Basic Detail about Understanding Low Blood Pressure
Overview
Hypotension term is associated with low blood pressure. The heart pumps the blood that flows throughout the body and exerts some pressure on the walls of arteries. This pressure is called blood pressure, produced in arteries while carrying oxygenated blood from the heart to the body. Blood pressure can be measured in systolic and diastolic blood pressure.
- Systolic Blood Pressure: When the heart beats and fills the arteries with blood, pressure in the arteries is called systolic blood pressure.
- Diastolic Blood Pressure: The pressure in arteries when the heart rests between the beats is called diastolic blood pressure.
The normal blood pressure range of both systolic and diastolic pressure is (120/80). Blood pressure lower than this range is considered low or hypotension. Low blood pressure without symptoms cannot cause a problem in healthy individuals.
But in the elderly, people's blood pressure shows the underlying condition that blood has not been supplied to the brains and vital organs. It measured as 90/60 or lower in adults. The change in blood pressure is related to certain factors that may vary the blood pressure throughout the day.
- Body position.
- Breathing rhythm.
- Stress level.
- Physical condition.
- Medication intake.
- Food and drink intake.
- Time of day.
The blood pressure is usually lowest during sleep at night and rises sharply after waking up.
Causes
Dropping blood pressure is normal if no symptoms are shown. If prolonged periods of hypotension occur, frequent untreated symptoms can be dangerous. There are certain factors responsible for hypotension.
1- Pregnancy: During the first 24 weeks, it is common for blood pressure to drop.
2- Prolonged bed rest: Bedrest for longer than 24 hours results in significant changes in blood pressure.
3- Decreased blood volume: The loss of a large amount of blood due to trauma, injury, or severe internal bleeding leads to a severe drop in blood pressure.
4- Dehydration: The excessive loss of water from the body may cause:
- Weakness.
- Dizziness.
- Fatigue.
- Drop in blood pressure.
Dehydration can be caused by the following:
- Fever.
- Vomiting.
- Severe diarrhea.
- Misuse of diuretics.
- Strenuous exercise.
5- Heart problems: Among the heart conditions, low blood pressure is also associated with:
- An abnormal heartbeat rate (bradycardia).
- Heart attack
- The problem with heart valves.
- Heart failure.
6- Allergic reactions (anaphylaxis): Allergic reactions may be fatal. It includes allergic reactions due to sensitivity to certain drugs like penicillin, certain foods like peanuts, and bee or wasp stings. Anaphylactic shock is associated with symptoms like:
- Breathing problems
- Hives
- Itching
- A swollen throat.
- A sudden drop in blood pressure.
7- Severe infection (Septic Shock): In severe infection of the lungs, abdomen, and urinary tract, bacteria may leave the original infected site and comes into the bloodstream. The bacteria release toxins in the bloodstream that affect blood vessels, resulting in a life-threatening drop in blood pressure.
8- Endocrine disorders: These include the conditions that arise in any change in hormone-producing glands. The endocrine system regulates the hormonal function and secretion in the body. The related conditions are:
- Hypothyroidism.
- Parathyroid.
- Adrenal insufficiency (Addison's disease).
- Diabetes.
9- Medications: Many drugs can trigger changes in blood pressure. Some of them are:
- Diuretics.
- Alpha-blockers.
- Beta-blockers.
- Medicines used for Parkinson's disease
- Tricyclic antidepressants.
- Medicine is used to treat erectile dysfunction.
- Narcotics and alcohol.
- Some over-the-counter medications when taken in combination with high blood pressure medication.
10- Nutritional Deficiencies: The lack of vitamin B12, folate, and iron may cause anemia that affects blood pressure. In some people, the cause of hypotension is unknown. It is called chronic asymptomatic hypotension. It is normal, and it does not create any harm.
Symptoms
An individual may experience the following symptoms if the blood pressure drops to 90/60 or below.
- Fatigue.
- Dizziness.
- Lightheadedness.
- Nausea.
- Lack of concentration.
- Blurry vision.
Severe symptoms can lead to complications and be life-threatening in some cases. The extreme hypotension symptoms may include:
- Confusion.
- Cold, clammy, pale skin.
- Rapidly, shallow breathing.
- Weak and rapid pulse.
- Fainting.
- Depression.
- Dehydration.
Types of Hypotension
Hypotension has divided into several categories according to when blood pressure drops.
1- Orthostatic Hypotension
Orthostatic means an upward posture and a drop in blood pressure due to the change in posture or position. Blood pressure is low when you stand up from a sitting or lying position. It commonly occurs in all ages.
Symptoms
It shows the following signs:
- Dizziness.
- Lightheadedness.
- Fainting.
It may be mild, and episodes last for a few minutes. The long duration may indicate a complication that must refer to the doctor.
Cause
Blood pools in the leg and abdomen due to the gravitational force. A person standing up quickly from a sitting or lying posture increases heart rate and constricts blood vessels to pump more blood to the brain.
If the body fails to compensate for this mechanism, the blood pressure falls, with dizziness, lightheadedness, blurred vision, and fainting. It commonly occurs in elders above 65 years.
Reasons and Risk Factors
Several reasons are responsible for orthostatic hypotension, including:
- Dehydration.
- Heart problems.
- Endocrine problems.
- Nervous system disorders.
- Eating meals.
The risk factors for orthostatic hypotension include:
- Age.
- Medication (beta-blockers and antidepressants).
- Certain diseases ( heart, anemia, Parkison's disease).
- Pregnancy.
- Heat exposure.
