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Postural Hypotension: What It Is and How to Manage It

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Postural hypotension (or orthostatic hypotension) is when your blood pressure drops when you go from lying down to sitting up or from sitting to standing. When your blood pressure drops, less blood can go to your organs and muscles. This can make you likely to fall.

What are the symptoms?
Although many people with postural hypotension have no symptoms, others do. These symptoms can differ from person to person and may include:

  • Dizziness or lightheadedness
  • Feeling about to faint, passing out or falling
  • Headaches, blurry or tunnel vision
  • Feeling vague or muddled
  • Feeling pressure across the back of your shoulders or neck
  • Feeling nauseous or hot and clammy
  • Weakness or fatigue

When do symptoms tend to happen?
When standing or sitting up suddenly

  •  In the morning when blood pressure is naturally lower
  • After a large meal or alcohol
  • During exercise
  • When straining on the toilet
  • When you are ill
  • If you become anxious or panicky

What causes postural hypotension?
Postural hypotension may be caused by or linked to:

  • High blood pressure
  • Diabetes, heart failure, atherosclerosis or hardening of the arteries
  • Taking some diuretics, antidepressants or medicines to lower blood pressure
  • Neurological conditions like Parkinson’s disease and some types of dementia
  • Dehydration
  • Vitamin B12 deficiency or anemia
  • Alcoholism
  • Prolonged bed rest

What can I do to manage my postural hypotension?

  • Tell your healthcare provider about any symptoms
  • Ask if any of your medicines should be reduced or stopped
  • Get out of bed slowly. First sit up, then sit on the side of the bed, then stand up
  • Take your time when changing position, such as when getting up from a chair
  • Try to sit down when washing, showering, dressing or working in the kitchen
  • Exercise gently before getting up (move your feet up and down and clench and unclench your hands) or after standing (march in place)
  • Make sure you have something to hold onto when you stand up
  • Do not walk if you feel dizzy
  • Drink 6-8 glasses of water or low-calorie drinks each day, unless you have been told to limit your fluid intake
  • Avoid taking very hot baths or showers
  • Try sleeping with extra pillows to raise your head

This information was written by Proactive Physical Therapy, an outpatient physical therapy clinic in Sioux Falls, South Dakota. At ProActive Physical Therapy, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They do not rush their patients or their clinicians. Rather, they perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

heart healthy physical activity

Heart Healthy Physical Activity

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The heart is often used as a symbol of vitality for good reasons. The heart pushes blood and oxygen to every cell in the body to be used as fuel and carries waste away. Without this process, the body cannot function. The heart plays a role in many aspects of your health and wellness.

Efficiency Matters
The heart beats an average of 60-80 beats per minute, which can add up to millions of beats in just one month. When something works this hard, it is important that it also works efficiently. Well-conditioned athletes can have resting heart rates below 50 beats/minute. Even though their heart beats slower, it can do the same amount of work or more than a heart that beats 60-80 beats/minute. An athlete’s heart pumps stronger during each beat, needing fewer beats to get the job done. Over a lifetime, a difference of 10-30 beats/minute can add up to quite a few beats.

An Ounce of Prevention…
The heart can be affected by physical and mental stressors. You can feel your heart speed up when you sprint across a busy road or when you have a burst of emotion like anger or surprise.

Physical activity can decrease the effect of stress on the heart and body. A fit body and mind will help improve heart health. Regular physical activity can:

Improve physical abilities by:
• Improving the heart’s ability to pump blood
• Increasing energy levels
• Increasing muscle strength and endurance
• Improving agility

Change physical appearance by:
• Toning your muscles which gives you a tighter appearance
• Burning calories which helps with weight loss or maintenance

Improve overall wellness by:
• Helping with stress management
• Improving self-image
• Helping to decrease anxiety and depression
• Improving relaxation
Improving the ability to sleep
• Creating a social activity opportunity
• Promoting healthier cholesterol levels

If you have heart problems, physical activity can still play an important role. A strong and healthy body can help you manage your condition. Physical activity can help reduce the stress on a sick or weak heart and decrease secondary risks like obesity and diabetes. If you do have heart health issues, talk to your doctor before starting an exercise program.

