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Two Simple Movements Can Reduce Dizziness When Standing Up, Study Finds

In a small trial, people felt less dizzy when standing after practicing two easy-to-do physical techniques.

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An visual abstract of the team’s study. The results on the right indicate that volunteers’ mean arterial pressure didn’t drop as much after trying out either technique.
An visual abstract of the team’s study. The results on the right indicate that volunteers’ mean arterial pressure didn’t drop as much after trying out either technique.
Graphic: Heart Rhythm

Researchers in Canada say they’ve come up with two simple physical techniques to help prevent a common cause of dizziness and fainting. In a small trial, they found that these maneuvers, which involve nothing more than moving your lower limbs, could effectively reduce the symptoms of initial orthostatic hypotension, a condition that temporarily leaves people light headed when they stand up.

Orthostatic hypotension is a form of low blood pressure that happens when people stand up from sitting or lying down, leading to dizziness or even fainting. Often, this condition can be linked to underlying neurological problems, or it can happen as a side effect of many medications, and these cases tend to affect older people. But other times, this drop in blood pressure comes and goes very rapidly, within as little as a minute, and it may not be linked to any other health problems; this form is called initial orthostatic hypotension (IOH) and it tends to affect younger people.

Though many people can experience IOH without ever registering it as a big problem, some sufferers can have repeated or severe enough episodes of IOH that it routinely affects their daily functioning. Study author Satish Raj, a heart rhythm cardiologist at the University of Calgary, and his colleagues have often seen these sorts of patients at their dysautonomia and fainting clinic. And they wondered if there was something more they could offer these patients besides lifestyle changes like drinking more water or medications.

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“On some level, everyone’s probably experienced this at some point in their life. But there are people in whom this happens a lot. And it can be disabling,” Raj told Gizmodo by phone.

As he explains it, when people stand up, blood flow normally shifts downward to below our chest. But in IOH, this change seems to be accompanied by a reflex, triggered by the activation of muscles as we stand up, that causes blood vessels to open widely—and it’s this combination that then causes the rapid but temporary drop in blood pressure. Based on Raj’s team’s earlier work, as well as other research, they hypothesized that people with IOH could short-circuit this process by activating the reflex early or by tensing the lower limb muscles as they stood, somewhat mitigating the blood pressure drop.

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To test this out, they recruited 22 volunteers with IOH to try out both of the techniques they developed. One method involved pre-activating the muscles behind the reflex from a sitting position, done simply by raising the knees one at a time for up to 30 seconds. The other asked people to stand and then tense up their lower limbs, by crossing their legs and clenching their thighs and butt. As a control, the volunteers would also stand up normally.

Compared to the control condition, on measures of both the volunteers’ circulation and their self-reported symptoms, people’s IOH improved after doing either technique. And Raj’s patients in the clinic have anecdotally reported similar success after adopting the strategies. The team’s findings were published Wednesday in the journal Heart Rhythm.

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“It’s free, it doesn’t have any drug side effects, and it’s totally within their control, which I think a lot of patients like,” Raj said.

It’s important to note that the trial’s findings are based on a small sample size, and that all of the volunteers were women. Raj says the trial wasn’t intended to only include women and that they took on volunteers on a first-come-first-served basis. The fact that women volunteered quickly might reflect that IOH affects them more often, but he sees no reason why these techniques wouldn’t help men with IOH. He noted that large-scale trials—the kind often needed for governments and health-related organizations to endorse treatments for a condition—are expensive to fund, but his team may yet conduct smaller trials to test out the methods in men or to determine whether combining the methods boosts their effectiveness.

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While it may take more research for others to widely support the use of these techniques, Raj hopes their work can at least raise awareness of IOH in general.

“To me, the bigger message here is that initial orthostatic hypotension exists. And that might sound like a silly thing to say, but I’ve had physicians referring patients that wait over half a year to see me for this problem. And I think that speaks to the fact that this isn’t recognized,” Raj said. “And so, my hope is that by highlighting the problem, and that there’s a possible treatment, some more people will recognize that they might have it. And then we can try out the simple treatment. But you can’t get that to the patient unless they realize what the problem is.”