Why Does Your Blood Pressure Increase When Standing?

It’s perfectly normal to have blood pressure fluctuation. Your body needs it to respond what you are doing and what your body needs. For instance, during exercise your blood pressure (BP) will increase in order to rapidly distribute more oxygen and nutrients to the cells of muscles. After exercise, it will naturally return to its normal levels. However, to avoid the risk of developing cardiovascular disease, the resting BP should be not higher than 120 /80 mm Hg. And did you know that the position of your body (such as while standing) can decrease and increase the levels of your BP?

What causes hypertension?

Hypertension is a medical condition to call high blood pressure. Generally, it’s categorized into 3 major phases; pre-hypertension, stage I hypertension, and stage II hypertension.Though sometimes hypertension is followed with certain symptoms, but many times it doesn’t generate any symptoms (one of reasons for why hypertension is considered as a silent killer).

Most cases of hypertension come with unknown exactly cause. Many experts think that many times it occurs due to combinations of different factors /conditions. However, some cases can be associated with certain medical problem such as kidneys failure and overactive thyroid.

Hypertension that occurs due to certain medical condition is medically called as secondary hypertension. And when it occurs due to diet & lifestyle factors or without known exactly cause – this kind of hypertension is medically called as primary /essential hypertension.

image_illustration30Before discussing the effect of standing on your BP, it’s also great idea to get to know some common factors /conditions that can have contribution in increasing your risk of developing hypertension:

  1. Unchangeable /uncontrollable risk factors include race (blacks are at higher risk than whites), family history of hypertension, and age (your risk of hypertension rises as you get older).
  2. Poor diet factors, these include excessive consumption of salt, lack of potassium, too much drinking alcohol, and lack of dietary vitamin D. See also best foods and worst foods for your BP in this section!
  3. Factors associated with the level of your physical activity. More physical activity that you can do a day is great to help maintain your BP at its healthy level. In fact, hypertension is more likely to occur if you get lack of physical activity. Therefore, it’s very essential to have regular exercise.
  4. Overweight /obesity. The heart will work harder when you are not on your best /healthy weight’s scale. This can trigger your systolic and diastolic pressure to rise easily. Systolic pressure is the pressure of the blood in your arteries when your heart is contracting. Diastolic pressure is the force of the blood against the artery walls when your heart is not contracting (at rest /between beats). Poor diet (particularly eating excessive calories) and poor exercise are two major factors that play a key role in increasing your risk of gaining more pounds of weight.
  5. Other lifestyle factors include stress and anxiety – both can cause a temporary raised blood pressure. Chewing tobacco also has an effect because it can cause blood vessel walls damage which then eventually can increase BP.

And for secondary hypertension, it can occur due to some chronic conditions such as kidneys disease (it ranks at the top cause of secondary hypertension), high cholesterol, thyroid problem, diabetes, having narrowing aorta condition at birth (coarctation of the aorta), adrenal gland problem, and sleep apnea.

Moreover pregnancy and the use of certain birth control pills sometimes also have an effect on BP.

How does standing decrease blood pressure?

The gravity is usually the major concern on decreasing BP while standing. Soon while you stand up, the flow of your blood through your blood vessels will go to the legs due to gravity.

It can decrease the amounts of blood that circulate back to the heart. As a result, there is less blood that can be pumped by the heart and then BP can decrease. However, typically it occurs temporarily (will be explained more in the next paragraphs).

Why does standing increase blood pressure?

When it comes to getting the accurate BP readings, standing should be avoided when you take the test with a sphygmomanometer (a medical tool used to measure your systolic and diastolic pressure) because it can affect your BP.  In general, doctors use the resting BP to determine whether your BP is categorized normal or hypertension!

To measure your BP, the cuff of sphygmomanometer is commonly placed on the arm. And to get the accurate reading of your resting BP, you need to get appropriate position in order to make sure that your arm position is at the level of your heart. That’s why the best position for accurate reading is with lying down.

How about standing? Your BP can increase while standing – higher than when you are sitting and much higher than lying down.

The raised BP can be noticed clearly when you move from sitting /lying down to standing.

Soon after standing from sitting, there will be a momentary drop of BP due to the decreased volume of blood flow through artery – as noted before. But typically, this only occurs at very short time. Because your body has baroreceptors (special cells that stimulate your heart to beat faster in order to respond this momentary drop). As a result, you will experience an increase in your BP after getting the initial drop.

During the movement from lying down /sitting to standing,  some people can get a condition called postural hypotension (a condition of a drop or significant drop of BP with standing). Sometimes doctor call this condition as orthostatic hypotension.

Some common symptoms of postural hypotension include fatigue, feeling light headed after you stand up from sitting /lying down, weakness, nausea, confusion, blurry vision, and fainting.

What are causes and risk factors of orthostatic /postural hypotension?

In general, this kind of hypotension occurs when there is certain condition that affects the way of your body in naturally regulating the mechanism of counteracting low BP. Typically, It can occur due to one or some of following conditions;

  1. NSD (nervous system disorders such as amyloidosis and Parkinson’s disease).
  2. Some heart problems (such as heart valve disorder, heart failure, heart attack, and bradycardia (low heart rate disorder)). These heart problems can affect the performance of your heart in pumping adequate blood to meet the body needs in certain condition such as from sitting to standing.
  3. Dehydration! Lack of liquid in the body or even mild of dehydration can be potential to cause loses blood volume which then can lead to postural hypotension.
  4. Diabetes. This glucose metabolism disorder can cause the nerves damage (nerves that help send signals maintaining blood pressure). Moreover, it also can cause dehydration because in fact there are many people with diabetes often experience frequent urination problem.

How about risk factors? According to NYU Langone medical center, your risk of orthostatic hypotension increase due to the following risk factors:

  1. Your age! If you are now over 65, you are greater risk of developing more episodes of this kind of hypotension.
  2. Having certain health conditions such as diabetes, Parkinson’s disease, and heart problems – as noted before!
  3. The side effects of certain medicines such as medicines to treat hypertension and Parkinson’s disease.
  4. Hot temperature – it can lead to dehydration.
  5. Pregnancy. While it can be potential to cause secondary hypertension, it also can cause postural hypotension.
  6. Long time in bed. If you stay in your bed due to illness for a long time, you can experience postural hypotension while standing up from your bed. To cope with this problem, before standing it’s much better to get sitting slowly. And then try standing slowly!
Citations /references:
Physoc.org; Postural effect on BP and heart rate | NYU medical center: Postural hypotension
  1. Kenric Ashe
    September 19, 2018 | Reply
    • Endi Ssi
      September 24, 2018 | Reply

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