Even if you are healthy, but have not exercised in a long time, you may need to talk to your doctor to make sure that you are in good physical condition to exercise.

heart veggies

Where to Start
For most people, you can begin right away. Find an activity program that you enjoy. Do not pick an activity that does not fit into your schedule, does not fit in with your personal preferences, or has too many obstacles, because you may lose interest quickly. A program that starts with too much intensity is also likely to lose your interest.

Work towards reaching these basic goals:
• 30-60 minutes of physical activity on most days of the week (total of at least 150 minutes/week)
• Include some strength activities at least 2 times/week

Make It Stick
Long-term regular physical activity will count more than a brief and spectacular burst of activity. Most people do not plan to become sedentary. It creeps up on you. Work to increase your physical activity the same way. Gradually add steps. Find activities you enjoy that can replace more sedentary activities.

Here are more tips that have been shown to be useful:
• Find an exercise partner. You are less likely to skip the activity if someone is waiting for you.
• Write it down or use a fitness tracker. Keep a log of your activities and how much you accomplished either by distance or time. It will help keep you honest.
• A long-term goal is fine, but also make short-term goals, because they provide quicker feedback.
• This is important, make it a priority. Plan it out. Find a time in your daily routine when you can regularly fit the activity in.
• Consider doing your activity in 10-minute spurts throughout the day. Spurts can be as effective as being active for 30 minutes straight.
• Be flexible. Life happens and you may find that you need to make adjustments to your routine. A rigid schedule and goal may not be worth the stress. Keep an open mind to new activities and schedules.

Make It Count
Any physical activity is better than none. But at least a few days per week you should aim for more than a leisurely stroll. A moderate intensity level is best to help you make health changes. Moderate intensity activity is enough to get your heart rate up and make you feel a little out of breath but not feel worn out when you are done.

Do not forget to enjoy your activity for the daily benefits it can bring and know that your heart appreciates it as well!

by Pamela Jones, MA

RESOURCES:
American College of Sports Medicine
http://www.acsm.org

American Heart Association
http://www.heart.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:
American Heart Association guidelines for physical activity. American Heart Association website. Available: http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/StartWalking/American-Heart-Association-Guidelines-for-Physical-Activity_UCM_307976_Article.jsp. Updated September 10, 2014. Accessed October 22, 2014.

Guide to physical activity. National Heart and Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/phy_act.htm. Accessed July 21, 2016.

Haskel W, et al. Physical activity and public health, updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Circ. 2007;116(9):1081.

How much physical activity do you need? Centers for Disease Control and Prevention website. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html. Updated June 4, 2016. Accessed July 21, 2016.

Promoting physical activity with a public health approach. American College of Sports Medicine website. Available at: http://www.acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/promoting-physical-activity-with-a-public-health-approach. Accessed July 21, 2016.

2008 physical activity guidelines for Americans. United States Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/default.aspx. Accessed July 21, 2016.

Last reviewed July 2016 by Michael Woods, MD Last Updated:10/22/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

healthy start

A Healthy Start in 2017

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It’s time to get a healthy start in 2017!  We provided some general health and wellness tips to get you on your way to an amazing year!  We call it the Pearls of Longevity!

PROTEIN
Eat 25 grams of protein each meal especially breakfast to prevent being hungry from carb cravings and crashes, help maintain and build muscle, and improve your immune system.

DID YOU KNOW?
For every 100 calories of protein you eat, it takes 25 calories to digest meaning you really only ate 75 calories! This is a 25% discount! For carbs and fat, you get less than a 10% discount.

EXERCISE
Exercise at least 30 minutes a day to burn calories and decrease stress. Lift weights or use body weight strengthening exercises to increase lean muscle and boost your metabolism.

DID YOU KNOW?
Exercise relieves symptoms of depression as well or even better than medication. Losing 10 lbs. decreases your risk of knee arthritis by 50%, while losing 10% of your body weight decreases joint pain by 50%!

ANTI INFLAMMATORY & ANTIOXIDANT-RICH FOODS
Fill half your plate at every meal to ensure you eat enough of these power foods.

