What is Primary Orthostatic Hypotension ?

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Primary orthostatic hypotension is a rare type of orthostatic hypotension. It is not a disease per se, but a condition caused by several disorders that affect a specific part of the autonomic nervous system, such as multiple system atrophy, young-onset Parkinson’s disease, pure autonomic failure, dopamine beta-hydroxylase deficiency, familial dysautonomia, and pure autonomic failure among others. The autonomic nervous system is the part of the nervous system that regulates certain involuntary body functions such as heart rate, blood pressure, sweating, and bowel and bladder control. Orthostatic hypotension is a form of low blood pressure that happens when standing-up from sitting or lying down. Common symptoms may include dizziness, lightheadedness, generalized weakness, leg buckling, nausea, blurry vision, fatigue, and headaches. Additional symptoms can include chest pain (angina), head and neck pain (often affecting neck and shoulders with a coat hanger distribution), decline in cognitive functioning such as difficulty concentrating, temporary loss of consciousness or “blackout”. Some people with primary orthostatic hypotension may also have high blood pressure when lying down. The treatment depends upon several factors including the specific underlying cause including The treatment depends upon several factors including the specific underlying cause and may include physical counter-maneuvers like lying down, sitting down, squatting clenching buttocks, leg crossing, and support garment and medication.
Treatment for orthostatic hypotension depends on the cause. Recommended treatments may include the following lifestyle changes:
•    Increase your fluid and water intake and limit your alcohol intake if you’re dehydrated.
•    Stand up slowly when getting out of a chair or bed.
•    Perform isometric exercises before getting up to help raise your blood pressure. For example, squeeze a rubber ball or a towel with your hand.
•    Work with a doctor to adjust your dose or switch to another medication if medication is the cause.
•    Wear compression stockings to help with circulation in your legs.
•    Avoid crossing your legs or standing for long periods of time.
•    Avoid walking in hot weather.
•    Sleep with the head of your bed slightly elevated.
•    Avoid eating large carbohydrate-rich meals.
•    Add additional salt to your daily meals to retain fluid.
For severe cases, your doctor may prescribe drugs that work to increase blood volume or constrict blood vessels. These drugs might include:
•    fludrocortisone (Florinef)
•    midodrine (ProAmatine)
•    erythropoietin (Epogen, Procrit)