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Do you think that low blood pressure (hypotension) is good for our health?
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What is hypotension?
Hypotension is the medical terminology for low blood pressure. Low blood pressure is when your blood pressure is below 120/80, the clinically defined ‘normal’ blood pressure [1].
Causes of hypotension?
The body is an integrated network of multiple systems working together. Therefore, when the causes of hypotension are evaluated, it makes sense to involve multiple systems.
Low blood pressure mechanisms can involve (a) structural changes within the heart, (b) blood vessel resistance, (c) neurological malfunction and/or (d) hormone (or endocrine) dysfunction.
As such, some of the causes of hypotension are:
Pregnancy [2-4]
Age [5]
Heart (and heart valve) conditions [6]
Hormone-relates diseases [7, 8]
Dehydration [9]
After eating (more common in older adults, especially those with high blood pressure, diabetes and Parkinson’s disease [5, 10])
Blood loss (either internally or externally) [11]
Severe infections (e.g. septicaemia) [12]
Severe allergic reactions (e.g. anaphylaxis) [13]
Lack of nutrients in the diet (low levels of B12 and folic acid can lead to anaemia (low blood count [14])
Shock (or immense body trauma) [15]
Posture changes [16, 17]
Eating disorders (anorexia nervosa causes structural changes within the heart [18-20])
Symptoms of hypotension?
Dizziness and light-headedness [16, 17]
Nausea [16, 17]
Dehydration or unusually thirsty [16, 17]
Reduced concentration [16, 17]
Blurred vision [16, 17]
Cold, clammy and pale skin [16, 17]
Fainting [16, 17]
High heart rate [16, 17]
Consequences of hypotension?
While high blood pressure is terrible for our cardiovascular health, so too is low blood pressure. To exist comfortably, we need a delicate balance between hypotension and hypertension – which is often situated between 120/80.
Some of the consequences of hypotension result from the originating causes (mechanisms):
Cardiovascular, endocrine and/or neurological disease [5, 15]
Lower oxygen levels in the blood [21]
Shock
Heart attack, stroke and kidney failure [5, 15]
Cognitive decline [5, 15]
How to avoid hypotension?
You can avoid hypotension through several lifestyle changes
These include:
Wearing compression (or support) stockings
Avoid caffeinated drinks late in the day
Avoiding alcohol intake
Avoid changing postures quickly (orthostatic hypotension) [16, 17]
Eat small frequent meals
Rest after consuming food
Avoid extended periods of sitting and lying down
Increase fluid (water) intake
Increase the position of your head while you sleep (more vertical and less horizontal)
Avoid severe (or traumatic) injury
Don’t be afraid to see the doctor if you suspect something is wrong
Medically, the following strategies could be used to avoid hypotension:
These include:
Checking the state of your cardiovascular, neurological and endocrine system functions regularly [5, 6, 15]
Monitoring blood volume and blood count
Treatments of hypotension?
A doctor may treat hypotension with:
Medications
Treating the underlying condition (if applicable)
Referrals to other specialties
You may consider following some of the lifestyle changes mentioned above.
Let's do our best to protect ourselves from hypotension!
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Reference:
[1] Wessely S, Nickson J, Cox B. Symptoms of low blood pressure: a population study. BMJ. 1990;301(6748):362-5.
[2] Ng PH, Walters WAW. The Effects of Chronic Maternal Hypotension During Pregnancy. The Australian and New Zealand Journal of Obstetrics and Gynaecology. 1992;32(1):14-6.
[3] Friedman EA. Hypertension-Hypotension in Pregnancy. JAMA. 1978;239(21):2249.
[4] Grünberger W, Leodolter S, Parschalk O. Maternal Hypotension: Fetal Outcome in Treated and Untreated Cases. Gynecologic and Obstetric Investigation. 1979;10(1):32-8.
[5] Moretti R. Risk factors for vascular dementia: Hypotension as a key point. Vascular Health and Risk Management. 2008;Volume 4:395-402.
[6] Cautela J, Tartiere JM, Cohen-Solal A, Bellemain‐Appaix A, Theron A, Tibi T, et al. Management of low blood pressure in ambulatory heart failure with reduced ejection fraction patients. European Journal of Heart Failure. 2020;22(8):1357-65.
[7] Laragh JH. Hypotensive Agents and Pressor Substances. JAMA. 1960;174(3):234.
[8] Gangula PRR, Wimalawansa SJ, Yallampalli C. Sex Steroid Hormones Enhance Hypotensive Effects of Calcitonin Gene-Related Peptide in Aged Female Rats1. Biology of Reproduction. 2002;67(6):1881-7.
[9] Arca KN, Halker Singh RB. Dehydration and Headache. Current Pain and Headache Reports. 2021;25(8).
[10] Aronow WS, Ahn C. Postprandial Hypotension in 499 Elderly Persons in a Long-Term Health Care Facility. Journal of the American Geriatrics Society. 1994;42(9):930-2.
[11] Gardner WJ. THE CONTROL OF BLEEDING DURING OPERATION BY INDUCED HYPOTENSION. Journal of the American Medical Association. 1946;132(10):572.
[12] Oehmcke S, Herwald H. Contact system activation in severe infectious diseases. Journal of Molecular Medicine. 2010;88(2):121-6.
[13] Brown S, Mullins R, Gold M. Anaphylaxis: diagnosis and management. 2006.
[14] Ganjehei L, Massumi A, Razavi M, Wilson JM. Orthostatic hypotension as a manifestation of vitamin B12 deficiency. Tex Heart Inst J. 2012;39(5):722-3.
[15] Iadecola C. The Pathobiology of Vascular Dementia. Neuron. 2013;80(4):844-66.
[16] Fedorowski A, Ricci F, Hamrefors V, Sandau KE, Chung TH, Muldowney JAS, et al. Orthostatic Hypotension: Management of a Complex, But Common, Medical Problem. Circulation: Arrhythmia and Electrophysiology. 2022;15(3):e010573.
[17] Ricci F, Caterina RD, Fedorowski A. Orthostatic Hypotension. Journal of the American College of Cardiology. 2015;66(7):848-60.
[18] Warren MP, Vande Wiele RL. Clinical and metabolic features of anorexia nervosa. American Journal of Obstetrics and Gynecology. 1973;117(3):435-49.
[19] Casiero D, Frishman WH. Cardiovascular Complications of Eating Disorders. Cardiology in Review. 2006;14(5):227-31.
[20] Giovinazzo S, Sukkar SG, Rosa GM, Zappi A, Bezante GP, Balbi M, et al. Anorexia nervosa and heart disease: a systematic review. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. 2019;24(2):199-207.
[21] Stahel PF, Smith WR, Moore EE. Hypoxia and hypotension, the “lethal duo” in traumatic brain injury: implications for prehospital care. Intensive Care Medicine. 2008;34(3):402-4.
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