DID YOU KNOW?
Eating lots of fruits, vegetables, nuts, olive oil, beans, salmon, spices, and even dark chocolate helps reduce inflammation and stress, decreases joint and muscle pain, and reduces your risk heart disease, hypertension, diabetes, cancer and stroke.

pushup_woman

RELAXATION & STRESS REDUCTION
Practice inhaling slowly through your nose until you feel your belly button move out and then slowly exhale through your mouth feeling your belly button move in. Practice at least 5 minutes a day while driving, at your computer, while watching TV or when in bed. Smile, laugh and hug someone once a day.

DID YOU KNOW?
Deep breathing reduces stress, muscle pain, and blood pressure, while improving memory, concentration and performance. Happiness and affection are considered by many experts to be the fountain of youth as it lowers stress and releases hormones that help fight aging.

LIQUIDS
Drink 2 cups of water or tea when you wake up and drink 1-2 cups in between meals. Coffee does not count as it can lead to dehydration.

DID YOU KNOW?
Water reduces hunger, improves metabolism, brings nutrients, and hydrates your muscles and connective tissue. This can reduce inflammation and scar tissue which can lead to decreased muscle and joint pain.

SLEEP
Sleep at least 7-8 hours per night consistently going to bed and waking up the same time even on weekends.

DID YOU KNOW?
Sleep releases growth hormone which helps keep you young, increase lean muscle and decrease body fat!

A healthy start can lead to great endings. Best of luck to you and yours and Happy New Year!

PT News

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This Month in PT News. Featuring articles from PTandMe partnering clinics!

flu

1. Survival Tips for Cold and Flu Season
Written by the Therapy Team at Integrated Rehabilitation Group – Seattle, WA

You’ve probably had many cold and flu viruses of varying severity. But you may still be surprised by just how badly a cold or flu virus makes you feel. Read more

car reverse

2. Going in Reverse: When Your Back Impedes Driving
Written by the Therapy Team at the Jackson Clinics – Middleburg, VA

When backing up your car, do you find it difficult to turn around to see what’s behind? Loss of rotational ability in the back is one of the problems we develop as we age. Read more

man stretching 2

3. 4 Ways To Improve Your Quality of Life Today
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

How often do you get home tired from a long day, frustrated with work, traffic, or co-workers? Our blood pressure has increased, stress levels have caused emotional, behavioral, and physical changes in us that otherwise would not be part of our normal calm day. Read more

heart health

February is Heart Healthy Month, Make Blood Pressure Control Your Goal

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Heart health is the focus this year as we celebrate American Heart Month. The Centers for Disease Control and Prevention (CDC) and Million Hearts® – a national effort to prevent one million heart attacks and strokes in the United States by 2017 – are encouraging Americans to know their blood pressure, and if it’s high, to make control their goal.

Uncontrolled high blood pressure is a leading cause of heart disease and stroke. In fact, more than 67 million Americans have high blood pressure. People with high blood pressure are four times more likely to die from a stroke and three times more likely to die from heart disease, compared to those with normal blood pressure.

High blood pressure often shows no signs or symptoms, which is why having your blood pressure checked regularly is important. It’s easy to get your blood pressure checked. You can get screened at your doctor’s office and drugstores or even check it yourself at home, using a home blood pressure monitor.

senior pumping iron

Make Control Your Goal
If you know you have high blood pressure, take these steps to help get it under control:
• Ask your doctor what your blood pressure should be. Set a goal to lower your pressure with your doctor and talk about how you can reach your goal. Work with your health care team to make sure you meet that goal. Track your blood pressure over time.
• Take your blood pressure medicine as directed. Set a timer on your phone to remember to take your medicine at the same time each day. If you are having trouble taking your medicines on time or paying for your medicines, or if you are having side effects, ask your doctor for help.
• Quit smoking — and if you don’t smoke, don’t start. You can find tips and resources at CDC’s Smoking and Tobacco website.
• Reduce sodium intake. Most Americans consume too much sodium, which can raise blood pressure. Read about ways to reduce your sodium and visit the Million Hearts® Healthy Eating & Lifestyle Resource Center for heart-healthy, lower-sodium recipes, meal plans, and helpful articles.

For more information on February Heart Healthy Month visit: www.cdc.gov/features/heartmonth
or:
www.millionhearts.hhs.gov

For more information on exercising your way to lower blood pressure visit: www.acsm.org/docs/brochures/exercising-your-way-to-lower-blood-pressure.pdf

More PTandMe Articles on blood pressure can be found here

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