Low Blood Pressure (Hypotension)
While hypotension, known as low blood pressure, may not cause any symptoms, it can also cause symptoms such as dizziness, darkening in the eyes, and fainting in many people. In some cases it can be life threatening.
Although the effects of blood pressure vary from person to person, it is defined as systolic (systolic blood pressure) below 90 mm Hg and diastolic (low blood pressure) below 60 mm Hg.
The causes of low blood pressure can range from simple dehydration (dehydration) to serious internal and surgical diseases. Although low blood pressure is a treatable condition, the most important thing is to find the cause and treat it.
Low blood pressure can cause serious signs and symptoms, especially when it develops suddenly. These include dizziness, poor concentration, blackout, nausea, cold skin, rapid breathing, fatigue, depression, thirst, and even fainting.
When to see a doctor?
Most of the time, low blood pressure is not due to a serious illness. If you feel good even though your blood pressure is low, if there is no severe dizziness, nausea, bad feeling, darkening in the eyes, with simple measures – for example, it may be due to water loss, excessive sweating, your complaints may regress with fluid intake – your blood pressure rises. If the fluid does not rise with a drink and if your complaints of severe dizziness, nausea, bad feeling, darkening of the eyes persist or persist, it is absolutely beneficial to see a doctor.
What are the causes?
Systolic blood pressure: The value, which is read first and evaluated as systolic blood pressure, is evaluated as a reflection of the pressure created by the heart in the veins while beating blood.
Diastolic blood pressure: The second reading and evaluated as diastolic blood pressure is the reflection of the pressure formed in the veins between heartbeats, during resting of the heart.
Recent guidelines state that the ideal for these two values is 120/80 mm hg.
However, blood pressure can show serious changes in a very short time, provided that it remains within normal limits. This can be affected by your body position, breathing rate, stress level, physical condition, medications you take, what you eat and drink.
Some conditions can lead to low blood pressure.
Pregnancy: The female circulatory system expands in the first 24 weeks of pregnancy, resulting in decreases of approximately 10 mm Hg in systolic blood pressure and 10-15 mm Hg in diastolic blood pressure. It returns to normal after pregnancy.
Heart diseases: In low heart rate, heart attack, heart failure, it can reduce blood pressure by enlarging the vessels by various mechanisms so that the circulatory system does not tire the heart too much.
Endocrine diseases: Hypothyroidism- underwork of goiter gland, hyperthyroidism- overwork of goiter gland, adrenal (adrenal gland) insufficiency, hypoglycemia- low blood sugar, diabetes-diabetes
Dehydration- anhydrous staying: Diarrhea, nausea, vomiting, prolonged dehydration, using diuretics,
Blood losses:
Sepsis: (serious infections)
Anaphylaxis (serious allergic reactions): Drug allergies, food allergies, insect stings
Malnutrition: Vitamin B12 deficiency, folate deficiency, iron deficiency
Various drugs: Diuretics (diuretics), various blood pressure drugs, Parkinson’s disease drugs, antidepressants (depressants)
Types of low blood pressure:
Low blood pressure when standing up (postural or orthostatic blood pressure): As the name suggests, the person’s sitting or It describes the blood pressure drops that occur after getting up suddenly from lying down. The most common causes are dehydration, prolonged bed rest, pregnancy, diabetes, heart diseases, burns, excessive heat, large varicose veins, neurological diseases. Likewise, many blood pressure medications, depression medications, and Parkinson’s medications can also cause postural hypotension.
It is commonly seen in the elderly population, especially over 65 years of age. But at the same time, this low blood pressure can be seen in completely healthy young individuals when they get up suddenly while sitting or lying down.
Postprandial hypotension: It describes sudden drops in blood pressure, especially after meals, which are mostly seen in elderly people. This event is related to the directing of the blood in our body to our digestive system after the meal. In healthy people, this low blood pressure is prevented by the increase in the heart rate and the contraction of the blood vessels. However, in some people, especially the elderly, if this mechanism does not work, low blood pressure may cause dizziness, blackout, and fatigue.
Neurological hypotension: This is a condition that can be seen mostly in young individuals. It is associated with sudden standing up, especially after prolonged sitting or lying down. Here, with a sudden departure, the blood collected in the legs suddenly returns to the heart, this is interpreted as an increase in blood pressure in the heart and sends a signal to the brain to lower the blood pressure. This misperception of the heart causes a sudden drop in blood pressure and can cause darkening in the eyes and dizziness.
Risk factors:
Low blood pressure can affect many people. There are some risk factors that can cause it.
Age: Especially in the elderly population (after 65 years), low blood pressure may occur while standing or after meals. Orthostatic hypotension may occur during rapid standing up and after meals. Neurological hypotension, on the other hand, can be seen mostly in young individuals due to fast life and movement.
Medications: Anyone who takes blood pressure medication is a candidate for low blood pressure.
Some diseases: Parkinson’s disease, diabetes, some heart diseases
Treatment and drugs:
If you have low blood pressure that is bothering you, the main thing is to cause this low blood pressure. to identify the possible situation. (Dehydration, heart disease, diabetes mellitus, goiter disease?) If there is a low blood pressure due to the drugs we use, you can talk to your doctor and reduce the dose.
If we do not have enough evidence to explain low blood pressure, what will be done is to try to increase our low blood pressure depending on our health status, existing diseases and age, and to minimize our existing complaints. There are many ways for this.
Getting more salt; Increasing the amount of salt in the diet can provide a significant increase in our blood pressure. However, it is more appropriate for patients with heart disease, high blood pressure, and especially the elderly, to consult their doctor.
Drinking more water: Anyone can benefit from this suggestion. By increasing the blood volume, water protects the body from dehydration. It raises blood pressure by both raising blood pressure and protecting it from dehydration.
Leg compression stockings: People with large varicose veins (varices) especially benefit. They reduce low blood pressure by facilitating the return of the collected blood in the enlarged leg veins to the heart.
Medications: Patients with chronic orthostatic hypotension and severe symptoms can use various medications under the supervision of a doctor
. (eg steroids)
Only the main thing in treatment is to find the underlying cause and treat it. lifestyle change and treatment.
Lifestyle changes;
As a result, we can list the things that can be done to increase your low blood pressure as follows.
Reduce alcohol intake for plenty of water; Alcohol lowers blood pressure by reducing the body water ratio. Water and other liquids, on the other hand, increase blood volume and raise blood pressure.
Eat healthy: focus on foods containing vegetables, fruit, fish and chicken, increase the salt rate in the diet as needed with the recommendation of your doctor.
Make body position changes slowly: Do not stand up suddenly, especially from lying and sitting positions. Especially when getting out of bed in the morning, take a deep breath and sit in bed for a few minutes before getting up, then get up. Keep your head slightly elevated while sleeping. If you feel symptoms of low blood pressure (dizziness, blackouts, weakness) lie down on a flat surface and place your feet and legs on a chair or similar high place. This action will direct blood from your legs to your heart and brain.
Eat frequently, consume foods with low carbohydrate content: This eating style will prevent blood pressure drops that will occur especially after heavy meals. Make sure your meals are low in carbohydrates (potatoes, rice, cake and bread). At the same time, as long as there are no known side effects, drinking tea and coffee will help increase your low blood pressure. But do not forget that you should not go to excessive consumption of coffee without consulting your doctor, as coffee can cause serious side effects (palpitations, increased blood pressure), especially in heart patients.
Cem Özcan
Internal Medicine Specialist
