Doc’s Advice

Dear Editor:

To Paul Richter: Congrats on your dad’s milestone. We should all be so lucky. His condition is called orthostatic hypotension and is commonly seen in older adults. When we go from lying or sitting to standing, blood pools in our legs due to gravity and our blood pressure drops. To counter this, our arteries have pressure sensors known as baroreceptors. Our arteries also have muscle in their walls. So, when we stand, a pressure drop is sensed by the baroreceptors which stimulate the arterial muscles to contract, making the arterial diameter (lumen) smaller, thereby raising blood pressure. This occurs in microseconds. But as humans age, deposits (plaque) made of cholesterol and calcium often form on the inner lining of arteries, making them stiffer. So, as often happens in older folks, when they stand, they get dizzy or even black out because their arteries cannot contract to counter the blood pressure drop. This is very hard to treat. Usually, medical advice is to stand at a much slower rate. Also, clinicians may cut back on blood pressure meds and tolerate a higher blood pressure. All the best.

Dr. Peter Galvin