Blood pressure is the pressure of circulating blood exerted on the arterial wall. Low blood pressure is a condition in which the blood pressure is lower than normal. You may have come across adults having high or low blood pressure. It can also occur in children. When the blood pressure is low, the vital organs of the body as well as other parts do not receive enough blood supply. As a result, the patient experiences several symptoms such as dizziness, blurred vision, intense fatigue, cold and clammy skin etc. The normal range of blood pressure in children between 3-5 years is between 90/60 mm of Hg to 110/80 mm of Hg.When the systolic blood pressure is less than 90 mm of Hg and diastolic pressure is less than 60 mm of Hg, it is termed as low blood pressure. In medical terminology, low blood pressure is called hypotension.
Causes of Low Blood Pressure in Children:
Hypotension in children can develop due to numerous reasons. At one the reasons can be mild and reversible such as anemia and dehydration and on the other hand the underlying cause may be life threatening such as septic shock. Below are given important reasons for low blood pressure in children:
- Dehydration: Dehydration is a condition in which there is imbalance of fluid and water in the body. There is a mismatch between the fluid intake and water needed by the body. Due to water imbalance there is simultaneous electrolyte imbalance in the body. Dehydration in children is serious condition which can occur as a result of diarrhea, vomiting, fever, too much of sweating during strenuous exercise etc. The decrease in fluid results in decrease in total volume of blood which ultimately results in low blood pressure.
- Anemia: Anemia is a condition characterized by low level of red blood cells. This will result in low hemoglobin level. In majority of cases, children suffer from iron deficiency anemia. Severe anemia can result in low blood pressure.
- Adrenal gland problem: Adrenal gland is located on the top of kidney. They are small glands but produce important hormones needed for various functions of the body. When the gland does not produce adrenal hormones, it leads to a condition called adrenal insufficiency. Adrenal insufficiency can cause less production of aldosterone hormone. Because of low aldosterone, there is low sodium in the blood. This leads to low blood pressure.
- Medicines: Certain medicines especially vasodilators and calcium channel blocker can potentially cause low blood pressure in children.
- Shock: Septic shock is a serious condition. It can develop due to infection in the body. In shock there is severe reduction of blood circulation in the body organs and tissue. This will lead to low blood pressure along with various other symptoms and signs. Profuse diarrhea causes hypovolemic shock because of loss of fluid in body.
Symptoms and Diagnosis of Low Blood Pressure:
A child suffering from low blood pressure may experience several symptoms. Following are the important symptoms:
- Intense lethargy
- Increased sleepiness
- Cold and clammy skin
- Perspiration on face and all over body.
- Blurred vision
- Depressed state of mind
- Increased thirst
- Easy fainting
Low blood pressure is easily diagnosed by recording the blood pressure with blood pressure instrument. However, the most important point is to find the underlying cause that has lead to hypotension. Unless that is not addressed, your blood pressure will not reach its normal level. Hence further tests are done to know the cause. This includes various tests such as complete blood count, X-ray of chest, sonography of abdomen, liver and kidney profile, blood culture for infection, electrocardiogram (ECG) to check heart function etc.
Low blood pressure in children results from various causes. Hence the treatment depends on addressing the underlying cause. Often low blood pressure in mild and it can be easily managed at home. For example if hypotension is one of the sign of dehydration, replenishing fluid and salts can correct dehydration and electrolyte balance. Once these two parameters become normal, blood pressure automatically becomes normal. The child is encouraged to drink more fluids in case of mild dehydration. If dehydration is severe, the child may require hospitalization for intravenous fluids. If the child has hypotension due to medications, then the pediatrician may change its dosage. However, in case of shock, immediate measures are necessary to save the life. The child may need intensive care in hospital. He may need intravenous fluids and blood as well as medicines to raise blood pressure as well as the strength of heart to pump enough blood in the body.