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Low blood pressure is also known as hypotension.

For millions of people who suffer from


hypertension (high blood pressure) hypotension may seem great. If symptoms are mild
hypotension usually requires no treatment. However, it can cause serious heart disorders, fainting
and also lead to neurological and endocrine disorders. If hypotension is severe key organs can
become deprived of oxygen and nutrients and the body can go into shock, a life-threatening
condition.

What is blood pressure?


The heart is a muscle that pumps blood around the body continuously. Blood that is low in
oxygen is pumped towards the lungs, where oxygen supplies are replenished. The heart pumps
this oxygen-rich blood around the body to supply our muscles and cells. The pumping of blood
generates pressure - blood pressure.
When we measure blood pressure, we gauge two different types of pressure:

Systolic pressure - the blood pressure when the heart contracts, specifically the moment
of maximum force of the contraction, which occurs when the left ventricle of the heart
contracts.

Diastolic pressure - the blood pressure between heartbeats, when the heart is resting and
opening up, (dilating).

A digital blood pressure and heart rate monitor showing an ideal reading
When our blood pressure is taken the doctor or nurse needs to measure both the systolic and
diastolic pressures. The figures usually appear with a larger number first (systolic pressure), and
then a smaller number (diastolic pressure). The figure will be followed by the abbreviation
mmHg, which means millimeters of mercury.
If your blood pressure is 120 over 80 (120/80 mmHg), it means a systolic pressure of 120mmHg
and a diastolic pressure of 80mmHg.
Our levels of blood pressure can fluctuate by as much as 30 or 40 mmHg during the day. It will
be at its lowest point when we are asleep or resting. When we are physically active, very stressed
or anxious our blood pressure rises. It is important that blood pressure is taken under similar
circumstances each time so that when the readings are compared they refer to the same state of
physical activity.

What is low blood pressure (hypotension)?


Anybody with a reading if 90/60 mmHg or lower is regarded as having hypotension (low blood
pressure). People with low blood pressure have some protection from factors which raise blood
pressure to undesirable levels. However, low blood pressure may be a sign of an underlying
problem, and can cause unpleasant symptoms.

What are the symptoms of low blood pressure


(hypotension)?
Many people whose blood pressure is low will experience no symptoms. If the hypotension is
not severe and there are no underlying conditions no treatment is necessary.
If blood pressure is so low that the supply of blood to the brain and other vital organs is
insufficient the patient will need medical attention. Severe hypotension is caused by an
underlying illness or condition.
Below are the most common symptoms of hypotension:

Blurred vision
Cold, clammy, pale skin
Depression
Dizziness
Fainting
Fatigue
General feeling of weakness
Nausea
Palpitations
Rapid, shallow breathing
Thirst.

Orthostatic hypotension (postural hypotension)


This refers to a lowering of blood pressure after changing posture. This can occur when you
stand up from a sitting or lying position, or sit up from a lying position. The low blood pressure
will return to normal levels rapidly. Postural hypotension occurs more frequently as we get older.
Low blood pressure after meals (Postprandial hypotension)
Sometimes blood pressure can drop after eating, causing light-headedness, dizziness, and
wooziness (faintness). This is known as postprandial hypotension. It more commonly occurs
among elderly people, especially elderly people who suffer from hypertension (high blood
pressure), diabetes, or Parkinson's disease.
After we eat our intestines require a significant increase in blood supply for digestion. The heart
responds by beating faster while blood vessels in other parts of the body narrow (constrict) to
help maintain blood pressure. When we reach old age the heart beat may not increase enough to
maintain blood pressure. Also, the blood vessels that were supposed to have narrowed do not
constrict sufficiently to maintain blood pressure. Consequently, blood pressure drops. If you are
prone to developing postprandial hypotension you may find that the following simple steps help:

Lie down after the meal.

Lower the carbohydrate content of your meals.


Eat smaller and more frequent meals - perhaps four or five small meals a day instead of 3
big ones.

What causes low blood pressure (hypotension)?


