Low Blood Pressure (Hypotension)

Blood is critical for the survival of the human body. It helps to carry nutrients and oxygen to all tissues and cells. The heart pumps blood throughout the body.

The blood vessels and arteries act as the delivery system. As the heart pumps, blood is pushed into these arteries. The blood vessels and arteries then carry the blood to every single area of the human body. 

Blood pressure is a measurement that shows how much work the heart does to pump blood through the body. A lot of focus is often placed on high blood pressure.

When a person’s blood pressure levels are high, it gradually causes damage to blood vessel walls. There is a severe increase in the risk of heart disease too1.

While hypertension is very dangerous, it is essential that people do not overlook the risks of low blood pressure. Also called hypotension, when blood pressure falls too low, several complications can develop.

We will look at what low blood pressure is and what it means. We consider what happens when the condition becomes symptomatic. The post also looks at how low blood pressure can be treated effectively. 

What Is Low Blood Pressure?

When blood pressure is measured, there are two readings that a person needs to look at. These two numbers represent diastolic and systolic pressure. Each plays a role in helping a person understand if their heart is working properly. 

  • Systolic pressure refers to the amount of pressure that the heart applies to arteries as it fills up with blood. 

  • Diastolic pressure refers to the amount of pressure the heart puts on arteries when it rests between two heartbeats. 

When a person’s blood reading goes below 90/60, they have low blood pressure. This is lower than what is considered normal blood pressure. The medical term for low blood pressure is hypotension. 

Generally, low blood pressure is more desirable than hypertension. This is because hypertension is known to cause serious damage to blood vessels. This leads to heart disease and can also contribute to events like heart attacks. Since the amount of pressure applied to artery walls is lower with hypotension, the same damage is not done. 

Many people keep their blood pressure levels relatively low and do not experience any side-effects in the process. If blood pressure falls below a specific measurement (90/60), then a person is at risk of some complications, however. 

Only some people with low blood pressure requirement treatment. This is usually the case if the person starts to experience symptoms and complications. It is often considered a sign that something else is going on in the patient’s body. When blood pressure declines too much, it can restrict blood supply to vital organs, including the brain and heart. 

There are rare cases where low blood pressure also leads to fatal side-effects. In some of these scenarios, it may even cause a person to experience life-threatening events. 

Some people experience chronic hypotension. In other cases, a person may rather experience episodes where their blood pressure suddenly drops. It is more dangerous for blood pressure to drop suddenly compared to having chronic low blood pressure

There are different kinds of low blood pressure scenarios that can develop – and each comes with its own classification. 

  • Postural Hypotension: This is when a person’s blood pressure levels fall quickly when they get up after lying down or sitting down for a while. This is linked to postprandial hypotension too. 

  • Neurally mediated hypotension happens when a person experiences a drop in their blood pressure levels after standing up for a long time. 

  • Vasovagal Syncope: A condition where neutrally mediated hypotension causes a person to pass out. 

There are other types of hypotension conditions too. 

Studies show that hypotension is very common in the general population2. In one study, ambulance respondents were asked to take note of blood pressure levels presented by patients during a 24-hour period. Almost half of the patients who were transported with the ambulance had low levels of blood pressure. 

What Are The Symptoms Of Low Blood Pressure?

Even though most low blood pressure cases are not serious, there are scenarios where a person can experience life-threatening complications.

This is why the ability to recognize a drop in blood pressure is so important. Individuals who have these symptoms should keep an eye on their blood pressure. If it declines too much, contacting a doctor becomes critical. Failure to respond can lead to shock – and this can put the person’s life in danger. 

People with chronic low blood pressure may not notice any apparent symptoms. Many of these individuals only learn about their hypotension when they go for a check-up or see the doctor about another concern. 

Those who experience a more sudden drop in their blood pressure levels may suffer some side-effects. Symptoms associated with a drop in blood pressure include:

  • Lightheadedness

  • Dizziness

  • Burred vision

  • Fading vision

  • Fatigue

  • Nausea

People often also find that they are unable to concentrate when their blood pressure levels are too low. 

It is possible for a person to faint when they have low blood pressure. 

In men, chronic low blood pressure may limit the supply of blood to the pelvis. This could even lead to erectile dysfunction, especially during a blood pressure drop. 

People should be able to recognize signs of shock too. This is an event that happens when blood pressure falls too low. It often results in a life-threatening situation. 

Symptoms associated with an extremely low blood pressure level include:

  • Shallow breathing

  • Rapid breathing

  • Confusion

  • Pale skin

  • A weak, yet rapid pulse

  • Clammy skin

  • The skin may also be old

What Causes Low Blood Pressure?

People need to understand why they have low blood pressure. By recognizing the causes, a person will be able to determine what leads to a dip in blood pressure levels. This also ensures the person can recognize specific elements in their life that may be adjusted for improved blood pressure regulation

It is important to also take note of the fact that blood pressure will generally vary through the course of 24 hours. Several things can affect the blood pressure level of a person at any given time. 

