Low Blood Pressure (Hypotention): Symptoms, Causes and Treatments

Hypotension or low blood pressure is a condition where blood pressure falls below a certain level of abnormal levels. Blood pressure is not always the same level.  It falls in sleep state and may rise when awakened. Blood pressure also increases when the person is excited, nervous or active. The body is very sensitive to changes in blood pressure. For example, if you get up quickly, your blood pressure may drop for a short time. The body regulates blood pressure to ensure that enough blood and oxygen reaches the brain, kidneys and other vital organs.

Most forms of hypotension occur because the body cannot normalize blood pressure or make it fast enough. Some people may always have low blood pressure. There are no signs or symptoms. In some people, certain conditions or factors cause an abnormal low blood pressure. The result is that the body provides much less blood and oxygen flow to its important organs. Often hypotension is a serious problem because it only causes symptoms or is due to a dangerous condition such as heart problems. If high blood pressure rises, low blood pressure can cause shock.

What are Low Blood Pressure Types?

There are several kinds of hypotension. People with low blood pressure have chronic blood pressure problems. They usually do not have signs or symptoms and do not need treatment. Low blood pressure is normal for such patients. Other types of hypotension occur when blood pressure drops suddenly. Signs and symptoms vary from mild to severe. There are 3 kinds of hypotension. These are aortostatic, neural mediated and shock-induced hypotension.

  1. Orthostatic hypotension: This type of hypotension occurs in a sitting or lying position. Dizziness and breathing interruptions occur. This low blood pressure problem occurs if the body cannot adjust the blood pressure and flow quickly enough for changes in positions. The drop in blood pressure usually takes just a few seconds after getting up. When blood pressure returns to normal, it may be necessary to sit or lie down for a short time. Orthostatic hypotension may occur in all age groups. However, it is more common, especially in the elderly who are weak and unhealthy.  This type of blood pressure may be a symptom of another health problem. Therefore, its treatment mostly focuses on the underlying conditions. In addition, the type of blood pressure called postprandial hypotension, a sudden drop in blood pressure occurs immediately after a meal. This type of hypotension mostly affects the elderly.
  2. Neural Mediated Hypotension: This type of hypotension after standing for a long time blood pressure drops. The result is fainting, nausea, dizziness or discomfort. Neural mediated low blood pressure affects children and young adults more often than people in other age groups.
  3. Severe Hypotension Due to Shock: Shock is a life-threatening problem where blood pressure is low and the brain, kidneys and other vital organs cannot reach enough blood to function in a healthy way. In the case of shock, blood pressure is much lower than in other types. A number of factors can cause shock.  Examples include blood loss, serious infections, severe burns, allergic reactions and poisoning. This can be fatal if not treated immediately.

What Causes Low Blood Pressure?

Some conditions that cause low blood pressure are as follows;

  • Excessive dehydration of the body,
  • Unhealthy and unbalanced nutrition,
  • Pregnancy conditions,
  • Some medications taken (some blood pressure, antidepressant, drugs used for heart and urine)
  • Psychological problems such as anxiety, stress and obsessiveness
  • Disorders of hormones (diabetes, thyroid gland problems)
  • Heart problems (heart failure, valve problems, heart attack)
  • Anemia
  • Central neural diseases such as Parkinson’s disease
  • Infections in the body
  • Blood loss due to injury
  • Lung and liver diseases
  • Eating problems,
  • Severe diarrhea.

Who has Low Blood Pressure?

Low blood pressure can affect people of all ages.  However, people in certain age groups are more likely to have certain types of low blood pressure.  Orthostatic and postprandial hypotension is high in the elderly. Children and young adults are more likely to have neural mediated hypotension. People taking certain medications, such as diuretics or high blood pressure medications, are at risk of low blood pressure. Other risk factors for low blood pressure include prolonged immobility, prolonged heat, and pregnancy. Low blood pressure during pregnancy is normal and usually disappears after birth.

What are the Symptoms of Low Blood Pressure?

  • Dizziness
  • Blurred vision
  • Temporary memory losses
  • Weakness
  • Fatigue
  • Heart palpitations
  • Nausea
  • Darkening of the eye.

How is Low Blood Pressure Diagnosed?

Low blood pressure can be diagnosed using a blood pressure cuff. The cuff measures both systolic pressure (the pressure applied to blood vessels when the heart beats) and diastolic pressure (pressure in the blood vessels while resting between heart beats).  Although there is no precise definition of hypotension, many doctors consider 90/60 to be the limiting point where low blood pressure can be reasonably diagnosed.

To fully determine the underlying cause, the doctor may require blood tests to check for conditions associated with diabetes, anemia, or low blood pressure. An electrocardiogram (ECG) can be used to detect heartbeat irregularities, structural heart abnormalities, and problems with the delivery of blood and oxygen to the heart muscle. Stress testing on a treadmill or stationary bike can also be used for diagnosis.

How is Low Blood Pressure Treated?

Treatment of low blood pressure depends on the type of hypotension the patient has, and the severity of the signs and symptoms. The aim of treatment is to normalize blood pressure to relieve signs and symptoms. Another goal is to manage any condition that causes hypotension. The response to treatment depends on the patient’s age, general health and strength.  In a healthy person, low blood pressure without any symptoms is usually not a problem and does not require treatment. If you have a sudden onset of low blood pressure, you should sit or lie down immediately. In addition, the following can be done to control low blood pressure;

  • Drink plenty of water or liquids containing sodium and potassium.
  • Alcohol should not be used.
  • It should be raised slowly when standing up.
  • If there is low blood pressure after birth, low carbohydrate meals should be eaten.
  • Avoid situations that trigger symptoms, such as standing for a long time.
  • Salt should be used as recommended by the doctor.

If the drug used causes low blood pressure, the doctor may change the medication or adjust the dose.  Several medications are used to treat low blood pressure. These medications that increase blood pressure include fludrocortisone and midodrine.

Shock-Induced Severe Hypotension Treatment

Shock is a life-threatening emergency. Shocked people need immediate treatment. If a person has signs or symptoms of shock, seek immediate help.

The main goals of shock treatment are:

  • Bringing back blood flow to organs as quickly as possible to prevent organ damage,
  • Finding the cause of shock and reversing it.

Special fluids are introduced into the bloodstream to ensure blood flow to the blood or organs. Medications to be given by the doctor will help to raise blood pressure or strengthen the heartbeat. Depending on the cause of the shock, other treatments such as antibiotics or surgery may be needed.

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