- Bed rest
- Alcohol
Complications
Orthostatic hypotension can cause serious medical complications in older adults, including:
- Loss of consciousness can cause serious injuries.
- Chronic conditions like heart failure and heart rhythm problems
- Develop a high risk of stroke as the brain receives less oxygenated blood.
Treatment and Prevention
The treatment mainly involves no drugs. The conventional ways of managing orthostatic hypotension include:
- Drink plenty of water and keep yourself hydrated. In diarrhea and vomiting, the loss of fluids has recovered by excessive fluid intake. Alcohol intake should be limited, which worsens orthostatic hypotension.
- Add salt to your meals with the doctor's advice to ensure how much salt is used to increase blood pressure.
- Avoid excessive exercise or strenuous activity during hot weather.
- Sit for one or two minutes on the edge of the bed before getting out.
- Sleep with a slightly elevated head on your bed.
- Compression stockings use to promote circulation and prevent the pooling of blood in the legs.
Severe cases can treat with drugs that increase blood pressure.
2- Postprandial Hypotension
The drop in blood pressure right after eating is called postprandial hypotension. The postprandial is a medical term used right after eating a meal. Based on physical activities, blood pressure changes throughout the day and night. The exercise will promote a temporary rise in blood pressure. The blood pressure is low during sleep at night due to no activity.
It is common in older people that lead to lightheadedness and falls. That may cause severe complications.
Cause
After eating a meal, digestion starts in your intestine, which requires additional blood flow. With an increased heart rate, the blood arteries constrict to provide more blood to the intestine. That causes a rise in blood flow pressure against the walls of arteries.
The body's autonomic nervous system manages blood vessels and heart rate changes. Suppose any medical condition related to the autonomic nervous system is present. Then the heart rate is not increased, and certain vessels may not constrict. The blood pressure becomes normal, but it results in severe conditions.
The more blood supply to the intestine other than all parts of the body. That may cause a sudden temporary drop in blood pressure. Fast absorption is another condition related to postprandial hypotension. It usually occurs in individuals who have diabetes.
Reasons and Risk Factors
The reasons and risk factors other than eating include:
- Heart valve disease.
- Dehydration.
- Pregnancy.
- Thyroid disease.
- Vitamin B12 deficiency.
The risk of postprandial hypotension is high in older age. Younger people rarely experience postprandial hypotension and other forms of low blood pressure. Parkinson's disease and diabetes are two common risk factors for postprandial hypotension.
The other factors involve using anti-hypertensive medication that can induce postprandial hypotension. The drugs amid low blood pressure cause an unsafe drop in blood pressure.
Complications
The complications can be severe, as the symptoms accompany fainting, which may lead to falling that causes trauma, bruise, and fractures. Loss of consciousness during driving may be fatal and causes severe injuries.
A stroke is a life-threatening complication when the blood supply is low to the brain. Other complication includes organ failure due to compromised blood supply to the organ in a shock condition.
Treatment and Management
The management and treatment can be done in the following ways:
- Reduce the dose of anti-hypertensive drugs, which should not be taken before a meal.
- Eating a more frequent and small portion of low-carb food.
- Walking after having dinner may help to raise slight blood pressure.
- Drinking water before a meal may prevent hypotension.
- Having a cup of coffee or tea before a meal at lunch may be helpful.
If the above changes are insufficient to prevent postprandial hypotension, then a medication (Sandostatin) is prescribed.
3- Neurally Mediated Hypotension
The drop in blood pressure after standing for a long time affects children and young adults. It is also known as vasovagal syncope or the fainting reflex. Due to standing for a long time, the blood pools in the legs and ankles. It causes a lack of blood supply to the heart, brain, and other organs.
It also results from overemotional and stressful conditions. It causes fainting due to a lack of communication between the brain and the heart.
Cause
Neurally mediated hypotension combines a drop in blood pressure and a slower heart rate. This results in reducing the flow of blood to the brain and causes fainting. Other than reacting to the emotions like fear, happiness, and depression. The case of neurally mediated hypotension are :
- Standing for long periods.
- Intense physical activity.
- Heat exposure.
- Seeing blood.
- Having blood drawn.
- Fear of bodily injury.
- Straining.
- Severe pain.
- Intense coughing.
Symptoms
There are very brief symptoms shown before fainting.
- Looking pale and gray.
- Lightheadedness or dizziness.
- Feeling sweaty.
- Nausea.
- Blurry vision.
- Weakness.
Treatment and Prevention
There is no specific treatment for neurally mediated hypotension, but it can cure according to the individual's symptoms. It is hard to avoid fainting, but if you feel like you might faint, lie down or sit down.
4- Severe Hypotension
Severe hypotension is related to chronic medical condition shock. It is associated with the decreased blood and oxygen supply to the body organ and results in organ damage and failure.
Cause
Anything that affects the flow of blood can cause severe hypotension, such as:
- Severe allergic reactions.
- Significant blood loss.
- Heart failure.
- Blood infections.
- Dehydration.
- Poisoning.
- Burns.
Symptoms
Severe hypotension leads to shock, and you may experience some symptoms that are:
- Rapid, weak, or absent pulse.
- Irregular heartbeat.
- Rapid, shallow breathing.
- Lightheadedness.
- Cool, clammy skin.
- Dilate pupils.
- Chest pain.
- Nausea.
- Confusion.
- Anxiety.
- Thirsty and dry mouth.
- Loss of consciousness.
- Low blood sugar.
Treatment
Severe hypotension is a life-threatening condition that must be treated immediately. Emergency personnel administers excessive fluids and blood products to raise your blood pressure.
