Understanding Low Blood Pressure: Causes, Symptoms, Risks and Treatments

Understanding Low Blood Pressure

Blood pressure is the force of blood pushing against the walls of arteries. It consists of two numbers - systolic and diastolic pressure. Systolic pressure is the pressure in the blood vessels when the heart beats. Diastolic pressure is the pressure between heartbeats when the heart is at rest.

Normal blood pressure ranges are:

• Systolic: 90-120 mmHg
• Diastolic: 60-80 mmHg

Low blood pressure, also called hypotension, occurs when blood pressure drops below normal ranges. For some people, low blood pressure does not cause any symptoms or problems. But for others, low blood pressure can lead to dizziness, fainting, fatigue, nausea, blurred vision, and other symptoms.

Causes of Low Blood Pressure

There are many potential causes of low blood pressure, including:

• Pregnancy - Blood pressure often drops in the first 24 weeks of pregnancy and then returns to pre-pregnancy levels.
• Heart conditions - Issues with heart rhythms, heart valves, or heart muscle contraction can all affect blood pressure.
• Endocrine problems - Thyroid disorders, adrenal insufficiency, and diabetes can cause low blood pressure.
• Nutritional deficiencies - Not getting enough iron, folate, vitamin B12, or vitamin D may lower blood pressure.
• Dehydration - Losing too much water from the body through vomiting, diarrhea or sweating can lead to dehydration and low blood pressure.
• Neurologic disorders - Issues with the central nervous system due to Parkinson's disease, multiple system atrophy, or neuropathy can affect blood pressure regulation.
• Medications - Certain prescription drugs like diuretics, antidepressants, heart medications, and erectile dysfunction drugs can lower blood pressure.
• Anemia - Having too few red blood cells reduces the ability for blood to carry oxygen which makes the heart work harder and lowers blood pressure.
• Sepsis - A severe infection in the body can lead to dangerously low blood pressure known as septic shock.

Who is at Risk for Low Blood Pressure?

While low blood pressure can happen to anyone at any age, certain groups have a higher risk including:

• Elderly adults - Older adults often naturally have lower baseline blood pressure levels.
• Young adults - Younger, healthy individuals can have lower blood pressure without health issues.
• Athletes and active people - Regular exercise and activity can lead to lower blood pressure.
• Pregnant women - Especially in the first half of pregnancy, blood pressure frequently drops.
• People with heart disease - Various heart conditions can reduce the heart's pumping ability.
• People taking certain medications - Diuretics, antidepressants, heart meds and others can lower blood pressure.

Signs and Symptoms of Low Blood Pressure

Some common signs and symptoms of low blood pressure include:

• Dizziness or lightheadedness - One of the most frequent symptoms, feeling dizzy or faint when standing up from sitting or lying down.
• Blurry vision - Decreased blood flow can affect visual functioning and cause blurred or spotted vision.
• Nausea - Low blood pressure can activate the vomiting reflex leading to feelings of nausea or even actual vomiting episodes.
• Confusion - Inadequate blood and oxygen delivery to the brain can result in temporary confusion or cognitive difficulties.
• Fatigue - Blood provides oxygen and nutrients to organs and tissues, so low blood pressure reduces energy levels and causes tiredness.
• Pale, cool, clammy skin - Restricted peripheral blood flow shows as pallor and feeling cold or damp in the skin.

However, some people with chronically low blood pressure get used to those levels and may have very few or no symptoms at all.

Potential Complications

While most cases of low blood pressure are not harmful on their own, significant drops can lead to concerning complications such as:

• Falls or accidents - Feeling faint or dizzy may increase risk of falls and traumatic injuries.
• Brief loss of consciousness - In more severe cases, blood pressure may drop low enough to cause temporary loss of consciousness.
• Organ damage - If blood pressure gets too low for too long, vital organs like the heart, brain and kidneys may not get enough blood flow leading to cell damage or even failure.
• Pregnancy complications - In pregnant women, stretched heart capacity combined with low blood pressure increases risks during delivery for both mother and baby.

Diagnosing Low Blood Pressure

If symptoms occur, doctors can diagnose low blood pressure. Typical testing includes:

• Blood pressure check - Repeated measures of blood pressure while lying down, sitting and standing.
• Patient history - Looking at risk factors and related symptoms or health conditions.
• Physical exam - Assessing overall health, heart, nervous system, thyroid, body hydration.
• Additional testing - Blood work, urine tests, cardiac testing, electrolytes and nutrient levels may provide useful diagnostic information in some patients.

Determining Underlying Causes

Finding potential underlying causes for low blood pressure generally involves reviewing:

• Prescription medications - Assessing effects and possible adjustments needed.
• Other existing health conditions - Heart disease, diabetes, infections, hormone disorders and more that affect blood pressure.
• Pregnancy status for women - Normal drops in early pregnancy need no treatment.
• Lifestyle factors like activity levels, diet and hydration.

Identifying and managing contributing factors provides the basis for improving hypotension in symptomatic patients whenever possible.

Treatment Options for Low Blood Pressure

Several possible medical treatments for symptomatic low blood pressure include:

• Increasing fluid and salt intake - Helps restore blood volume which directly increases pressure.
• Compression stockings - Squeeze leg muscles to push blood back to heart and brain.
• Medications - Drugs for congestive heart failure, corticosteroids or hormonal supplements in some cases.
• Surgery - Rarely needed to repair faulty heart valves or extremely abnormal structures reducing blood pressure.

Lifestyle Adjustments

Some helpful lifestyle tips for managing low blood pressure are:

• Raise head of bed to sleep with feet slightly elevated.
• Take more time when changing positions.
• Engage muscles by crossing legs, pressing hands together when standing.
• Eat small, nutritious meals throughout the day.
• Drink adequate fluids daily.
• Reduce alcohol which acts as a vasodilator lowering pressure.
• Wear layered clothing to prevent chill and stimulate blood flow.

The Takeaway

Having low blood pressure only causes concern when ongoing symptoms or health risks occur. Seeking treatment focuses first on hydration and lifestyle adjustments. Prescription medications, medical devices or surgery are last resort options reserved for more dangerous cases not controlled by safer measures.

Maintaining adequate blood flow to the brain and organs is key for those prone to dips in blood pressure. Simple precautions taken regularly can often minimize troublesome symptoms of hypotension.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.