Hypotension is when your blood pressure is lower than normal and usually does not cause significant problems. However, sudden drops in blood pressure or very low levels can cause symptoms such as dizziness, fainting, weakness, and fatigue. Low blood pressure can be easily managed with simple lifestyle changes, but it can also be a harbinger of an underlying serious disease.
Although hypotension is not discussed as frequently as high blood pressure, it is an important condition that affects quality of daily life in some cases. In this article, we will comprehensively discuss what low blood pressure is, its causes, symptoms, who gets it, diagnosis and treatment methods, and simple measures you can take in your daily life.
What is Hypotension?
Hypotension is when your blood pressure is usually lower than 90/60 mmHg. Blood pressure is the force your heart applies to your blood vessels to pump blood to your body. Low blood pressure can mean that adequate blood flow cannot be provided to your organs and brain. While low blood pressure is normal and healthy for some people, sudden drops or chronic low blood pressure can seriously affect your quality of daily life.
Unlike high blood pressure, hypotension generally does not lead to cardiovascular diseases in the long term. However, especially sudden blood pressure drops can cause fainting and injuries. The symptoms of low blood pressure are a sign that sufficient oxygenated blood is not reaching your brain and other organs. This condition leads to complaints such as dizziness, blurred vision, and difficulty concentrating. Finding the underlying cause of low blood pressure is very important for creating an effective treatment plan.
What are the Types of Hypotension?
Hypotension is divided into different types according to how it occurs, and each has its own specific causes and management approaches. Orthostatic hypotension is the most common type and occurs when your blood pressure drops when you suddenly get up from sitting or lying down. Postprandial hypotension is the drop in blood pressure after eating and is more common in the elderly. Neurogenic hypotension occurs due to a problem in your nervous system.
Let’s get to know the main types of hypotension more closely:
Orthostatic (Postural) Hypotension:
This is when your blood pressure drops within 2-3 minutes when you suddenly stand up from sitting or lying down. It occurs when your body cannot adjust blood pressure against gravity. It is common in elderly people, those experiencing dehydration (fluid loss), and people using certain medications.
Postprandial Hypotension:
This is when your blood pressure drops after eating. Since blood flow to organs in your digestive system increases, blood flow to other parts of the body decreases. It is especially common in elderly people and those with high blood pressure or diabetes.
Neurogenic Hypotension:
This is the inability to regulate blood pressure due to a disorder of the nervous system that plays a role in communication between the brain and body. It can occur in people with neurological diseases (such as Parkinson’s, Multiple Sclerosis).
Shock:
This is a very serious and sudden drop in blood pressure. This condition is a life-threatening situation where insufficient blood reaches organs due to the heart’s inability to pump adequate blood or excessive dilation of blood vessels. Its types are:
- Hypovolemic shock is a condition that develops due to excessive blood or fluid loss. Severe dehydration, burns, or major internal bleeding can lead to this condition. Symptoms include excessive thirst, rapid pulse, cold and pale skin.
- Septic shock is a condition caused by excessive dilation of vessels due to severe infections and dangerous drop in blood pressure. It usually progresses with symptoms such as high fever, confusion, and rapid breathing.
- Anaphylactic shock is a condition that occurs due to severe allergic reaction resulting in vessel dilation and rapid drop in blood pressure. Shortness of breath, swelling in face or throat, skin rashes, and loss of consciousness may be seen.
- Cardiogenic shock is a condition that develops due to the heart’s inability to pump adequate blood. It usually occurs after heart attack or serious arrhythmias. It may show symptoms such as rapid breathing, chest pain, and excessive weakness.
When shock develops, the patient needs immediate medical intervention. First, intravenous access is established and fluids are given, oxygen support is provided, and necessary medications are administered to balance blood pressure. Adrenaline injection is vital in anaphylactic shock (allergic shock). Strong antibiotics are used in septic shock (infection-related shock). In hypovolemic shock (due to blood or fluid loss), intravenous fluids are given and blood transfusion is performed if necessary.
How Does Low Blood Pressure Develop?
Blood pressure is the pressure blood exerts on vessel walls. There are three basic factors that determine this pressure. These 3 factors are the amount of blood the heart pumps, the width of vessels (vascular resistance), and the total blood volume in circulation. Decrease in blood volume (for example, fluid loss, bleeding, or excessive sweating), excessive dilation of vessels (for example, in hot environments or during allergic reactions), or the heart’s inability to pump blood strongly enough (heart failure, arrhythmias, etc.) can cause blood pressure to drop.
What Causes Hypotension?
Hypotension can have many causes. Dehydration is one of the most common causes and occurs due to decreased blood volume from fluid loss in your body. Besides this, heart diseases, endocrine problems (thyroid or adrenal gland disorders), excessive blood loss, or serious infections can also lead to low blood pressure. Some medications, especially diuretics and blood pressure medications, are among the most important factors that can cause hypotension.
Let’s examine the main causes of low blood pressure in more detail:
- Fluid Loss (Dehydration): Vomiting, diarrhea, excessive sweating, or inability to take adequate fluids reduces your blood volume and lowers your blood pressure.
- Heart Problems: Heart failure, heart rhythm disorders (bradycardia), or heart valve diseases can lead to hypotension by causing your heart to be unable to pump adequate blood.
- Endocrine Problems: Underactive thyroid (hypothyroidism), adrenal insufficiency (Addison’s disease), or hypoglycemia (low blood sugar) unbalance hormones that affect your blood pressure.
- Medications: Blood pressure medications such as diuretics, beta blockers, calcium channel blockers, some antidepressants, and erectile dysfunction medications can cause hypotension.