Some medications

Alpha blockers
Beta blockers
Tricyclic antidepressants
Diuretics
Drugs for Parkinson's disease
Sildenafil (Viagra), more so if in combination with nitroglycerine.

Anesthesia
Blood pressure is usually deliberately reduced for surgery. Hypotensive anesthesia - deliberately
lowering blood pressure for surgery - reduces intraoperative blood loss as well as surgical time.
Feeling faint in the toilet - urinating (micturition syncope), defecating (defecation syncope)
If you strain when urinating or having a bowel movement the vagus nerve is stimulated, causing
an increase in acetylcholine levels in the body. Acetylcholine dilates the blood vessels. Dilated
blood vessels bring blood pressure down which reduces blood supply to the brain. A sudden drop
in blood supply to the brain can cause dizziness and fainting (syncope). Micturition syncope
means feeling faint/fainting when urinating, and defecation syncope means feeling faint/fainting
while having a bowel movement. In virtually all cases the problem resolves quickly and no
treatment is required. Swallow syncope and cough syncope, feeling faint/fainting from
swallowing or coughing are also caused by the stimulation of the vagus nerve.
Serious injuries and/or internal bleeding
If you lose a lot of blood from a serious injury or internal bleeding blood volume will drop,
leading to severe and potentially dangerous hypotension. Serious burns can lead to shock and a
reduction in blood pressure.
Septicemia, blood poisoning, severe infection
Virulent bacteria from an infection somewhere in the body can invade the bloodstream
(septicemia). The patient can go into septic shock; a life-threatening drop in blood pressure.

Dehydration
When your body loses more water than it takes in you eventually become dehydrated. Hydration
levels (levels of water in the body) do not have to drop much before you start feeling dizzy and
weak - dehydration-induced weight loss of just 1% can lower blood pressure enough to cause
symptoms. Dehydration can be caused by severe diarrhea, vomiting, heat, overusing diuretics,
and over-exercising. If water or blood levels drop dramatically the patient can go into
hypovolemic shock - the severe water/blood drop in volume means the heart cannot pump the
blood properly, resulting in life-threatening hypotension.
Endocrine problems (not including diabetes)
The endocrine system is a system of glands involved in the release of hormones - examples
include the thyroid gland, and the adrenal gland. The thyroid gland makes and stores hormones
that help in the control of the heart rate, blood pressure, body temperature, and the rate at which
food is broken down and converted into energy (part of metabolism). Low blood pressure can be
caused by hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid). If the
adrenal glands do not work properly (adrenal insufficiency) there is also a risk of hypotension the adrenal glands are located just above each kidney and are chiefly responsible for regulating
the stress response.
Diabetes
Damage to the nerves in the body, including those in the autonomic nervous system, is a
complication of diabetes. Autonomic dysfunction makes people more susceptible to orthostatic
hypotension (postural hypotension) - feeling faint when you suddenly sit up from a lying
position, or stand up from a sitting/lying position.
Heart disease
Badycardia (very low heart rate), heart valve problems, heart attack and heart failure can cause
very low blood pressure, mainly because the heart is unable to pump enough blood to keep the
pressure up.
Pregnancy
Blood pressure usually drops during pregnancy because the circulatory system expands during
gestation. Systolic pressure typically falls about 5 to 10 points, while diastolic pressure may fall
by 10 to 15 points. This is a normal part of a healthy pregnancy and is rarely cause for concern.
Soon after childbirth blood pressure will resume to normal levels.
Anaphylaxis (severe allergic reaction)

Some people may have a severe allergic reaction to some substances, foods, exercise,
medications, latex, or insect bites. One of the symptoms could be a severe drop in blood
pressure, as well as hives, itching, swollen neck and breathing difficulties.
Diet deficiency
A diet with insufficient quantities of vitamins B-12 and folate can cause anemia. Anemia often
results in hypotension.
Eating disorders
Anorexia nervosa has abnormally slow heart rate and low blood pressure among its many
complications. Bulimia nervosa leads to electrolyte imbalances that can lead to irregular
heartbeats and possibly heart failure - both these heart problems tend to result in serious
hypotension.

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