The Healthy Geezer: Lightheadedness after eating is troubling

By Fred Cicetti

Q: I usually get a bit lightheaded when I stand, but this feeling is much worse when I get up from the dinner table. I don’t drink. Any ideas?

A: There’s a possibility you have “postprandial hypotension” or, in layman’s language, low blood pressure after a meal. This is a senior malady; few younger people experience this. Other possible symptoms include dizziness, blurred vision, nausea and fainting. I recommend going to a doctor to have your symptoms checked.

When you eat, blood pours into your digestive system. To maintain your blood pressure, your heart pumps more often and your blood vessels constrict. But these compensatory mechanisms don’t work for some people. 

To help prevent postprandial hypotension, eat small portions several times a day and limit high-carbohydrate foods such as potatoes, rice, pasta and bread. 

There’s another form of low blood pressure called “postural hypotension” that affects some people when they stand up. Also called “orthostatic hypotension,” this is especially common in older adults who are more likely to use high blood pressure drugs. When you experience postural hypotension, blood pools in your legs.

Low blood pressure is commonly caused by drugs for high blood pressure, surgical medications, anti-anxiety agents, diuretics, heart medicines, antidepressants, narcotic painkillers and alcohol.

Other causes of low blood pressure include dehydration, heart failure, heart arrhythmias, shock from infection, stroke, severe allergic reaction, major trauma, heart attack and advanced diabetes.

The effects of hypotension can lead to falls, which can be serious for seniors. Here are some pointers for avoiding the dangers of low blood pressure.

When arising, let your feet hang over the side of your bed. Then flex your toes up and down about a dozen times. Stand up slowly. Count to 10 before you start walking. This is a good idea whenever you get up from lying or sitting for more than 20 minutes. Crossing your legs while sitting upright may also help increase blood pressure. 

Some experts define low blood pressure as readings lower than 90 systolic (the first number) or 60 diastolic (the second number). However, low blood pressure is relative, so doctors often define blood pressure as too low only if there are symptoms.

In many instances, low blood pressure isn’t serious. However, it is important to see your doctor if you have hypotension symptoms, because they sometimes can point to serious problems. Chronic low blood pressure may increase the risk of Alzheimer’s-type dementia in some older adults. 

Low blood pressure without symptoms rarely requires treatment. In symptomatic cases, doctors address the primary problems such as heart failure. When hypotension is drug-induced, treatment usually involves altering the drug regimen.

It is possible to raise blood pressure when that is required. Here are some ways: 

• Eating more salt. However, too much sodium can cause heart failure, especially among seniors.

• Don’t increase your salt without consulting with your doctor.

• Drink more water. Fluids increase blood volume and help prevent dehydration.

• Compression stockings used to treat varicose veins may help reduce the pooling of blood in your legs.

There are also medications your doctor may prescribe.