I had a fainting spell a couple of years ago or so. Got up in the night to take a whizz. As I stood there at the toilet, I could feel myself losing consciousness. I opened the door with the intent of heading to the bed and lying down when I blacked out. I fell against the now open door and bounced back onto the toilet which I fell against with my hip. The racket of me slamming against the door woke my wife and she found me sitting on the floor going in and out of consciousness.
I went to the doctor that day and she determined that the extra blood pressure med I was taking (amlodapine) had caused "an unsafe drop in blood pressure". Had I not opened that door I would very likely have fallen straight into the tiled shower that faces the toilet and could very possibly have ended up like Saget. Fortunately I did not hit my head. I had a huge bruise/hematoma on the hip that hit the toilet, but otherwise I was very lucky. I should have sat down immediately on the toilet once I started blacking out instead of trying to make it back to the bed. But that was the first time I ever blacked out and I guess I was somewhat in denial about what was happening.
At the time, I was taking Valsartan HCT, Amlodapine and Metoprolol. Over time, my BP had become lower and I did not require the Amlodapine any longer. I still take the Valsartan and I have to take the Metoprolol (a beta blocker) for a skipping heart beat/arrhythmia. I also take my BP meds in the evening now instead of the morning. It is easy to get overmedicated on these things. If you change anything about your lifestyle, like exercising more or taking supplements that lower BP, it can get too low.
It is also good to get in the habit of getting up slowly, particularly from bed. When you go from a prone position to a standing one, your BP drops. I don't walk around in a daze, but I can tell my reaction time is slower because of BP meds. When I am driving, I cannot get very close to the vehicle in front of me because of it. Beta blockers block your adrenaline and make you feel less "on edge".
I've read the responses down to #18, and find them all appropriate to consider; but so far yours is the one that I can identify best with. That is because you say that your current intake of prescribed meds are the tablets combining Valsartan and hydrochlorothiazide (HCTZ plus the tablet metoprolol.
What I have to say applies directly to these three substances and to OTC supplements taken with them, and not to other scripted meds (although my comments might be considered for them also).
My model is comparable to a pump with particular limits within itself, thar delivers from a limited volume supply an incompressible fluid to an elastic bag or balloon whose walls are stretchable up to a point, but then may burst, drastically lowering both pressure as well as volume of fluid that may be circulated. Destruction of brain tissue or heart muscle, and even death follows
I had no idea of the nature and behavior of my circulation system at the time in 2010 that a large benign tumor (meningioma) was removed from my cranium by surgery at the age of 74. Regularly checked, my physical condition had always from youth indicated an excellent functioning of the heart and circulatory function.
It was immediately after my discharge from the hospital that I was provided with an Omron HEM-780 digital heart monitor which I have used regularly ever since. Then subsequent to weaning (about a month) from the post-operative meds, my own general practitioner placed me on two prescribed meds: (1) Novartis' proprietary product Diovan HCT (= valsartan + hydrochlorothiazide) together with (2) metoprolol succinate; the purpose being suppression of high systolic blood pressure to avoid rupture of the blood vessels in the now-healing brain tissue. My doctor also prescribed that I should daily take one regular 325 mg aspirin (lowers blood pressure by keeping capillaries open) and one 1000 softgel fish-oil capsule (makes it harder for plaque to form).
The first cause of dizziness to appear was incidents of low overall blood pressure of 100mm systolic or less. one so low that I almost died from it except for direct administering intravenous saline solution by the arriving EMT. It was so low that his digital monitor could not sense and register. It was suffering from nauseous dry heaves because of it. But injecting saline immediately, by the time I was on the gurney and in the ambulance ready to start for the hospital, the systolic was measurable (40mm) and the nausea had much lessened.
On the 20-minute run to the hospital, my body quickly received both the first and then the second liter of saline, and was on the third at the time I was transferred from the ambulance to the hospital's Emergency section for diagnosis and admittance.
At that point taking of vitals showed my BP to be 80/40 with ordinary pulse and temp normal.
That was the night of July 4, a very hot day in which I had neglected feeding myself and stayed in my bedroom with the cooling fan supplementing the inefficient old air conditioner. I finally went down to the hot kitchen about 9 pm to make some pancakes (too ht for lunch or dinner).
It was then that I started to become dizzy (vertigo) while cooking over the hot stove. as well as being hungry, so much that I had to sit down, and soon to lie down on the floor, whence finally I was barely able to crawl into the living room and dial 911 to get the ambulance. My only clothing at home in that heat was my under-briefs, and that is how I went to the hospital.
In the emergency room, my need for the intravenous saline was much lessened, so that by 2 am I was still on the third one, nut mow I finally had volume and water enough to need to urinate. Vitals were at ~115/55mm and no nauseous or vertigo whatsoever. From then on, I felt fine, all through the following day of testing, and the third day at discharge (with my friend bringing some clothes for decency).
What I learned, as a physical chemist, was that it was the blood volume that counts, upon which one must base one's critical thinking and diagnosis.
