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Know Your Low Blood Pressure (Hypotension) & Treatment

Dr. Indrajeet Tyagi and Dr. Iranna Hirapur
10/26/2023

Know Your Low Blood Pressure (Hypotension) & Treatment
by Dr. Indrajeet Tyagi and Dr. Iranna Hirapur

There is no specific number at which day-to-day blood pressure is considered too low, Blood pressure around 110/60 mmHg to 130/80 mmHg is usually considered normal, while people with readings above 140/90 mmHg are hypertensive. People with blood pressure 90/60 mmHg or below are hypotensive.What is considered low blood pressure for one person might be OK for someone else. Hypotension is the term for blood pressure that is too low. The condition is benign as long as none of the symptoms showing lack of oxygen are present. The risk of both low and high blood pressure increases with age due in to normal changes during aging.

Is low blood pressure serious?

In healthy people, low blood pressure without any symptoms is not usually a concern and does not require treatment. However, low blood pressure can be a sign of an underlying problem especially in older people and could reduce blood flow to the heart, brain, and other vital organs. You can have health problems when your blood pressure drops suddenly and your brain does not have an adequate blood supply. This can lead to dizziness, lightheadedness, and sometimes fainting. 

What are the symptoms of low blood pressure?

Most of the times, doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as:

 

Confusion

Dizziness or lightheadedness

Nausea

Fainting (syncope)

Fatigue

Neck or back pain

Headache

Blurred vision

            Fast Breathing

Heart palpitations/feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast

What are the underlying causes of low blood pressure?

Low blood pressure can occur with causes such as:

Causes

Explanation

Prolonged bed rest (orthostatic)

 

Depression or Parkinson's disease

 

Pregnancy:

blood pressure drops during the first 24 weeks of pregnancy

Decreases in blood volume

Blood volume may decrease due to significant loss of blood from major trauma, dehydration or severe internal bleeding. It may lead to a severe drop in blood pressure.

Certain medications

Diuretics that treat hypertension and other drugs over-the-counter drugs may cause low BP when taken in combination with high PB medications; also heart medications such as beta blockers; drugs for Parkinson’s disease; tricyclic antidepressants; erectile dysfunction drugs, particularly in combination with nitroglycerine; narcotics; and alcohol

Heart problems

Abnormally low heart rate (bradycardia), problems with heart valves, heart attack and heart failure can lead to low BP

Endocrine problems

An underactive thyroid (hypothyroidism), adrenal insufficiency (Addison’s disease), low blood sugar and, in some cases, diabetes can cause low BP

Severe infection (septic shock)

During septic shock, when bacteria leave the original site of an infection, most often in the lungs, abdomen or urinary tract, and enter the bloodstream then bacteria produce toxins that affect blood vessels, leading to a profound and life-threatening decline in blood pressure.

Allergic reaction (anaphylaxis)

Penicillin, certain foods such as peanuts or bee or wasp stings can cause fatal allergic reaction. This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure.

Neurally mediated syncope (hypotension)

This disorder causes blood pressure to drop after standing for long periods, leading to symptoms such as dizziness, nausea and fainting that may happen because of a miscommunication between the heart and the brain.

Nutritional deficiencies

A lack of the essential vitamins B-12 and folic acid can cause anemia, which in turn can lead to low blood pressure

Dehydration

can sometimes cause blood pressure to drop but may cause other symptoms such as weakness, dizziness and fatigue

What to do when we notice a sudden decline in blood pressure?

A single lower-than-normal reading is usually not cause for alarm unless you are experiencing any other symptoms or problems. If you experience dizziness, lightheadedness, nausea or other symptoms, it is a good idea to consult with your health care professional. To help with your diagnosis, keep a record of your symptoms and activities at the time they occurred. 

What are the types of low blood pressure?

1) Postural hypotension: Sudden drops in blood pressure happen when you rise from a lying or sitting position to standing. Because your cardiovascular or nervous system doesn't react appropriately to sudden position changes. Less than 20% of people over 65 have postural hypotension.

2) Neurally mediated hypotension: This type of hypotension happens when you stand up for a long time because of communication problems between your brain and heart. It is more common in younger people.

3) Postprandial hypotension: Sometimes, your blood pressure drops an hour or two after a meal because it is caused by blood pooling into the vessels of the stomach and intestines. It is most common in older people with high blood pressure or nervous system conditions like Parkinson's disease. It tends to happen after large meals containing many carbohydrates. 

4) Multiple system atrophy with orthostatic hypotension: This rare type of low blood pressure happens when you are lying down. It involves your involuntary nervous system, which controls things like your blood pressure, breathing, and heart rate. 

What Are the Treatments for Low Blood Pressure?

For many people, chronic low blood pressure can be effectively treated with diet and lifestyle changes. Others need medication to manage their symptoms.

Eat a diet higher in salt

Drink lots of nonalcoholic fluids

Limit alcoholic beverages

Drink more fluids during hot weather

Regular exercise promotes blood flow

Try eating smaller, more frequent meals.

Be careful when rising from lying down or sitting

Raise the head of your bed at night

Avoid heavy lifting.

 

Avoid straining while on the toilet

Avoid standing still for long periods

Avoid prolonged exposure to hot water

 

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