What Effect Does Low Blood Pressure Have – Systolic – The top number is systolic Blood Pressure and relates to the peak pressure in your arteries when blood is pumping through your body (when your heart beats).
Diastolic – The bottom number is the diastolic record and arterial circulation pressure when the heart is at rest (between beats)
What Effect Does Low Blood Pressure Have
Blood pressure measurements and symptoms vary throughout the day and night, which is why doctors prefer to look at recordings over 24 hours rather than a single reading.
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Low blood pressure is also known as hypotension. This is usually defined in adults as a systolic record of less than 90 mmHg, although it has been suggested that under 110 mmHg is a more appropriate definition for older people.
Blood pressure and heart rate are controlled by the autonomic nervous system (the nervous system that controls bodily functions that we don’t have to think about).
There is a lot of overlap between low blood pressure, vasovagal syncope and PoTS (see last paragraph for more details), and these conditions can exist in the same person.
It is important to recognize that low blood pressure can cause no symptoms and is a common normal finding in young people and athletes.
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However, in some people, low blood pressure causes symptoms that can significantly interfere with their quality of life.
A decrease in systolic BP of 50-60 mmHg or more is usually associated with loss of consciousness.
There are many factors that can contribute to low blood pressure. In some people, they have only one factor e.g. dehydration. In others, there is a combination that adds up to cause problems. For example, prolonged standing, heat, alcohol and hyperventilation (over-breathing) can also contribute.
This happens more often in old people who take a lot of medication. However, it can cause symptoms in younger people. There may be underlying medical conditions such as Joint Hypermobility Syndrome, Diabetes, Parkinson’s disease, Addison’s disease or Autonomic Failure. Dehydration, hunger*, low body weight and deconditioning (including chronic out of shape / not fit) can reduce blood pressure.
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There are many different names and definitions for different types of low blood pressure and this can be confusing.
This is a decrease in systolic BP of at least 20 mm Hg or diastolic BP of 10 mm Hg usually within 3 minutes of standing.
‘Orthostatic’ means caused by standing posture; people with low blood pressure mostly have problems when they are standing, and sometimes by sitting up. This is the result of the brain having a high level of heart.
This happens within 15 seconds of standing up suddenly. The autonomic nervous system usually corrects this fall in BP very quickly and the symptoms are usually very short-lived. ‘Head rush’ can occur in young, healthy people.
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This is when blood pressure drops due to changes in the activity of the autonomic nervous system.
This happens when a decrease in blood pressure and / or heart rate leads to fainting. This can also be called ‘common fainting’ or ‘simple fainting’. Your doctor may further classify these into cardioinhibitory or vasodepressor vasovagal syncope:
Vasodepressor means a decrease in blood pressure when blood vessels cannot narrow (constrict) enough to maintain blood pressure. Blood pressure tends to drop more slowly because blood pools (collect) in the veins of the limbs and abdomen and pulse pressure (the difference between systolic and diastolic blood pressure) can be small. The heart rate can increase to compensate.
This term is used when there is a specific trigger (or situation) provokes vasovagal syncope such as coughing, swallowing, laughing and passing urine or feces. Fear, pain or blood tests can also be triggers.
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People can suddenly develop hypotension when they are not feeling well such as due to loss of circulation of blood volume (hemorrhage), loss of fluids (burns, dehydration) or when the heart does not pump efficiently (heart failure). This condition is called ‘shock’ when low blood pressure causes insufficient blood supply to the body’s organs.
If blood pressure drops as a result of eating a meal, this is called postprandial hypotension. ‘Prandial’ means related to meals. This problem is thought to be caused by dilation of blood vessels in the abdominal cavity and increased blood flow to the intestines, which lowers blood pressure in general.
If you feel faint – act immediately! Try to sit or squat down, or better yet, lie down and elevate your legs in the air. If you can not do this, cross your thighs, clench your buttocks and tummy muscles * and make tight fists. Taking a short walk or rocking up and down on your toes can help. This counter maneuver squeezes the blood back towards the heart and head*.
Try to identify the cause of low BP and remove or treat, where possible. Medication is a common cause and causes include antihypertensives (for high BP treatment), diuretics (water tablets), anti-Parkinson drugs and tricyclic antidepressants.
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A high fluid intake is usually recommended which is 2-3 liters per day (except in conditions such as heart failure and severe kidney disease). Try to increase fluid intake before rising as people are often a little dehydrated on waking. Drink 2 glasses of water before doing activities that may worsen symptoms such as shopping or if you have symptoms of low blood pressure.
A high salt intake can help if you have low or normal blood pressure, but only with your doctor’s advice as this can be dangerous in some medical conditions such as heart and kidney disease.
Eating smaller meals more often can help with postprandial hypotension. Refined carbohydrates (found in foods made from white flour, sugary foods, white pasta, etc.) should be avoided or eaten later in the day when the patient can lie down afterward.
Stay as physically fit as possible. Exercise in a horizontal or seated position can be better tolerated such as swimming, recumbent exercise bike, Pilates.
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Take care first thing in the morning as people often find this when symptoms are worse. Get out of bed slowly (especially when getting out of bed at night to go to the toilet). Drink 2 glasses of water 30 minutes before going up.
Aim to keep your weight in the normal range – BMI 19-25. People who are very underweight are more susceptible to low BP.
Observe your posture – elevating the legs; sitting cross legged and fidgeting can help symptoms. Get up slowly from a lying or sitting position.
Tilt exercises involve spending longer periods of time standing or on a tilt table. Patients should be very motivated to persist with this treatment.
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Medications can be used to increase blood pressure if the above measures fail. Examples include fludrocortisone and midodrine. There may be benefit from emerging drugs such as droxidopa and pyridostigmine, but there is insufficient evidence to incorporate these into routine guidelines.
The symptoms of PoTS and orthostatic hypotension can be very similar. In fact, a number of people experience both problems at the same time. During the standing test or the tilt table test, people with PoTS have an increase in heart rate of 30 beats per minute or more in 10 minutes of being upright (or up to more than 120 bpm). Although the definition says that there is no drop in BP in PoTS, some people with PoTS also drop their BP and, occasionally, heart rate. This is because abnormalities in the autonomic nervous system that cause PoTS can also cause a drop in BP – see diagram 1 above. This combination of findings is common in joint hypermobility syndrome and chronic fatigue syndrome.
In vasodepressor syncope or presyncope, there may be an increase in heart rate that accompanies a decrease in BP. This is called reactive tachycardia and can look like PoTS. Treatment for both conditions is very similar.
This information is general information about PoTS and is not an alternative to medical advice from your doctor or other healthcare professional. You should always consult your doctor or healthcare professional. Hypotension is low blood pressure. Since healthy blood pressure can vary from person to person, hypotension is defined as blood pressure that is lower than the normal value expected for a given person.
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Blood pressure can change throughout the day and is based on many things, including activity, medications and age. It is important to know the cause of hypotension before trying to treat it. However, in many cases, people can achieve healthy blood pressure using natural methods or treatments.
Hypotension is blood pressure that is lower than it should be based on a person’s expected healthy blood pressure range. This is the opposite of high blood pressure (hypertension).
A healthy blood pressure range depends on the person’s age, health condition, activity level and any medications used. For most people, a healthy blood pressure is around 120/80 mm Hg. Many doctors consider low blood pressure to be anything below 90 mm Hg systolic (top number) or below 60 mm Hg diastolic (bottom number). (1)
With hypotension, there is low blood flow in the body. This means that the body may not get enough oxygen and nutrients. When that is the case, people experience symptoms of low blood pressure. If blood pressure is low
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