That is, because of: (1) taking the meds (loss of both water and electrolytes), (2) not eating (not re-establishing the electrolyte ingestion that keeps water content of ones blood), and (3) loss of both water and salt by sweating (by the evaporation that cools); the body, to keep properly adjusting (a) first loss of the water to cool, thus increasing beyond tolerance the concentration of electrolytes; then (b) the kidneys adjusting to within the acceptable tolerance the removal of electrolytes through urinating them; thus wind up the diminishing of total blood volume, and from that a lowering of blood pressure in an unfilled vessel which the elastic walls are not providing the sustaining back-pressure that the heart needs to pump well and slowly. At this stage, the pulse rate is probably much higher, not because of activity, but of the necessity of pumping at a faster rate to get enough blood from the lower volume around the system.
This is what brings on a state of vertigo. Just drinking more water will make it go away, but should be discounted as the final answer since the response is only temporary. The concentration that was OK (but at an unacceptable low blood volume) will be unacceptably diminished by the intake of more water. The water will then be soon excreted, and the consequential re-lowered volume will cause the vertigo to return.
How the blood volume is restored is by keeping in ones cupboard some pints (~500 ml) of "Pedialyte" (trade name) that is given to infants when thy have experienced nausea or diarrhea that puts them in the same state (or sunstroke for adults), a bottle labeled "Pediatric Electrolyte" (constituents exactly the same as the trade-marked "Pedialyte") and sold in the Dollar Tree stores for a dollar or so.
Drinking that will supply an excess of electrolytes acceptable to one's circulation, in which the body will demand and keep more water to put the concentration to normalcy, and thus raise the volume of blood to the proper volume, about 5 liters, of the adult's circulation. Remember, my loss of two liters from a privably lowered state, did put me at death's door. There will be no vertigo nor typically accompanying cramps (hand, arm, leg, foot, or perhaps oral muscle spasms) that also appear with low blood pressure. Fr the cramps, one can have handy a half-spoon of salt to just swallow with some water. Happens often at night, waking one from sleep.
So that is how I handled the low-blood-pressure-vertigo (measured with the monitor) for several years, when it appeared. Taking the pediatric electrolyte solved the vertigo problem within a few minutes, every time.
My presentation of this anecdotal analysis to the medical experts mentioned above has been verbally validated and vindicated by them, and allowed me to apply it to my own situation without objection by them.
--------
However, there is another aspect that only they must effect in one's protocol of prescribed meds. Clearly, with the Diovan HCT and metoprolol and/or its generic equivalent, all three substances are variable both in amount to be ingested,and in supplier manufacturing those substances. It is a fact that there have been Asian suppliers from whom faulty "valsartan" has obtained and supposedly corrected. Make sure that your pharmacy is giving you proven, not merely opinionated, quality substances. After that, test out with your prescriber that your dosage is consistent with its results overall with your usage as truthful to your daily ingestion as prescribed. Sometimes I have forgotten, and other times i have deliberately not taken (especially about the HCTZ diuretic) overuse causes vertigo from the lowering of blood volume that it causes.
Stopping the prescribed medication altogether is NOT the preferred solution for this issue. That is very poor medical judgment.
Then, too, if the regular intake of too much diuretic seems to be resulting dizziness, one needs to go back to the prescribing doctor or another cardiac specialist and adjust the dosage to its best amount and mode of ingestion. One should not cease the medication nor the prescribing doctor as a solution.
There is the aspect of experiencing vertigo even though the vitals show blood pressure regularly higher than in the past or incidentally much higher than wanted. That happened to me, and disabled me while working alone on a home repair project such that I had not the strength nor move standing up. I had to have a friend take me to the Emergency at the hospital. During the few hours there, I got better and was sent home enough OK to go on.
I had complained about this to my personal physician before, so he sent me to a cardiologist. But prior to that appointment, I was scheduled for a CAT scan, in which which a regrowth of another meningioma was unexpectedly found which otherwise would not have been discovered, for the lack of any other possibly observable symptoms. In it, the new meningioma was successfully dealt with by treatment with Cyberknife X-radiation, but through which all the experts separately agree that the vertigo was NOT caused by the tumor, but came from crystals residing in and modifying the sense of stability supplied by the ear's auditory mechanism. But it is clear that as an after-effect, the high blood pressure was another evidence of (caused by?) edema (swollenness) of the brain tissue while the healing from the diffuse impingement of the X-ray paths when passing through but concentrated within the now the tumor that is responding well to the Cyberknife sessions.
Now consider--it took experts to resolve the separation of the vertigo symptoms from the high blood pressure symptoms, didn't it? That shows a clear point of advice: don't abandoning your medical advisors to be a good recommendation from an un-medically-or-scientifically-educated friend.
Have y'all followed this so far? Well, remember, I'm not a MD-degreed trained physician myself, so I'm really not an expert in it, but there is a logical way to proceed in these issues, and many "logical" but unworkable opinions also.
Always consult with and hold your personal physician to high standards, and get at least a second diagnosis (more than just an opinion)--or more, if you can get them.
(Coming from a B. S. Eng., M. S., Ph. D., with post-doctoral studies and 25 years innovation of profitable products, now age 85.)