If you’ve ever stood up and felt your vision fade, your head spin, or your heart race so fast it scared you, you know how disruptive these symptoms can be. 

Orthostatic hypotension (OH) and postural orthostatic tachycardia syndrome (POTS) are two conditions that often feel alike, but they differ in important ways. OH is driven by a sudden drop in blood pressure, while POTS is defined by a sharp rise in heart rate. 

In this article, you’ll learn how to tell them apart, where they overlap, and how tracking your own symptoms can help bring clarity to your care.

The relationship between orthostatic hypotension and POTS

Orthostatic hypotension and postural orthostatic tachycardia syndrome are both conditions that involve challenges with the body’s ability to regulate blood flow when moving from lying down or sitting to standing.

While OH is primarily defined by a significant drop in blood pressure when standing, POTS is characterized by a sustained rise in heart rate without a major blood pressure drop. Both fall under the umbrella of autonomic disorders, which is why people may experience overlapping symptoms like dizziness or fainting, making them sometimes difficult to distinguish.

Symptoms of orthostatic hypotension vs POTS

Symptoms of these conditions often overlap, which is why careful tracking and medical evaluation are so important. Using the Human Health app, you can log symptoms like dizziness, fainting, or fatigue and share patterns with your healthcare provider.

Dizziness and lightheadedness

Many people with either condition report dizziness or lightheadedness when standing up. This happens because the body struggles to adjust blood flow quickly enough, leading to reduced circulation to the brain.

Fainting

Fainting (syncope) can occur in both POTS and orthostatic hypotension.

In orthostatic hypotension, a drop in blood pressure upon standing can reduce blood flow to the brain, causing fainting. People with POTS commonly feel faint or lightheaded, but actually losing consciousness is less common.

Fatigue and brain fog

Ongoing fatigue and difficulty concentrating (brain fog), are common in both conditions. These symptoms may stem from reduced blood flow to the brain and the body’s constant effort to maintain stability.

Palpitations

While palpitations are more strongly linked to POTS due to the rapid rise in heart rate, some people with OH also report palpitations.

Because these symptoms can look so similar, tracking how and when they occur gives you and your provider clearer insight into which condition might be driving them.

Orthostatic hypotension vs POTS: How do they differ?

Although POTS and orthostatic hypotension share some symptoms, they affect blood pressure and heart rate differently.

Orthostatic hypotension is defined by a drop in blood pressure of at least 20 mmHg systolic or 10 mmHg diastolic within three minutes of standing. This can reduce blood flow to the brain, causing dizziness or fainting.

In contrast, POTS is characterized by a sustained increase in heart rate of at least 30 beats per minute in adults within 10 minutes of standing, without a significant drop in blood pressure.

With the Human Health app, you can log both blood pressure and heart rate changes when you stand. Over time, this information may reveal patterns worth sharing with your doctor.

How doctors diagnose orthostatic hypotension and POTS

Getting a diagnosis of POTS or orthostatic hypotension isn’t always straightforward. Not only do these conditions share many of the same symptoms, but symptoms such as dizziness, fatigue, and palpitations can also occur with a range of other health conditions. This can make it difficult to identify the underlying cause.

Although awareness is improving, POTS is still frequently misdiagnosed or overlooked, sometimes leaving people waiting years for answers. Orthostatic hypotension can also go undetected, particularly when blood pressure isn’t routinely checked after standing.

If you’ve been struggling to get answers, keeping a record of your symptoms, including when they occur and what seems to trigger them, can help your doctor understand what you’re experiencing.

What to expect during your appointment

Your doctor will usually start by asking about your symptoms, medical history, and any medications you take. They may then measure your blood pressure and heart rate while you’re lying down and again after you stand up. This is known as an active stand test.

The results can help your doctor determine whether your symptoms are associated with a drop in blood pressure, as seen in orthostatic hypotension, or an unusually large increase in heart rate, as seen in POTS.

In some cases, your doctor may recommend a tilt-table test. During this test, you lie on a table that gradually tilts you into an upright position while your heart rate and blood pressure are monitored.

Your doctor may also recommend blood tests or heart tests to rule out other possible causes of your symptoms.

What if your test results are normal?

Symptoms and blood pressure changes can vary throughout the day, so a single test may not always provide a clear answer. Your doctor may recommend repeating measurements or carrying out further tests if your symptoms suggest a problem.

This is where symptom tracking can be particularly useful. Recording when you feel dizzy, faint, or unusually tired, along with any heart rate or blood pressure readings you have, can give your doctor a clearer picture of your symptoms over time.

Managing orthostatic hypotension and POTS

Although POTS and orthostatic hypotension affect the body differently, some approaches to managing their symptoms are similar.

Treatment depends on your diagnosis, symptoms, and any underlying health conditions, so it’s important to work with your healthcare provider to find what’s right for you.

Lifestyle changes that may help

There are several ways to manage day-to-day symptoms, often alongside other treatments.

