How to Take Orthostatic Blood Pressure

Medical professionals must learn how to take orthostatic blood pressure. There are a number of reasons that this is a necessity, not the least of which involves attempting to diagnose patients who are having a specific set of concerns, yet have not received an official diagnosis. Some individuals have issues with blood pressure depending on their body position. It may appear to be perfectly normal while they are sitting or lying down as long as they have been doing so for a very long amount of time. However, when they stand up it becomes a different story. Anyone who experiences a rapid heartbeat immediately upon standing or who faints or gets dizzy when they stand up might be suffering from this type of medical condition. While it is treatable, it is difficult to treat unless a definitive diagnosis can be made. That is why it is vitally important that any individual who could potentially be suffering from this condition be properly evaluated by someone who knows how to take orthostatic blood pressure readings correctly.

What Makes Orthostatic Readings Different?

Many people have a tendency to take someone’s blood pressure when they are sitting down and they have been doing so for at least a few minutes. There is certainly nothing wrong with this procedure. In fact, that is the procedure that most individuals follow. However, when a patient comes in with signs and symptoms that indicate that they could potentially have a condition related to orthostatic blood pressure issues, it is important to test that theory by taking their vitals while they are doing something beside merely sitting down. This is essentially the only way to determine whether or not their problems are being caused by a sudden drop in blood pressure or in some cases, a rapid increase in both heart rate and blood pressure that is involved with a very specific form of hypertension.

The ProcedureHow to Take Orthostatic Blood Pressure

In order to properly take orthostatic blood pressure, a medical professional must have the patient lie down and be still for a full five minutes. At the end of the five-minute period, vitals are measured, including, respirations and blood pressure. Special attention is paid to the blood pressure and the pulse, as these are the two things that are typically adversely impacted by someone who is suffering from this condition. After the vitals have been taken, the patient has been directed to stand up and stand still for one minute. At the end of one minute, vitals are taken again and the patient is then directed to continue standing for two more minutes. The vitals will then be taken a third time. All of the information is compared to the information received when the patient was lying down. Generally speaking, a 10 point drop in diastolic blood pressure or a drop of 20 points overall indicates that a problem exists. Furthermore, it is considered problematic if the patient complains of any type of dizziness or lightheadedness. Further testing can then be conducted.

Special Considerations

Of course, there are times when a patient simply cannot stand up for a full three minutes and in some cases, they are unable to stand at all. In cases such as these, measurements can be taken while the patient is lying down and then they will be allowed to sit up for the second and third readings. While this is not as accurate, it is the only thing that can be done if the patient is unable to stand.


Patients may go for years with orthostatic blood pressure problems and not be properly diagnosed. It is a relatively rare problem and therefore, it doesn’t always get diagnosed the first time a person walks into the doctor’s office. For anyone that suspects they might have this type of problem, it is important to get a second opinion if necessary in order to ensure that it has been completely ruled out. If a patient is getting dizzy or experiencing lightheadedness upon standing, there has to be something going on and this is usually the first thing that is ruled out before other things are considered. If it is not ruled out first, it is virtually impossible to consider other potential diagnoses, as this is by far one of the most common issues with patients who are complaining of these types of problems. However, the test must be done properly or it will not yield accurate results. Therefore, it should only be performed by someone who knows exactly how to do it and has experience with doing it on patients in a clinical setting.