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Are You At Risk For Hypotension? Symptoms And Risk Factors

Symptoms Of Low Blood Pressure

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.

We are ever alert about not letting our blood pressure rise, but we don’t pay as much attention to keeping our blood pressure from dropping below normal. A common belief is that hypotension or low blood pressure is not as harmful as hypertension or high blood pressure. But hypotension, especially shock-related hypotension, can be just as dangerous and even fatal. Fortunately, understanding hypotension, its symptoms, causes, and methods of prevention can also help you control it.

4 types of hypotension

 

  • Postural or orthostatic
  • Postprandial
  • Neurally mediated
  • Severe

A normal pressure reading is around 120/80 mmHG. 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. For many, a fall in blood pressure may be unsettling and can disrupt their normal function. Symptoms include:

1. Dizziness Or Fainting

After A Sudden Movement

You may feel giddy after a sudden movement, such as getting up from a chair or out of the bed. This is known as orthostatic or postural hypotension.

Prevention: Stand up slowly and avoid sudden jerks in movement. Increase salt intake for orthostatic hypotension. Under medical guidance, you can consume about 10–20 g of salt per day.1

This 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 if you take a few minutes to rest and let the blood pressure return to normal.

After A Meal

Prevention: Eat small, low-carb meals. Include foods like soaked raisins, soaked almonds with milk, carrot juice, basil leaves, and even caffeine drinks that are know to stabilize the body. Drink water before meals and rest after meals.23 4

You may also feel lightheaded after a meal if you suffer from postprandial hypotension. In a healthy person, more blood is pumped to help the digestive system during a meal. At the same time, the blood vessels away from the stomach are signaled to become narrower to keep the pressure even. If you have postprandial hypotension, however, the blood vessels do not narrow down, making the pressure drop everywhere else apart from the digestive system. As a result, you feel dizzy or even faint.

After Standing Or Sitting For A Long Time

Prevention: Wear compression stockings to maintain the blood pressure in your legs. These stockings help blood move smoothly throughout your body. 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. When you change position, instead of signaling the heart to pump more blood, as a healthy 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.5

After A Traumatic Experience

Prevention: While preventing a shock may not always be possible, if you tend toward low blood pressure, avoid triggering situations like scary or upsetting movies, places, or scenarios.

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 anything 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.6 If you’re sweating profusely, your limbs are going cold and blue, and you can’t seem to breathe, call for medical help immediately.

2. Sweaty Or Clammy Skin

Refill the water and electrolytes lost after a bout of excessive sweating. Drink more (non-alcoholic!) fluids and stay hydrated on at least 6–8 cups of water or other low-calorie drinks daily.

As not enough blood is being circulated, your body temperature remains low, keeping your skin cold and clammy. Sometimes, sweating might itself 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 turn blue.7 That is a medical emergency.

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 causes blurry vision.

4. Fatigue

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

Again, poor blood 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 one experiences extreme fatigue without any underlying condition – often suffer from neurally mediated hypotension.8

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 reduced blood flow to the heart due to hypotension is also possible.

Risk Factors Include Dehydration, B12 Deficiency, And Aging

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: Dehydration, Anemia, B12 Deficiency

This could include dehydration, heart disease, infections, or anemia. It can even occur during pregnancy because of the dilation of blood vessels and is not a cause for 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 Parkinson’s, dementia, and B12 deficiency.9

Postprandial Hypotension: Aging And High Blood Pressure

This form of low blood pressure is common among the elderly due to an overall slowing down of bodily functions linked to aging. It may also be common in people with high blood pressure or conditions like diabetes, Parkinson’s disease, and multiple system atrophy. In these diseases, the parts of the brain that control the nerves responsible for managing the body’s internal processes are damaged.10 11

Neurally Mediated Hypotension: Faulty Nerve Signals

Neurally mediated hypotension occurs after long 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.12 Though the exact cause is not yet understood, neurally mediated hypotension is thought to be caused by faulty nerve signals between the brain and the heart. It may also be genetic.13

Shock-Related Severe Hypotension: Trauma

This 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.14

With the few preventive measures we have mentioned, it is possible to check your blood pressure from dropping below normal. Be especially careful when you go on restrictive diets.

Low Pressures Is Not Always Bad

Do note that some people have a naturally low blood pressure – this is known as 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.15

References   [ + ]

1. 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.
2. Williamson, Gary, and Arianna Carughi. “Polyphenol content and health benefits of raisins.” Nutrition Research 30, no. 8 (2010): 511-519.
3. 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.
4. Eating can cause low blood pressure. Harvard Medical School.
5. Patient Information Brochure on Neurally Mediated Hypotension and Its Treatment. Johns Hopkins Hospital
6, 7, 12. What Are the Signs and Symptoms of Hypotension?. National Heart, Lung, and Blood Institute.
8. 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.
9. Postural hypotension. CDC.
10. Lipsitz, Lewis A. “Orthostatic hypotension in the elderly.” New England Journal of Medicine 321, no. 14 (1989): 952-957.
11. Postprandial Hypotension. Merck Manual.
13. Patient Information Brochure on Neurally Mediated Hypotension. Johns Hopkins Hospital.
14. 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).
15. What Is Hypotension?. National Institutes of Health.

Disclaimer: The content is purely informative and educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.