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Hypotension: Symptoms, Causes, And Prevention

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Hypotension: Symptoms, Causes, And Prevention

Hypotension is blood pressure (BP) below 90/60 mmHG. Usually, low BP alone is not unhealthy, and some people may have it all the time. But it becomes a cause of worry if it makes blood flow to the brain and vital organs inadequate and manifests as clammy skin, blurry vision, dizziness, or is linked to a health condition like heart disease. Its most severe and fatal form is shock, where the patient can even get a stroke or heart attack.

Have you been experiencing fleeting moments of weakness or dizziness? Maybe, it’s low blood pressure or hypotension. 

A simple mention of blood pressure medication is enough to make your friends think that you are under high stress and struggling with a rising sphygmomanometer reading. Who can blame them? The blood pressure topic typically brings high blood pressure (hypertension) to mind. We also tend to assume that low blood pressure is a good thing. However, this is far from the truth, and it can be just as dangerous. Fortunately, understanding hypotension can also help you control it.

Hypotension Is Low Blood Pressure

If your blood pressure reading is lower than 90/60 mmHG, you have low blood pressure.

Hypotension is the medical term for abnormally low blood pressure. A normal pressure reading is around 120/80 mmHG (systolic pressure/diastolic pressure). When the heart is actively pumping blood, blood fills the arteries and the pressure is at its highest, giving us the systolic reading. This is the top number. When the heart is resting between beats, we get the diastolic reading, the bottom number. Anything below 90/60 is a sign of low blood pressure. This means that your heart is failing to pump blood at the ideal force.

Symptoms Of Low Blood Pressure

For many, a fall in blood pressure may be unsettling and can disrupt their normal function. Symptoms include:

1. Dizziness Or Fainting

If you know you are prone to postural hypotension, make your movements smooth and slow. Don’t jerk back into action.

After A Sudden Movement: Postural Hypotension

You may feel giddy after a sudden movement, such as getting up from a chair or out of bed. This is known as orthostatic or postural hypotension and happens when blood flow and pressure don’t adjust fast enough to the sudden change in position. During this time, organs and muscles aren’t receiving enough blood. And while this can happen very quickly, it will settle down by taking a few minutes to rest and let blood pressure return to normal.

After A Meal: Postprandial Hypotension

Eat smaller meals with fewer easily digested carbs and always drink water before you eat.

You may also feel lightheaded after a meal if you suffer from postprandial hypotension. In a healthy person, during a meal, more blood is pumped to help the digestive system and the blood vessels away from the stomach are signaled to become narrower to keep the pressure even. In your case, however, the blood vessels do not narrow down, making the pressure drop everywhere else apart from the digestive system, making you feel dizzy or even faint. How to combat this? Drink water before meals; keep the meals smaller and with fewer simple carbs; and rest after meals.1

After Standing Or Sitting For A Long Time: Neurally Mediated Hypotension

Try a few simple stretches to keep shifting positions and avoid long periods of idleness. If you feel giddy, lie down to even out your blood circulation.

You may feel giddy or even faint if you have neurally mediated hypotension. If you’ve been standing or sitting for a long time, blood collects in your legs due to gravity. Now when you change position, instead of signaling the heart to pump more blood, as a normal person’s brain would, your brain thinks you have high blood pressure and signals the heart to pump less blood and to dilate the blood vessels. As a result, the brain receives little blood, making you dizzy or even black out for a while. Don’t be scared. Lie down to negate the effect of gravity and redistribute the blood across the body.2

After A Traumatic Experience: Severe Hypotension

If you’re sweating profusely, your limbs are going cold and blue, and you can’t seem to breathe, call for medical help immediately.

The most dangerous form is severe hypotension, involving shock and loss of consciousness. This may be caused by a traumatic experience like a severe head injury, poisoning, allergic reaction, or heart attack or something that causes heavy blood loss or heart failure. Your pressure might drop so low that vital organs – such as the kidneys, heart, and brain – don’t get enough blood and malfunction. The visible signs are sweating, cold limbs, breathing difficulties, and severe distress. This can be fatal, so you need to focus on getting immediate medical attention.3

2. Sweaty Or Clammy Skin

Rehydrate yourself after strenuous physical activity so that the pressure doesn’t drop too low.

As not enough blood is being circulated, your body temperature remains low, keeping your skin cold and clammy. Sweating might even be the reason for the drop in your pressure as excessive sweating removes electrolytes from your body and affects blood pressure. If you have severe hypotension caused by shock, your skin may even turn blue.4Make sure you refill the water and electrolytes lost after a bout of excessive sweating.

3. Blurry Vision

Low blood pressure means a poor circulation to the eyes and not enough oxygen and nutrients. As your retina needs a constant supply of blood and oxygen to function properly, this lack causes blurry vision.

4. Fatigue

If you are always tired despite enough rest, get yourself checked for low blood pressure.

Again, poor circulation and lack of oxygen in the brain and the vital organs is responsible for fatigue and general weakness. In fact, patients with chronic fatigue syndrome – a condition in which patients suffer from extreme fatigue without any underlying condition – often suffer from neurally mediated hypotension.5

5. Nausea

Nausea is common during episodes of postprandial hypotension or in cases where poor blood circulation due to low blood pressure interferes with your digestion.

