Orthostatic hypotension in young adults

Initial orthostatic hypotension (occurring within 10 to 15 seconds of standing) is common and physiological in young adults. True orthostatic hypotension (persisting past 60 seconds of standing) is rare in young adults and an acute reversible cause should be investigated.

Most young patients describing orthostatic symptoms do not exhibit a significant fall in blood pressure; rather, they have orthostatic intolerance—symptoms of light-headedness, nausea, headache and palpitations. This may represent vasovagal syncope or presyncope, or less commonly postural orthostatic tachycardia syndrome (PoTS).

Management of vasovagal syncope and PoTS follows several of the nondrug strategies employed in orthostatic hypotension, and should focus on leg-tensing manoeuvres, morning hydration and exerciseWinker, 2005. If nondrug therapy is not sufficient, refer to a specialist physician (eg cardiologist, general physician) for drug therapy.