Hypertension, also known as high blood pressure, is called “the silent killer” for a reason: It can have far-reaching consequences for your health, but for the most part, it’s not accompanied by any warning signs whatsoever. Dizziness is sometimes thought to be a symptom of high blood pressure — but it’s not usually the case, says preventive cardiologist Luke Laffin, MD. He explains how dizziness may be related to your blood pressure and what’s probably happening instead.

Why does this happen?

High blood pressure isn’t actually associated with feelings of dizziness, Dr. Laffin says. But to try to figure out what’s at the root of your issue, it’s important to first figure out what kind of dizziness you’re having. Doctors usually put this symptom into two different categories.

Vertigo probably isn’t a blood pressure issue

One kind of dizziness is the kind that feels like the room is spinning. This feeling is typically associated with vertigo, which can be caused by a variety of conditions, including ear infections, head injuries and more — but not high blood pressure. “Vertigo symptoms are very unlikely to be caused by any type of blood pressure issues,” Dr. Laffin says. “For most people, it’s an inner ear issue.” If you’re experiencing frequent vertigo, it’s important to talk to your doctor to try to identify and treat the cause.

Changes in blood pressure can cause lightheadedness

The other kind of dizziness is lightheadedness — when you feel woozy or unsteady on your feet, like you might faint. “That is oftentimes not caused by high blood pressure but by changes in blood pressure,” Dr. Laffin explains. “Going from a high blood pressure to a low blood pressure can definitely result in lightheadedness, feeling unsteady and sometime seven frank syncope, or passing out.” This kind of sudden change in blood pressure can happen when you switch positions, like if you stand up quickly after you’ve been lying down for a while or kneeling in your garden. Typically, our bodies can adjust quickly to these changes in position, sending enough blood flow to our brains to accommodate changes in position. Sometimes, though, it takes your body a moment to adjust, which temporarily causes less blood flow to your brain. That’s when you feel lightheaded.

It could be low blood pressure

Both vertigo and lightheadedness can actually be signs of low blood pressure, not high blood pressure. Low blood pressure is more common in older adults and people with health conditions or those who take certain medications.

How to deal with feeling dizzy

It’s normal to have an occasional dizzy spell when you stand up. “It doesn’t mean that there’s some major problem,” Dr. Laffin notes, “and the biggest way around it is to make sure that you’re hydrated.” To try to prevent dizziness when you change positions:

• Drink your water. Your blood pressure can dip when there’s not enough fluid in your body, so staying hydrated is key.
• Change positions slowly. To prevent dizziness, pace yourself when you rise from a sitting, kneeling or sleeping position.
• Don’t stay in one position for too long. When you’re in one position for a long time, whether it’s sitting or standing, blood begins to settle in your legs, which can contribute to dizziness when you do finally switch positions. To prevent this, take breaks and switch positions.
• Check your meds. Your medications could be impacting your blood pressure. Ask your doctor whether that could be the case for you.

But if you find yourself frequently dizzy, or if you pass out when changing positions (or any time, really), it’s time to check in with a medical professional to see what might be at play. “If this happens multiple times a day or to an extreme extent, that’s a sign to talk with your doctor,” Dr. Laffin advises.