- Serious Blood Loss or Trauma: Blood loss from an injury or internal bleeding reduces blood volume and lowers blood pressure.
- Prolonged Fasting: When adequate food and fluid are not taken, the circulatory system is affected, which can lead to dizziness and low blood pressure.
- Sudden Position Changes: Suddenly standing up while sitting or lying down causes blood to pool in the legs and temporary reduction in blood flow to the brain. This condition is called orthostatic (postural) hypotension.
- Severe Infections, Blood Loss, or Allergic Reactions: Conditions such as sepsis (serious infection), major blood losses, or anaphylaxis can cause sudden and dangerous blood pressure drops, creating vital risk.
- Age: As age advances, vessel elasticity may decrease and blood pressure control may become difficult.
- Genetic Factors: Low blood pressure may be more common in people with family history.
What are the Symptoms of Hypotension?
The most common symptoms of hypotension are dizziness, lightheadedness, and fainting. Besides these, you may also experience complaints such as blurred vision, difficulty concentrating, fatigue, and pain in the back of the neck. Low blood pressure symptoms usually become more pronounced during position changes, after eating, or prolonged standing. The presence of these symptoms may be a sign that your brain is not getting enough oxygen.
Let’s examine the most common symptoms of low blood pressure in detail:
- Dizziness and Lightheadedness: A feeling experienced especially when you suddenly stand up and lasts for a short time.
- Fainting (Syncope): Loss of consciousness due to temporarily interrupted blood flow to the brain.
- Blurred or Double Vision: Low blood pressure can also affect blood flow to your eyes.
- Fatigue and Weakness: General energy decline due to the body not getting enough oxygen.
- Difficulty Concentrating: Occurs due to affected brain functions.
- Nausea and Cold, Sweaty Skin: Symptoms that can appear especially in serious conditions like shock.
What Can Hypotension Lead To?
Although hypotension is generally not dangerous, it can bring some risks and potential complications. Sudden blood pressure drops increase the risk of injury by causing fainting and falls. Very low blood pressure can prevent adequate blood and oxygen from reaching your organs, leading to serious and permanent damage such as kidney failure or heart attack.
The main conditions that hypotension can lead to are:
- Falls and Injuries: Dizziness and fainting caused by low blood pressure can lead to falls and serious injuries (bone fractures, head trauma).
- Organ Damage: When blood pressure drops to very low levels, blood flow to vital organs such as heart, brain, and kidneys decreases. This condition can cause organs to not get enough oxygen and be damaged in the long term.
- Shock: This is the most serious consequence of low blood pressure. It is a life-threatening situation where your heart cannot pump adequate blood to the body, organs lose their function, and requires emergency medical intervention. This condition can lead to multiple organ failure.
- Constant fatigue, dizziness, and weakness can restrict your daily activities.
How is Hypotension Diagnosed?
Hypotension is diagnosed by measuring your blood pressure with a blood pressure monitor. Having your blood pressure lower than 90/60 mmHg in multiple measurements indicates that you have hypotension. Your doctor performs a physical examination to find the cause of low blood pressure and may request additional tests such as blood tests, ECG, or echocardiogram to reveal the underlying cause.
The main methods used in hypotension diagnosis are:
- Blood Pressure Measurement: Your blood pressure is measured while sitting, lying, and standing with a standard blood pressure monitor to evaluate the presence of postural hypotension.
- Blood Tests: Performed to investigate possible causes such as dehydration, anemia, low blood sugar, or hormonal imbalances.
- Electrocardiogram (ECG): Performed to evaluate heart rhythm disorders or problems related to heart muscle.
- Echocardiogram (Heart Ultrasound): Used to detect heart failure or heart valve problems.
- Holter Monitor: A portable device used to monitor your blood pressure or heart rhythm for 24 hours.
What is Good for Hypotension? (Treatment and Prevention)
There are many things you can do to control the symptoms of mild hypotension and improve your quality of life. Consuming plenty of fluids, slightly increasing your salt intake with your doctor’s approval, and moving slowly when changing positions are the simplest but most effective methods. Also, limiting alcohol consumption and doing simple exercises that will help regulate blood circulation can be beneficial.
Practical suggestions and treatment methods that may be good for low blood pressure:
- Consume Plenty of Fluids: You should prevent dehydration and increase your blood volume by drinking plenty of water throughout the day.
- Increase Salt Consumption: With your doctor’s approval, you can consume sodium-containing foods to raise your blood pressure. However, you should definitely do this by consulting your physician.
- Eat Small and Frequent Meals: Especially for those with postprandial hypotension, eating 5-6 small meals a day instead of large meals can prevent blood pressure drops.
- Limit Alcohol Consumption: Alcohol can lower your blood pressure and cause dehydration.
- Move Slowly: Instead of suddenly getting up from bed or your seat, you should get up slowly and gradually.
- Wear Supportive Stockings: Compression stockings like varicose vein stockings can help blood in your legs return to your heart, increasing your blood pressure.
- Medication Treatment: When lifestyle changes are not sufficient, your doctor may recommend medication treatment.
When Should You See a Doctor?
If you frequently experience symptoms such as dizziness, lightheadedness, fainting, or blurred vision along with your low blood pressure, you should see a doctor. Especially if your blood pressure drops suddenly, you have fainting spells, or you lose consciousness, this situation may require emergency medical intervention and you should go to the nearest emergency room without delay. These symptoms may be a sign that adequate blood is not reaching your brain.
Reference: Hypotension
