In simple terms
Orthostatic hypotension is a drop in blood pressure that happens when someone stands up. For a few seconds, less blood reaches the brain.
The usual result is lightheadedness or dizziness on rising. About one third of people who meet the clinical definition feel nothing at all.
How it works
The definition is precise. Blood pressure must fall by at least 20 mm Hg systolic, or 10 mm Hg diastolic, within three minutes of standing, and the fall must be sustained.
Clinicians measure pressure lying down, then again at one, two and three minutes after standing. The heart rate response helps identify the cause. A rise of less than 0.5 beats per minute for each 1 mm Hg of pressure lost is an inappropriately small response, which points to a nerve problem.
Causes fall into two groups. Neurogenic causes involve damage to the nerves that control blood vessels, as in Parkinson’s disease, multiple system atrophy or nerve damage from diabetes or vitamin B12 deficiency. Non-neurogenic causes include low blood volume, heart conditions such as heart failure and aortic stenosis, and medicines including diuretics, antidepressants and antipsychotics.
Why it matters
It becomes much more common with age. Fewer than 5 percent of people aged 45 to 49 have it, compared with about 15 percent at ages 65 to 69 and more than a quarter of people aged 85 and older. Roughly one in five adults over 60 living in the community is affected.
The stakes are higher than a moment of dizziness suggests. It is linked to falls, cardiovascular disease, heart attack, stroke and higher mortality, and a third of those affected have no warning symptoms.
The US Centers for Disease Control and Prevention treats it as a fall risk, because organs and muscles receive less blood when pressure drops. Its guidance for the public is to report symptoms to a healthcare provider and ask whether current medicines should be reviewed.
Where you’ll see it
- Medicine leaflets that list dizziness on standing among side effects.
- Falls assessments in hospitals, clinics and care homes.
- Neurology appointments, where it can be an early sign of a nerve disorder.
- Routine check-ups where pressure is taken both lying and standing.
Example
A reading of 130/80 lying down that settles at 105/74 two minutes after standing meets the definition, because systolic pressure fell 25 mm Hg.
Often confused with
Hypotension in general. Plain hypotension describes a low reading at rest. Orthostatic hypotension is about the change on standing, and can occur in people whose resting pressure is normal or even high.
Key facts
- Orthostatic hypotension is defined as a sustained fall in systolic blood pressure of at least 20 mm Hg, or diastolic blood pressure of at least 10 mm Hg, within three minutes of standing.1
- Prevalence rises steeply with age: under 5 percent at ages 45 to 49, about 15 percent at 65 to 69, and more than 25 percent at 85 and older.1
- About one third of people who meet the definition are asymptomatic.1
- Causes are grouped as neurogenic, including Parkinson's disease, multiple system atrophy and neuropathy from diabetes or vitamin B12 deficiency, and non-neurogenic, including volume depletion, heart failure, aortic stenosis and medicines such as diuretics, antidepressants and antipsychotics.1
- Pressure is measured at one, two and three minutes after standing, and a heart rate to blood pressure ratio below 0.5 beats per minute per mm Hg suggests a neurogenic cause.1
- It is associated with falls, cardiovascular disease, myocardial infarction, stroke and higher mortality.1
- The CDC links the drop to reduced blood flow to organs and muscles, and advises people to tell a healthcare provider about symptoms and ask whether medicines need adjusting.2
This entry explains a medical term. It is not medical advice. If you are concerned about your health, speak with a qualified health professional.
Go deeperWhy Do You Feel Dizzy When You Stand Up Too Fast?Related concepts
Quick checkHow large a blood pressure fall counts as orthostatic hypotension, and how soon after standing?Show answer
A sustained fall of at least 20 mm Hg systolic or 10 mm Hg diastolic, within three minutes of standing up.
Sources
- StatPearls, NCBI Bookshelf (National Library of Medicine). Orthostatic Hypotension. Undated (accessed 15 September 2026)
- US Centers for Disease Control and Prevention, STEADI. Postural Hypotension: What It Is and How to Manage It. Undated (accessed 15 September 2026)
Editorially reviewed by Specialty Digest Editorial TeamLast reviewed September 16, 2026Researched and drafted with AI assistanceReport an issue