Hypotension, commonly known as low blood pressure, occurs when your blood pressure readings are consistently lower than 90/60 mmHg. This condition can manifest with either low systolic, diastolic, or both values. Although it is not classified as a disease, hypotension is considered a syndrome that affects individuals across all age groups and genders.
Different Forms of Hypotension
- Orthostatic or Postural Hypotension: This type manifests upon standing up or suddenly altering one's position, leading to symptoms like dizziness and blurry vision.
- Postprandial Hypotension: Primarily affecting the elderly, this occurs after eating substantial meals due to increased blood flow to the digestive system.
- Neurally Mediated Hypotension: Affecting mainly young adults and children, this form arises from faulty brain-heart communication during extended periods of standing.
- Multiple System Atrophy with Orthostatic Hypotension: A rare form resulting from damage to the autonomic nervous system, affecting both high and low blood pressure conditions.
Common Causes and Risk Factors
Hypotension has various causes, ranging from lifestyle choices to medications to underlying health conditions. The most frequently encountered causes of hypotension are as follows:
- Nutrient deficiencies, particularly in protein, vitamins B and C
- Sudden or chronic blood loss due to accidents or internal ulcers
- Dehydration from excessive sweating or diarrhoea
- Heart-related issues
- Severe infections
- Pregnancy complications
- Depression
Symptoms of Hypotension
- Dizziness and loss of balance
- Rapid heart rate and palpitations
- Blurred vision
- Nausea and fatigue
- Rapid, shallow breathing
- Thirst and clammy skin
Diagnosis and Testing
Normally, the doctor will inquire about the patient's medical history and their symptoms. A comprehensive check-up will be conducted, including the measurement of blood pressure to determine if it falls within the normal range. Additionally, the doctor will carefully examine for any indications of shock, which can be life-threatening. Other tests that may be performed include:
- Blood tests: These tests are simple to perform and do not take much time. They can be conducted while the patient is either sitting or lying down. Blood tests provide valuable information about the components of blood and can indicate if the patient is anemic or has low blood sugar, both of which can cause hypotension.
- Tilt table test: This test involves the patient lying on an examination table specially designed to tilt to various angles, allowing for the measurement of blood pressure as the table moves.
- Electrocardiogram (EKG): This test assesses the heart's electrical activity as it beats, aiming to detect any abnormalities.
- 24-hour Holter monitoring: This test records the heart's activity over a 24-hour period using a small, portable instrument that allows the patient to continue their normal activities. This method enables the easy detection of any potential issues.
- Exercise stress test: This test evaluates the heart's function while the patient engages in physical exercise. Some heart abnormalities are easier to detect when the heart is working harder and pumping more blood, which is induced by exercise.
- Assessment of the autonomic nervous system: This assessment measures changes in heart rate during specific activities that affect blood pressure, such as deep breathing or placing the hand in cold water.
- 24-hour urine test: For this test, the patient will be required to collect their urine over a 24-hour period using a provided container, which they will take home. The collected urine will then be tested in a laboratory. (During the collection process, it is important to keep the urine in a cool place.)
Treatment Approaches for Hypotension
Treatment for hypotension focuses on controlling blood pressure, relieving symptoms, and addressing the underlying cause. Here are some ways to manage mild hypotension:
- If hypotension is due to dehydration, lack of electrolytes, blood loss, or bloodstream infection, intravenous fluids can help raise blood pressure.
- Treat the underlying cause of hypotension. If an abnormality or disease is suspected, additional tests and specific treatment may be ordered. Hormonal problems may require evaluation by a specialist and hormone replacement therapy.
- Medication can be used if lifestyle changes and intravenous fluids do not alleviate symptoms. The type of medication prescribed will depend on the cause of the hypotension. Options include alpha-adrenergic receptor agonists to increase blood pressure and relieve symptoms; steroids to prevent electrolyte loss, increase fluids, and raise blood pressure, and vasopressors to increase blood pressure.
Self-Care Guidelines for Hypotension
- Medication can be used if lifestyle changes and intravenous fluids do not alleviate symptoms. The type of medication prescribed will depend on the cause of hypotension. Options include alpha-adrenergic receptor agonists to increase blood pressure and relieve symptoms, steroids to prevent electrolyte loss, increase fluids, and raise blood pressure, and vasopressors to increase blood pressure.
Possible Complications
Untreated hypotension can lead to minor accidents like falls, or severe health issues affecting vital organs, sometimes resulting in fatal outcomes.
Prevention Tips
There are various factors that can cause hypotension, making it impossible to completely prevent. However, the following measures can help minimize the associated risks:
- Drink adequate water daily
- Limit alcohol consumption
- Consume a balanced diet
- Move slowly between positions
- Regular blood pressure monitoring
