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Low Blood Pressure (Hypotension)

Hypotension, or low blood pressure, is when the blood pressure level falls below the normal range of 120/80mm Hg (systolic/diastolic). Although low blood pressure without symptoms is not a major concern in healthy individuals, it can be a sign of an underlying problem, especially in older adults, leading to inadequate blood flow to the heart, brain, and other vital organs.

Hypotension can be either a condition on its own or a symptom of various underlying conditions. There are two types of hypotension: absolute hypotension and orthostatic hypotension. The former is when the resting blood pressure is below 90/60 mmHg, while the latter occurs when blood pressure drops by 20 mmHg or more for systolic pressure and 10 mmHg or more for diastolic pressure within three minutes of standing up from a sitting position.

Symptoms of hypotension usually appear when the body can't compensate enough for the drop in blood pressure, and it can result in unpleasant, disruptive, or dangerous effects. The body tries to control blood pressure by increasing the heart rate or constricting blood vessels. However, a rapid decrease in blood pressure can indicate that certain body parts aren't receiving enough blood flow. This condition becomes more common as people get older.

Symptoms of Low blood pressure

In certain individuals, low blood pressure levels can indicate underlying pathology, especially when it drops suddenly and is accompanied by signs and symptoms such as dizziness or lightheadedness, fainting, blurred or fading vision, nausea, fatigue, lack of concentration, and lethargy.

Extreme hypotension can lead to a life-threatening condition known as shock. Symptoms of shock include confusion, particularly in older individuals, cold, clammy, pale skin, rapid, shallow breathing, and a weak and rapid pulse. It is important to seek immediate medical attention if any of these symptoms occur.

Causes of Low blood pressure

Low blood pressure, or hypotension, is a condition where the blood pressure is lower than normal. A blood pressure level below 90/60 mmHg is generally considered low. Low blood pressure can be a sign of an underlying problem, especially in the elderly. Some common symptoms of hypotension include dizziness, fainting, blurred vision, nausea, fatigue, lack of concentration, and lethargy.

Medical conditions that can cause low blood pressure include pregnancy, heart problems, endocrine problems, dehydration, blood loss, severe infection, severe allergic reaction, and lack of nutrients in the diet.

Medications that Result in Low Blood Pressure

Some medications can cause low blood pressure, including diuretics such as furosemide and hydrochlorothiazide, alpha blockers like prazosin, beta-blockers such as atenolol and propranolol, drugs for Parkinson's disease containing levodopa or pramipexole, certain types of antidepressants like doxepin and imipramine, and drugs used for erectile dysfunction such as sildenafil and tadalafil, especially when taken with nitroglycerin.

Diagnosis of Low blood pressure

To determine the exact cause of low blood pressure, doctors may recommend additional testing beyond medical history, physical exams, and blood pressure measurements. Blood tests can identify conditions like hypoglycemia, hyperglycemia, or anemia that can cause low blood pressure. An electrocardiogram can detect heart rhythm issues or structural problems, while a tilt table test can simulate the transition from lying down to standing up and help diagnose conditions like orthostatic hypotension.

Treatment of Low blood pressure

Hypotension can be treated by increasing blood volume through fluid resuscitation such as IV fluids, plasma or blood transfusions, constricting blood vessels with certain medications, changing how the body handles fluids through medications that maintain fluid and salt in the body, increasing salt intake (with caution) and drinking more water to prevent dehydration.

Risk factors of Low blood pressure

Low blood pressure can affect anyone, but certain types are more common depending on age and other factors. A decrease in blood pressure on standing or after eating is more common in adults over 65, while it mainly affects children and younger adults. People taking certain medications such as alpha-blockers for high blood pressure are at a higher risk of developing low blood pressure. Certain diseases such as Parkinson's disease, diabetes, and some heart conditions can also increase the risk of low blood pressure.

Complications of Low blood pressure

Moderate low blood pressure levels can lead to complications such as dizziness, weakness, fainting, and increased risk of injury due to falls. Severe low blood pressure can deprive the body of oxygen, potentially resulting in heart and brain damage.