Hypotension: Symptoms, Causes, Risk Factors, Diagnosis, Management, Home Remedies and Various Types of Hypotension

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Blood pressure varies from person to person, so it is not easy to define what is normal blood pressure, high blood pressure as well as low blood pressure. Hypotension (low blood pressure) in general can be taken as systolic (the top number in blood pressure reading) blood pressure of below 90 mm of Hg and diastolic (the bottom number in blood pressure reading) blood pressure of below 60 mm of Hg. We all know the ill effects of high blood pressure, hence, some people may think low blood pressure can be blessing. However, it is not so because hypotension can cause various symptoms such as dizziness, lightheadedness, headache, fainting etc. In severe cases of hypotension, it may even be life threatening. Hence, we need to watch for hypotension too. If you have hypotension, there is nothing to worry about, because, it can be managed satisfactorily. It can be treated properly, especially if the cause can be found.

Sometime you may have symptoms of hypotension without actually having low blood pressure. For example, if you have constantly high blood pressure (e.g. 150/90 mm Hg) and for any reason your blood pressure suddenly come down to 120/80 mm Hg, i.e. sudden lowering of systolic BP by 30 mm Hg, this your body may not be able to adjust and cause symptoms such as dizziness, lightheadedness etc. This is because your body physiology have adjusted to raised BP and when sudden fall in BP occurs your body physiology responds accordingly and cause symptoms.

What symptoms can hypotension cause?

Many people may not have symptoms if they have blood pressure which is generally considered as hypotension (i.e. systolic below 90 mm of Hg and diastolic below 60 mm of Hg). However, most people will experience symptoms at similar blood pressure level, such as,

  • Lightheadedness, dizziness, headache
  • Blurring of vision
  • Rapid breathing
  • Fainting (rarely)
  • Inability to concentrate
  • Skin may become pale, clammy and cold
  • Fatigue, thirst
  • Depression

If you have low blood pressure consult your doctor when it becomes troubling for you due to various symptoms you may experience.

What are possible causes of low blood pressure?

Various medical conditions cause hypotension, such as

  • Hormonal problems: diabetes, thyroid and parathyroid disorders can cause hypotension.
  • Heart problems: various heart diseases may cause hypotension, such as heart valve problems, very low heart rate (known as bradycardia), heart failure, heart attack etc.
  • Pregnancy: during pregnancy circulatory system expands rapidly and may cause hypotension.
  • Blood loss: sudden blood loss due to accident or any other cause can reduce blood volume and cause hypotension.
  • Dehydration: it leads to lowering blood volume and hypotension.
  • Septicemia: septicemia can lead to septic shock, which is life threatening.
  • Anaphylactic shock: this is another kind of severe hypotension, where there is sudden and huge drop in blood pressure due to sudden dilatation of blood vessels.

Certain medications can cause hypotension and these include,

  • Diuretics (furosemide), alpha blockers (prazosin), certain beta blockers (such as propranolol, atenolol), anti-Parkinsonian drugs, drugs used for erectile dysfunction (such as sildenafil-brand name viagra), certain antidepressants etc.

What are the risk factors of developing hypotension?

Hypotension can occur to anyone. However, certain conditions may increase risk of hypotension, such as,

  • Certain medications, such as alpha blockers (used for treating high blood pressure and some other medical conditions) can cause hypotension.
  • Age: elderly individuals above 65 years of age are at risk of developing hypotension on standing (orthostatic hypotension), after eating a meal (called postprandial hypotension). Children and young adults can develop hypotension due to neural miscommunication.
  • Certain diseases such as diarrhea, heart diseases, Parkinson’s disease etc. may cause hypotension.

Diagnostic tests used for hypotension:

To find out the cause of hypotension, certain tests may be prescribed by your doctor. These tests include, ECG, ecocardiogram, blood tests (blood sugar test, hemoglobin estimation, because anemia can cause hypotension due to low blood volume), valsalva maneuver, stress test, tilt table test (this is done to detect how your blood pressure respond to various body postures) etc.

Treatment of hypotension:

Before a proper treatment can be started, it is important to find out the cause of hypotension, if possible (by investigation). For example, if hypotension is due to dehydration, proper hydration can manage hypotension. However, in many cases the actual cause of hypotension may not be found. The following are generally used for management of hypotension,

  • Take more table salt. In hypertension doctors ask you to limit salt intake to minimum, because sodium in salt can raise blood pressure. This is good for hypotension and doctors recommend taking salt liberally to raise blood pressure.
  • Drink adequate water. Dehydration is a common cause of hypotension, hence drinking more water is recommended. More water can increase blood volume as well as prevent dehydration.
  • Use of compression stockings can help raise blood pressure by preventing pooling of blood in leg veins.
  • Medications for hypotension: certain medications can help raise blood pressure in hypotension, such as fludrocortisone (by increasing blood volume), midodrine (by preventing vasodilatation) etc. When above mentioned modalities for treatment of hypotension fails, drugs may be prescribed.

Home remedies for hypotension:

Depending on the cause, hypotension can be prevented and managed with simple home remedies. These include,

  • Eat healthy: very important for hypotension (as well as for hypertension). Make sure your diet contain recommended quantity of protein, fats, carbohydrates, fiber, minerals and vitamins, preferably from fresh sources.
  • Drink more water and lower alcohol consumption. Alcohol causes dehydration. Dehydration is a leading cause of hypotension and drinking more water regularly can prevent dehydration and hypotension.
  • Eat small and frequent meals instead of two or three large meals and preferably low carbohydrate and high protein diet.
  • Change body postures slowly, especially if you have orthostatic hypotension. Get up from lying down position and stand up from sitting position slowly.

What are different types of hypotension?

Hypotension can be

  1. Orthostatic or postural hypotension: there is drop in blood pressure when there is change in body posture, e.g. from sitting to standing, from lying down to sitting or standing etc.
  2. Postprandial hypotension: this type of hypotension is seen after eating a meal. This is due to large amount of blood flow to digestive system after eating for digestion and absorption. Commonly seen among elderly people of above 65 years of age.
  3. Neurally mediated hypotension: occurs mostly among young adults, due to faulty communication between brain and heart.
  4. Hypotension due to damage of nervous system: due to degeneration of various body systems

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