How to Check Your Standing (Orthostatic) Blood Pressure at Home
Lie down for 5 minutes and take a reading, then stand and measure again at 1 and 3 minutes. A drop of 20 mmHg systolic or 10 diastolic is the red flag.
This article is educational content, not medical advice. Always talk to a healthcare professional about your blood pressure.
To check your standing blood pressure at home, lie down quietly for five minutes and take a reading. Then stand up, keep the cuff on, and measure again after one minute and after three minutes. Compare the standing numbers with the lying one: a fall of 20 mmHg or more in the top number, or 10 mmHg or more in the bottom number, is the pattern doctors call orthostatic hypotension.
That's the routine the US Centers for Disease Control and Prevention (CDC) gives clinicians in its STEADI falls-prevention toolkit. Blood pressure and pulse are taken after five minutes lying down, then at 1 and 3 minutes after standing. The CDC counts a systolic drop of at least 20 mmHg, a diastolic drop of at least 10 mmHg, or feeling lightheaded or dizzy as an abnormal result. The National Heart, Lung, and Blood Institute (NHLBI) uses the same 20/10 mmHg definition within three minutes of standing. Mayo Clinic notes the most common symptom is lightheadedness or dizziness on standing, which usually passes within a few minutes. A home check gives your doctor useful numbers, not a diagnosis.
What is orthostatic blood pressure?
"Orthostatic" just means "related to standing upright." When you stand, gravity pulls blood toward your legs, and within seconds your body tightens blood vessels and nudges your heart rate up to hold pressure steady. If that response is slow, pressure drops and less blood reaches the brain for a moment: the woozy feeling some people have when they climb out of bed.
An orthostatic check measures that response, which seated readings can't show. That's why our guide to the best position for a reading treats standing as a special-purpose check rather than the daily default.
Before you start: safety first
A standing check can trigger the dizziness you're looking for, so make sure a dip can't become a fall.
- Have someone with you, especially if you're older or have felt faint before.
- Do it next to your bed or a sturdy chair you can sit straight back onto.
- Skip it if you're already dizzy, unsteady or have fainted recently. Mention it to your doctor instead.
- If you feel faint at any point, sit or lie down straight away and stop the test. Feeling faint is itself worth telling your doctor about.
Prepare the way the American Heart Association advises for any home reading: no caffeine, exercise or smoking for 30 minutes beforehand, an empty bladder, and the cuff on a bare upper arm.
How to check your standing blood pressure, step by step
- Lie down and rest for 5 minutes. Fit the cuff first, and rest the arm on a pillow so the cuff sits level with your heart.
- Take the lying reading. Write down systolic, diastolic and pulse. This is your baseline.
- Stand up and start the timer. Sit on the edge of the bed for a moment first if you tend to get dizzy, then stand while holding onto something steady. Leave the cuff on.
- Support the arm at heart height. Rest your forearm on a shelf or counter so your helper's hands stay free. The AHA asks for the arm supported with the cuff at heart level, and a dangling arm can hide a real drop.
- Measure at 1 minute. Record all three numbers, plus any symptoms.
- Measure at 3 minutes. Record again, then sit down.
- Do the subtraction. Lying minus standing, for both numbers, at each time point.
If lying down isn't practical, the NIH's StatPearls review also describes a sitting-to-standing check. Use the same starting position every time and note which one.
How to read the results
The question is how far each standing number falls below your lying baseline, not whether any single reading looks high or low. Here are two made-up examples with the same baseline:
| Position and time | Example A | Example B |
|---|---|---|
| Lying, after 5 minutes | 118/76, pulse 64 | 118/76, pulse 66 |
| Standing, 1 minute | 114/78, pulse 72 | 96/68, pulse 82 |
| Standing, 3 minutes | 116/78, pulse 70 | 98/70, pulse 80 |
| Biggest systolic fall | 4 mmHg | 22 mmHg |
| What it suggests | A normal, small adjustment | Meets the 20 mmHg systolic criterion: share it with your doctor |
In Example A, pressure dips slightly and comes back. Example B crosses the systolic line at both time points, though neither standing reading looks alarming alone. So compare, rather than judging one number.
Record your pulse too, because a clinician will want to see how it changed. Our explainer on the heart rate number on your monitor covers that third number.
Three minutes isn't the whole story. The NIH's StatPearls review describes a delayed form that appears only after three minutes, which a doctor can test for with a longer stand or a tilt table.
Why might your blood pressure drop when you stand?
Mayo Clinic says occasional drops usually have an obvious cause, such as dehydration (from fever, vomiting, diarrhea or heavy sweating) or a long spell of bed rest. Heat and large meals can trigger symptoms in some people. Other causes include heart and nervous system conditions and some medicines, including blood pressure medicines. It's more common in older adults.
If you take any medicine and your standing readings drop, don't change, skip or stop a dose on your own. That decision belongs to your prescriber. Bring them the numbers and what you felt. For more on low readings in general, see what is considered low blood pressure.
When should you see a doctor?
Occasional mild lightheadedness isn't usually a worry, according to Mayo Clinic. Make an appointment if you get symptoms on standing often, or your home checks repeatedly show a 20/10 mmHg drop. If you lose consciousness, even for a few seconds, see a doctor right away.
Seek medical help immediately if a fall in pressure comes with confusion, chest pain, fainting or trouble speaking.
If a reading is above 180 systolic or 120 diastolic and you have chest pain, shortness of breath, back pain, numbness, weakness, vision changes or trouble speaking, it's a hypertensive emergency: seek medical help immediately by calling emergency services, without waiting to re-measure. With no symptoms, wait at least 1 minute and measure once more. If it's still above 180/120, seek medical help immediately. The AHA calls this severe hypertension and says to contact your healthcare professional right away. Don't keep re-measuring to get a lower number.
Logging standing checks with BPlus
An orthostatic check gives three readings that only mean something side by side. BPlus is a logging app that keeps them together.
Enter systolic, diastolic and pulse by hand, or scan your own monitor's display with the camera. The time, date and arm are stamped automatically. Add a note to each reading, like "standing 1 min, lightheaded", so the position stays with the number.
The app charts readings over time and exports a PDF or CSV report for your doctor. Your data stays on your device, works offline and needs no account.
BPlus is a wellness and logging tool, not a medical device. It doesn't measure blood pressure, detect orthostatic hypotension or diagnose anything, and it's no substitute for professional care.
Mini-FAQ
What is a normal blood pressure drop when standing? A small dip that recovers quickly is typical. The NHLBI and CDC flag a fall of 20 mmHg or more in the top number, or 10 mmHg or more in the bottom number, within three minutes of standing. Feeling dizzy counts as a finding too, whatever the numbers show.
Can I check orthostatic blood pressure from sitting instead of lying down? Yes, if lying down isn't practical. The CDC's protocol starts lying down, but some clinicians use sitting. The starting position shapes the comparison, so use the same one every time and write down which it was.
How often should I check my standing blood pressure? Only as often as your doctor suggests, since the AHA's standard home routine is seated readings. If you're asked to do standing checks, doing them at the time of day your symptoms tend to come on gives the most useful picture.
Sources
Keep your readings in one calm place
BPlus does the logging with you: record by hand or scan your monitor, watch your trends, and export a doctor-ready report when you need one.
Medical disclaimer. BPlus is a wellness and informational tool that helps you record, organize and understand your blood pressure readings. It is not a medical device and does not diagnose, treat, cure or prevent any disease. BPlus does not measure blood pressure on its own. Always consult a qualified healthcare professional. Readings are not a substitute for a clinically validated blood pressure monitor.