6. Tightness Or Squeezing In The Chest

A squeezing or tightness in the chest doesn’t always mean you have a blocked artery; it could be low pressure too.

Angina is the medical term for the pain, heaviness, tightness, or squeezing in the chest you may feel if you have low blood pressure. It is usually a symptom of coronary heart disease and occurs when the coronary arteries become blocked or narrowed. But a lack of blood to the heart due to hypotension is also possible.

Low Pressure Is Not Always Bad

Low pressure isn’t bad for all folks. Some people have a naturally low blood pressure – something called chronic asymptomatic hypotension – and are perfectly healthy. It’s their “normal.” A low blood pressure only becomes a cause for worry if it triggers undesirable symptoms or is linked to a serious health condition like heart disease.6

What Causes Low Blood Pressure?

Any factor that disturbs the body’s mechanism of controlling blood flow places the body at risk of hypotension.

The causes of low blood pressure include dehydration, anemia, vitamin B12 deficiency, alcoholism, pregnancy, old age, long periods of inactivity, or even a traumatic experience like a head injury or profuse bleeding.

  • Orthostatic hypotension can be triggered by dehydration, heart disease, infections, or anemia. It can even occur during pregnancy because of the dilation of blood vessels and is not a cause of worry unless there are frequent dizzy or fainting spells. Diuretics and medication for anxiety or depression can also increase the risk of hypotension. It can also be a result of alcoholism, prolonged bed rest, or one of the following conditions: Parkinson’s, dementia, and B12 deficiency.7
  • Postprandial hypotension is also common among senior citizens due to an overall slowing of bodily functions linked to aging. This is why your grandpa looks like he’s about to nod off after a hearty meal.8
  • Neurally mediated hypotension is caused by large periods of stillness, like sitting in a car for too long or standing in a slow queue. It is seen more often in children and younger adults.9
  • Shock-related severe hypotension usually isn’t in your control. But it can be fatal and immediate medical help is critical. Additionally, hypotension due to septic shock or severe sepsis needs antibiotic treatment within an hour.10

How To Prevent Low Blood Pressure

Now that you know about the different types of hypotension, it’s time to crack down on how you can prevent (or minimize) overall risk. Orthostatic hypotension and neurally mediated hypotension may require simple lifestyle changes:

  • Drink more (non-alcoholic!) fluids and stay hydrated. Fuel up on at least 6–8 cups of water or other low-calorie drinks.
  • Stand up slowly and avoid sudden jerks in movement.
  • Eat small, low-carb meals for postprandial hypotension.
  • Avoid triggering situations like scary or upsetting movies, places, or scenarios.
  • Wear compression stockings to maintain the blood pressure in your legs. These stockings help blood move smoothly throughout your body.
  • Increase salt intake for orthostatic hypotension. Under medical guidance, you can consume about 10–20 g of salt per day.11
  • Eat foods that stabilize the body. Examples include soaked raisins, soaked almonds with milk, carrot juice, basil leaves, and even caffeine drinks.1213

Remember, shock-related severe hypotension is a life-threatening emergency. Call a doctor and try to maintain the blood flow to organs. When possible, remove the source of the shock immediately.14

References   [ + ]

1. Eating can cause low blood pressure. Harvard Medical School.
2. Patient Information Brochure on Neurally Mediated Hypotension and Its Treatment. Johns Hopkins Hospital
3, 4, 9. What Are the Signs and Symptoms of Hypotension?. National Heart, Lung, and Blood Institute.
5. Wilke, W. S., Fetnat M. Fouad-Tarazi, Joseph M. Cash, and Leonard H. Calabrese. “The connection between chronic fatigue syndrome and neurally mediated hypotension.” Cleveland Clinic journal of medicine 65, no. 5 (1998): 261-266.
6. What Is Hypotension?. National Institutes of Health.
7. Postural hypotension. CDC.
8. Lipsitz, Lewis A. “Orthostatic hypotension in the elderly.” New England Journal of Medicine 321, no. 14 (1989): 952-957.
10. Mok, Katie, Michael D. Christian, Sandra Nelson, and Lisa Burry. “Time to administration of antibiotics among inpatients with severe sepsis or septic shock.” The Canadian journal of hospital pharmacy 67, no. 3 (2014).
11. Figueroa, Juan J., Jeffrey R. Basford, and Phillip A. Low. “Preventing and treating orthostatic hypotension: as easy as A, B, C.” Cleveland Clinic journal of medicine 77, no. 5 (2010): 298.
12. Williamson, Gary, and Arianna Carughi. “Polyphenol content and health benefits of raisins.” Nutrition Research 30, no. 8 (2010): 511-519.
13. Stansbury, Jill, Paul Saunders, David Winston, and Eugene R. Zampieron. “Treating Adrenal Insufficiency and Hypotension with Glycyrrhiza.” Journal of Restorative Medicine 1, no. 1 (2012): 102-106.
14. How Is Hypotension Treated?. National Institutes of Health.