What is Hypotension:
Hypotension is also known as low blood pressure, which occurs when the pressure exerted against your artery walls is lower than the healthy limit. Low blood pressure can lead to vital organs not receiving an ample blood supply.
Blood pressure is a ratio of systolic to diastolic blood pressure readings. Systolic pressure is read when your heart beats, and diastolic is read when your heart is at rest (between beats). Lower than 120/80 is considered healthy; if blood pressure is 90/60 or lower, an individual could be diagnosed with hypotension.
Causes of Hypotension:
Hypotension can be caused by many things, but isn't always reason for alarm. Many people have naturally low blood pressure and are perfectly healthy. Blood pressure is lower during sleep cycles, followed by a quick rise upon waking.
If your blood pressure usually runs on the low side, but you don't have any symptoms and feel normal, then monitoring of your blood pressure may be all that's necessary. If your blood pressure is consistently extremely low, or if your pressure level drops extremely quickly, then this may be a sign of an underlying health concern that will need to be addressed. Low blood pressure levels can be triggered by:
- Anaphylaxis (severe allergies)
- Endocrine problems (such as thyroid or adrenal issues)
- Infection (septicemia)
- Heart failure
- Blood loss
Types of Hypotension:
Hypotension falls into three main categories:
- Orthostatic (or postural) hypotension can occur when an individual stands up suddenly after lying down; it generally never lasts more than a few minutes at most. Postprandial orthostatic hypotension happens after an individual has eaten. This type of hypotension is most common in older adults, people with hypertension (high blood pressure), or those with Parkinson's disease.
- Neurally mediated hypotension (NMH) occurs when an individual stands for a prolonged period of time, or changes positions quickly. This typically affects children and adolescents, and usually is outgrown by adulthood.
- Severe hypotension can occur as a result of shock, blood loss, infection, or anaphylaxis. It can be brought about by injury or trauma.
Shy-Drager syndrome, or Multiple System Atrophy, is a progressive disorder of the central and autonomic nervous system similar to Parkinson's disease, and is characterized by orthostatic hypotension. Though it can also occur without orthostatic hypotension.
Risks for Developing Hypotension:
Usually hypotension is not a cause for concern. However, if your blood pressure is consistently low, it may be due to an underlying medical condition as listed above. The risk for developing hypotension increases with age, and can also be caused by Parkinson's disease, diabetes, or heart disease.
Additionally, hypotension can be triggered by use of the following:
- Anti-anxiety or antidepressant medications
- Heart medications
- Anesthetic medications used in surgeries
Symptoms of Hypotension:
An individual who has hypotension may not exhibit any symptoms. In this case, if the individual feels fine, then there is no reason to seek medical attention.
When hypotension leads to the following symptoms, it may be necessary to consult your physician:
- Cold, clammy skin
- Dizziness, lightheaded sensation, or physical weakness
- Blurred vision
- Black or red stools
Diagnosis of Hypotension:
Your doctor will perform a physical examination, including checking for breathing, pulse, and temperature. Your blood pressure will be monitored often to ascertain if there are any sudden drops in pressure level. If your hypotension is severe, a hospital stay may be warranted so your condition can be monitored more closely.
Your doctor will want to know if you take any medications, what your diet consists of, any symptoms you're experiencing, and if there has been any recent injury or illness that may be a factor. He or she will also want to know if you experience any dizzy or fainting spells and if these occur when sitting, standing, or lying down.
If your doctor deems it necessary, the following tests may be performed:
- Blood testing
- Metabolic testing
- Electrocardiogram (ECG)
- X-rays of the torso
- Stress tests
- Tilt table tests (to evaluate your body's response to changes in position)
Treatment for Hypotension:
Some individuals just normally have lower blood pressure, and don't need to be treated. However, treatment may be necessary depending on if the hypotension is caused by an underlying medical condition. Your doctor may advise you to increase your fluid intake and decrease alcohol intake, as well as to improve your diet and exercise regularly.
If you have orthostatic hypotension, it may be caused by medication. Your doctor may need to change the dosage or the prescription itself. If dehydration is the cause, administration of fluids can alleviate hypotension.
Individuals who have NMH should avoid situations that can cause episodes of hypotension (i.e., standing for prolonged periods; one may need to stand up slowly if you've been supine or sitting). Increasing sodium intake or medication can also alleviate NMH. Compression stockings or elastic tubes can be used in the lower body to raise blood pressure in the lower extremities.
In the event of severe hypotension, emergency medical treatment is always required. This can include medication to increase blood pressure, antibiotics, or even blood transfusions.
Additional Resources For Hypotension:
Low Blood Pressure Help - A site with information on blood pressure readings, tips for lowering blood pressure, as well as effects of hypotension and links to articles on the subject.
Healthy Ojas - Information on hypotension, as well as home remedies, exercises, and tips for managing the condition.
Dizziness and Balance - Information on causes, treatments, and research on orthostatic hypotension.
The Newcastle upon Tyne Hospitals - Information on care for the elderly with hypotension, as well as contact information for questions.