• Track your symptoms. Use the Human Health app to record dizziness, fainting, fatigue, and any changes in your heart rate or blood pressure. Over time, you may notice patterns or triggers that you can discuss with your healthcare provider.
• Stay hydrated. Drinking enough fluids can help support blood volume and may improve symptoms, particularly if dehydration makes them worse. Your healthcare provider can advise you on how much fluid and salt is appropriate for you.
• Consider compression garments. Compression stockings or abdominal binders may help reduce blood pooling in the lower body when standing, improving symptoms for some people.
• Move at your own pace. Standing up gradually may help prevent sudden dizziness. For people with POTS, exercise programs that begin with seated or reclined activities may also help improve tolerance to physical activity. Ask your healthcare provider what type of movement is suitable for you.

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Medications and other treatments

If lifestyle changes aren’t enough to manage your symptoms, your doctor may recommend medication. The options depend on your diagnosis, symptoms, and any underlying health conditions.

For orthostatic hypotension, treatment may involve addressing an underlying condition or reviewing medications that could be contributing to low blood pressure. If symptoms persist, medications such as midodrine or droxidopa may be considered to help improve blood pressure when standing, depending on the underlying cause.

For POTS, medications such as low-dose propranolol or ivabradine may help reduce a rapid heart rate and improve symptoms in some people. Other medications may be considered depending on your symptoms and how you respond to treatment.

Finding the right approach can take time. Your healthcare provider can help you weigh the benefits and potential side effects of different treatments and adjust your care plan as needed.

With the Human Health app, you can track which medications you are prescribed, note any side effects, and share this information with your healthcare provider to help tailor your care plan.

‍Use the Human Health app to track symptoms, flares, patterns & more

When POTS and orthostatic hypotension share so many symptoms, it can be difficult to understand what’s happening in your body, especially if you’re still seeking a diagnosis or trying different treatments.

With the Human Health app, you can track your symptoms, heart rate, blood pressure, and medications in one place. Over time, you can look for patterns, see how your symptoms change alongside treatments, and export PDF reports to share with your healthcare provider.

Start tracking with Human Health and bring a clearer picture of your symptoms and treatment history to your next appointment.

Frequently asked questions

Can you have both POTS and orthostatic hypotension?

Yes, it’s possible to experience both, although they have different diagnostic criteria. POTS is diagnosed when your heart rate rises significantly upon standing without a substantial drop in blood pressure.

Some people may experience orthostatic hypotension at other times, so having one condition doesn’t necessarily mean you’ll never experience the other. Your doctor may need to repeat testing to understand how your heart rate and blood pressure respond to standing.

Can POTS or orthostatic hypotension go away?

It depends on the underlying cause. Orthostatic hypotension may improve when contributing factors, such as dehydration or certain medications, are addressed. For others, it may require ongoing management.

POTS symptoms can also improve over time, although some people experience persistent symptoms that require longer-term treatment.

Is POTS or orthostatic hypotension dangerous?

Both conditions can significantly affect daily life, but the risks differ. Orthostatic hypotension can increase the risk of fainting and falls, particularly in older adults.

POTS is not generally considered life-threatening, although symptoms can be severe and disruptive. New, worsening, or unexplained symptoms should always be assessed by a healthcare professional.

When should I see a doctor about dizziness when standing?

If you regularly experience dizziness, lightheadedness, palpitations, or feeling faint when standing, it’s worth speaking with your doctor. These symptoms can have several possible causes. POTS and orthostatic hypotension are just two.

Seek urgent medical attention if you experience fainting accompanied by chest pain, severe shortness of breath, or other concerning symptoms.

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Disclaimer: Human Health is a health tracking platform and does not provide medical advice, diagnosis, or treatment. The information in this guide is intended to support, not replace, conversations with qualified healthcare professionals.

Sources:

• Orthostatic Hypotension, StatPearls (2025)
• Postural Tachycardia Syndrome (POTS), National Institute of Neurological Disorders and Stroke
• Differential diagnosis of orthostatic hypotension (2020)
• Orthostatic Hypotension: Management of a Complex, but Common, Medical Problem (2022)
• Postural Orthostatic Tachycardia Syndrome (POTS): A Frequently Missed Diagnosis (2023)
• Orthostatic Hypotension: A Practical Approach (2022)
• Postural Orthostatic Tachycardia Syndrome (POTS), John Hopkins
• Feature | POTS: Recognition Is Rising, But Management Gaps Remain (2026)
• Practitioners’ views on the measurement and management of postural hypotension in general practice: a qualitative inquiry (2025)
• Diagnosis and treatment of orthostatic hypotension (2022)
• Diagnosis and management of postural orthostatic tachycardia syndrome (2022)
• Abdominal Compression as a Treatment for Postural Tachycardia Syndrome (2020)
• Preventing and treating orthostatic hypotension: As easy as A, B, C (2010)
• Treating Lows: Management of Orthostatic Hypotension (2024)
• Oral medications for the treatment of postural orthostatic tachycardia syndrome; a systematic review of studies before and during the COVID-19 pandemic (2025)