Low Blood Pressure (Hypotension): Symptoms & Treatment

Understanding Low Blood Pressure

Blood pressure is an important vital sign that can provide insight into the health of your heart and circulatory system. The top number, known as systolic blood pressure, measures the pressure in your blood vessels when your heart beats. The bottom number, called diastolic blood pressure, measures the pressure when your heart is at rest between beats. Normal blood pressure is considered less than 120/80 mm Hg.

Low blood pressure, also called hypotension, occurs when the force of blood pushing against the walls of your arteries is lower than normal. While a reading below 90/60 mm Hg is often considered low blood pressure, what's considered normal can vary somewhat from person to person. For some, lower numbers are normal, while for others, readings below 100/60 mm Hg could signal an underlying health issue.

Causes of Low Blood Pressure

There are several factors that can contribute to low blood pressure, including:

• Dehydration
• Pregnancy
• Heart conditions
• Endocrine problems
• Nutritional deficiencies
• Medications
• Sepsis
• Neurally mediated hypotension

Dehydration from vomiting, diarrhea, excessive sweating, or inadequate fluid intake can result in reduced blood volume. This disrupts circulation and lowers blood pressure.

During pregnancy, circulatory changes and expansion of blood volume can cause blood pressure to drop. This is considered normal but can result in some lightheadedness or dizziness when standing.

Certain heart conditions like atrial fibrillation, heart valve disorders, heart attack, and heart failure can impair the heart's ability to pump blood effectively and cause hypotension.

Endocrine disorders like diabetes, parathyroid disease, and low thyroid production can interfere with balance of hormones and mineral levels needed to maintain blood pressure.

Deficiencies in iron, vitamin B12, and folate can affect the production of red blood cells and oxygen delivery in the body, lowering blood pressure.

Medications like diuretics, beta blockers, ACE inhibitors, calcium channel blockers, and alpha blockers prescribed for high blood pressure can also lower it too much. Other drugs like antidepressants, Parkinson's medications, erectile dysfunction drugs, and narcotics can also cause hypotension.

Sepsis, a body-wide infection, can set off dilated blood vessels and poor circulation resulting in plummeting blood pressure.

In some people, blood pressure can drop suddenly when standing due to abnormal reflexes in the autonomic nervous system. This is called neurally mediated hypotension.

Risk Factors

Those at increased risk of low blood pressure include:

• Elderly adults
• Pregnant women
• Endurance athletes
• People with heart disease
• Those with endocrine disorders
• People taking certain medications
• Those with nutritional deficiencies

As we age, changes to the heart and blood vessels can make us more prone to blood pressure drops. Decreased reflexes and medications may also play a role.

Pregnancy comes with major circulatory changes needed to nourish the developing baby. These can reduce blood pressure.

Intense aerobic training and cardiovascular endurance sports like marathon running and cycling can lead to slower heart rates and lower blood pressure.

Those with certain heart conditions may have weaker pumping ability, potentially causing hypotension.

Endocrine imbalances from thyroid disorders, diabetes, or parathyroid disease can disrupt hormones needed for blood pressure regulation.

Numerous prescription medications like diuretics, beta blockers, ACE inhibitors, and calcium channel blockers can also lower blood pressure beyond normal levels.

Deficiencies in key nutrients like iron, vitamin B12, and folate diminish the blood's oxygen carrying capacity, which can reduce blood pressure.

Symptoms of Low Blood Pressure

In many cases, low blood pressure may cause no symptoms at all and is only detected during routine screening. But for some, abnormally low readings can be accompanied by:

• Dizziness
• Fainting (syncope)
• Decreased concentration
• Blurred vision
• Fatigue
• Nausea
• Cold, clammy skin
• Rapid, shallow breathing
• Depression or anxiety

These symptoms typically occur when moving from a sitting or lying position to standing. As gravity pulls blood to the legs and away from the head, the brain receives less oxygenated blood. This triggers symptoms.

Low blood pressure can also cause chest pain, shortness of breath, and headache in some people as the heart works harder to circulate blood throughout the body.

When to See a Doctor

Occasional episodes of low blood pressure may not be concerning, especially if you are dehydrated, have been standing for long periods, or are pregnant. But if low numbers persist, it's important to see a doctor to identify any underlying condition.

