position is frequently the result of Orthostatic Hypotension (OH), a drop in blood pressure through failure of the carotid sinus reflex. Common treatments for OH may includes altering or reducing potentially causative medications, prescribing medications to either expand intravascular volume (Fludrocortisone) or promote vasoconstriction (Midrodine), or educate the patient regarding non-pharmacological treatments . Below is a list of non-pharmocological recommendations that may reduce the symptoms associated with OH.
IMPLEMENT
Dorsiflex feet several times before standing
Make slow careful changes in position
Eat small, frequent meals
Increase salt and fluid intake
Elevate head of bed 5 to 20 degrees
Schedule activities in the afternoon
Wear compression stockings
AVOID
Standing motionless
Rising quickly after prolonged lying or sitting
Large meals
Alcohol consumption\Vigorous exercise
Heat, hot baths, and hot environment
Dehydration
Working with arms above shoulders
Straining with urination or defecation
Coughing spells
Rapid ascent to high altitude
Hyperventilation
Fever
Adapted from: Bradley JG, Davis KA.(2003) Orthostatic hypotension Dec 15;68(12):2393-8. Am Fam Physician.
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About Alan Desmond

Dr. Alan Desmond is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. In 2015, he received the Presidents Award from the American Academy of Audiology.