The person’s stress levels, breathing rhythm, and the time of the day – these are all things that affect blood pressure. Food and drinks can also alter blood pressure, as we as certain medications. 

There are a few conditions that have been linked to low blood pressure:

  • Endocrine problems, such as hypoglycemia and Addison’s disease, may cause blood pressure to decline. Parathyroid disease is also linked to hypotension. 

  • Issues with the heart may also be a concern in people with low blood pressure. Problems like heart valve dysfunction and bradycardia can cause hypotension. People who experience a heart attack may also have low blood pressure. 

  • Pregnant women will also be at risk of developing low blood pressure. Following birth, the woman will usually find that blood pressure returns to a more regulated level. 

  • A person who suffers severe blood loss will also develop hypotension. This blood loss may be caused by internal bleeding or an external injury. 
  • A person who develops anaphylaxis can suffer a sudden and significant drop in their blood pressure. Anaphylaxis is a serious allergic reaction that can cause life-threatening events to happen. 

  • Septicemia, a term that refers to a severe infection, also holds a link to reducing blood pressure levels. When the infection is exceptionally severe, it can cause septic shock. In such a case, blood pressure declines to life-threatening low levels. 

  • Dehydration is another issue that comes to mind when looking at hypotension causes. This problem also causes dizziness, fatigue, weakness, vomiting, fever, and more. 

It is important to note that some medications may also cause blood pressure to drop. There are a few different drugs that have been linked to a risk of hypotension. Some include:

Risk Factors

There are also a few risk factors that people need to realize. This can help a person determine how likely they might be at developing hypotension. Recognizing these will also allow a person to take appropriate preventative steps. 

Age is considered a major risk factor. Older people generally tend to be at a higher risk of hypotension. The risk seems to increase significantly after the age of 65. If young adults are affected, they usually experience neutrally mediated hypotension. 

Medication is another risk factor. People who take medication for hypertension have a risk of experiencing a drop in blood pressure – this is generally the case when the blood pressure medication the patient take is too strong. 

There are a few diseases that also play a part in risk factors for hypotension. This includes Parkinson’s disease, heart disease, and diabetes. 

Complications

A chronic low blood pressure level often does not cause people serious complications. Those people with chronic hypotension will usually not have a life-threatening low blood pressure level. There are, however, complications that can develop when blood pressure drops too much. 

A drop in blood pressure can cause a person to experience weakness and dizziness. Fainting is also possible. The major complication here is the significant increase in the risk of falls. When a person falls, they may suffer serious injury. 

It is also important to note that blood flow carries oxygen to the heart, brain, and other organs. When there is a significant drop in blood pressure, oxygen supply to these body parts become limited. In such a case, there may be tissue damage that occurs. 

Diagnosis

The diagnosis process for hypotension starts with a blood pressure test. A doctor may need to measure the patient’s blood pressure at different times to make a diagnosis. This is because blood pressure can change based on the time of day and be affected by other factors. 

The purpose of a diagnosis is to help the doctor determine why a patient is experiencing low blood pressure. There are a couple of potential causes. 

The doctor will usually start with a physical examination. There are a few tests that the doctor may order too, apart from measuring the patient’s blood pressure levels in the office. 

  • Blood tests: The doctor may request that blood tests be done on the patient. This can help in detecting hypoglycemia and hyperglycemia. The doctor can use these tests to see if the patient is developing diabetes. They can also use a blood test to provide a measurement of red blood cell count.

    Anemia, a condition where red blood cell count is low, may contribute to low blood pressure. This usually causes low blood volume too. It can lead to severe hypotension in some cases.

  • Tilt Table Test: This test involves looking at blood pressure reading in a standing position. A tilt table is used during the procedure. 

  • Electrocardiogram: This type of test helps the doctor get a better idea of the patient’s heart health. A device is attached to the patient. The machine records electric signals from the heart. 

Treatment

There are a few treatment options that may be considered. The patient may be advised to consume more fluids. The doctor may also ask the patient to include more salt in their diet3.

Compression socks may be given to the patient if they have swelling and pain in their legs. Some medications may help with hypotension too. Fludrocortisone is sometimes given to patients with orthostatic hypotension, for example. 

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Conclusion

Low blood pressure is a serious problem that patients need to understand. The condition can cause several complications, including fainting. People need to be able to recognize the signs of low blood pressure. The individual also needs to understand what the potential causes and risk factors for hypotension are. Understanding the treatment options gives a person the knowledge to know what to do if they have low blood pressure. 

Sources

  1. InformedHealth.org [Internet]. (2012) High blood pressure: Overview. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK279239/
  2. Journal of Human Hypertension. (2000) Arterial Hypertension: Prevalence of Low Blood Pressure in the General Population Using Ambulatory Blood Pressure Monitoring. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/10805049/
  3. Mayo Clinic. Low blood pressure (hypotension). [online] Available at: https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/diagnosis-treatment/drc-20355470

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