Seeking emergency care is warranted if low blood pressure is accompanied by: - Loss of consciousness - Lightheadedness or dizziness that does not improve with rest - Sudden, severe headaches - Shortness of breath - Chest pain - An irregular heart beat

These symptoms can indicate a serious heart, neurological or endocrine issue causing low blood pressure and requiring prompt medical attention.

Complications of Low Blood Pressure

If left untreated, chronically low blood pressure can potentially lead to:

• Frequent fainting
• Severe fatigue and weakness
• Blurred vision
• Difficulty concentrating
• Rapid, shallow breathing
• Depression and anxiety
• Heart palpitations
• Kidney dysfunction
• Electrolyte imbalances

As oxygen delivery to the brain and other vital organs drops chronically, it can take a toll over time. Inadequate blood flow to the kidneys can also impair their ability to filter waste products from the bloodstream.

Those with low blood pressure are also at higher risk of falls and serious injury due to dizziness and fainting episodes.

Treating Low Blood Pressure

Treatment will depend on the underlying cause of low blood pressure. Steps may include:

• Increasing fluid and salt intake
• Changing positions slowly
• Wearing compression garments
• Raising the head of the bed
• Stopping problematic medications
• Starting medications to raise blood pressure
• Treating heart conditions
• Correcting endocrine disorders
• Supplementing nutritional deficiencies

If dehydration is contributing, drinking more fluids and getting adequate salt can help restore blood volume. Moving slowly from lying down to standing and wearing compression stockings allow the body to better accommodate position changes.

Discontinuing drugs causing hypotension and starting medications to constrict blood vessels like Florinef can help minimize dips. Treating underlying heart failure, thyroid disorders, or anemia also addresses the root causes of low blood pressure.

Preventing Low Blood Pressure

Strategies to help prevent low blood pressure include:

• Staying well hydrated
• Increasing salt intake
• Raising the head of the bed
• Wearing compression garments
• Avoiding excess alcohol
• Changing positions slowly
• Monitoring medications
• Exercising regularly
• Managing chronic illnesses
• Checking blood pressure periodically

Drinking adequate fluids, consuming some salt, sleeping with extra pillows, and wearing compression stockings or abdominal binders can all help keep blood pressure from dropping excessively.

Reducing alcohol, moving deliberately between positions, and having medications adjusted prevents precipitous blood pressure declines. Staying active, controlling underlying medical conditions, and monitoring blood pressure helps minimize hypotension risk.

Living with Low Blood Pressure

Those with chronic low blood pressure can employ strategies to reduce symptoms and stay safe:

• Increase fluid and salt intake
• Move slowly when changing position
• Take breaks when standing
• Avoid excess heat and prolonged standing
• Sit or lie down when feeling lightheaded
• Exercise regularly to improve cardiac conditioning
• Wear compression garments
• Elevate the head when sleeping
• Monitor blood pressure

Consuming adequate fluids and salt, compressing the legs and abdomen, and moving deliberately from lying down to standing sustain blood return to the heart. Allowing time for the body to adjust prevents fainting.

Sitting or lying down when symptomatic, exercising to build fitness, elevating the head, and checking blood pressure routinely also helps manage low blood pressure.

When to Contact Your Doctor

Be sure to contact your doctor if you experience:

• Lightheadedness, dizziness, or fainting
• Changes in blood pressure
• Fatigue, weakness, or worsening symptoms
• Chest pain, palpitations, or shortness of breath
• Confusion, blurry vision, or difficulty concentrating
• New medications for other conditions

Reporting worrisome symptoms, blood pressure fluctuations, or side effects of new medications allows your doctor to evaluate your hypotension and adjust treatment accordingly to keep you safe.

Outlook for Low Blood Pressure

The prognosis for low blood pressure depends on the underlying cause. With mild chronic hypotension, simply being careful to avoid sudden position changes and staying well hydrated may be sufficient. Compression garments and medications to constrict blood vessels may also minimize symptoms.

If an underlying condition like heart disease, endocrine imbalance, or nutritional deficiency is responsible, treating the root issue can help eliminate low blood pressure. Prognosis tends to be good when the cause is found and properly addressed.

In some cases, very low blood pressure may be refractory to treatment and require ongoing monitoring and precautions. With care and follow up, most people with hypotension can maintain a good quality of life.

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.