LOW BLOOD PRESSURE (HYPOTENSION) – WHEN IS IT WORRYING?

Chronically low blood pressure does not usually cause problems or symptoms in most healthy adults. In fact, it can be quite normal. But what if your blood pressure suddenly drops or starts causing symptoms such as dizziness or fainting?

In certain cases, low blood pressure may be mild, non-problematic and often harmless and easily reversible. However, in other situations, it can be quite severe, starving your organs of oxygen and eventually leading to death. It can also cause symptoms that can significantly affect your quality of life. This all depends on the underlying causes of low blood pressure.

So, when should you worry about hypotension? Keep reading to find out.

What is blood pressure?

Blood pressure is a measure of the force your heart uses to pump blood through your body. It is measured in millimetres of mercury (mmHg) and is given as 2 figures:

• Systolic pressure - the pressure at which your heart pumps blood out.
• Diastolic pressure - the pressure at which your heart rests between beats.

In a blood pressure measurement, the top number corresponds to systolic pressure and the bottom number to diastolic pressure.

As a general guideline:

• Normal blood pressure is considered to be less than 120/80 mmHg.
• High blood pressure is considered to be equal to or greater than 140/90 mmHg.
• Low blood pressure is considered to be equal to or less than 90/60 mmHg.

What is low blood pressure?

Hypotension is the medical term for low blood pressure, which is when your blood pressure is lower than the normal limit (90/60 mmHg). Low blood pressure is not an independent condition on its own, and rather a manifestation of a wide range of medical conditions that can vary greatly in seriousness and severity.

Chronic low blood pressure with no symptoms is almost never worrisome. However, certain serious conditions can cause your blood pressure to become severely low. In such cases, there is a significant risk that your body will not receive enough oxygen to carry out its normal functions.

What are the causes of low blood pressure?

Acute causes – A sudden drop in blood pressure can be life-threatening. The causes of this type of hypotension are:

• Loss of blood due to hemorrhage
• Extreme changes in body temperature
• Sepsis, a serious blood infection
• Severe dehydration due to vomiting, diarrhea, or fever
• A severe allergic reaction, called anaphylaxis, which causes an irregular heartbeat
• Heat exhaustion or heat stroke

Chronic causes – Some conditions can cause prolonged periods of low blood pressure that can become dangerous if left untreated. These conditions include:

• Pregnancy, due to hormonal changes and expansion of the circulatory system
• Heart problems, such as bradycardia (low heart rate), heart valve problems, and heart failure
• Hormonal problems, such as hypothyroidism, diabetes, or hypoglycemia
• Certain prescription drugs, such as those for depression, Parkinson's disease, or erectile dysfunction
• Enlargement or dilation of blood vessels (aneurysms)

Aside from medical conditions, many individuals naturally have a slightly lower-than-normal blood pressure. People who have persistently low blood pressure without any annoying symptoms or an underlying condition usually have nothing to worry about and require no treatment at all.

What are the symptoms of low blood pressure?

Symptoms of hypotension vary from case to case and are strongly related to the initial cause and context of the abnormality. Some people may feel nothing at all, while others may feel very ill.

In general, symptoms of low blood pressure may include:

• Fatigue
• Dizziness
• Light-headedness
• Nausea
• Clammy skin
• Depression
• Loss of consciousness
• Visual disturbances
• Rapid and shallow breathing

The severity of symptoms can also differ, and those can also be chronic or severe depending on the initiating factor. For example, a person with an anaphylactic shock will have more intense and acute symptoms compared to someone who has hypothyroidism.

When to worry about low blood pressure?

Low blood pressure without symptoms is rarely a cause for concern.

However, if low blood pressure is associated with recurrent dizziness, fainting, shortness of breath, or light-headedness, this may be a sign that you need medical evaluation. A cardiologist can examine you and determine the cause of your condition and whether there’s anything to worry about or not.

More acute and severe symptoms, such as those seen with sepsis or anaphylaxis, warrant emergency medical care. Such conditions can quickly progress to circulatory shock and a dangerously low blood pressure, which can be fatal.

Is low blood pressure dangerous?

While high blood pressure can be a serious health risk, chronically low blood pressure is usually of little concern. As long as you don't have symptoms of low blood pressure, doctors aren't concerned about its effects on your health. Generally speaking, the lower your blood pressure, the better. In fact, studies have shown that the risk of heart attack, stroke, and other cardiovascular diseases decreases when your blood pressure is below 120/80.

As long as you feel OK, there's no need to worry about "low numbers".

Low blood pressure can be dangerous, however. This greatly depends on the cause, your health, and the severity of hypotension. You need to know that most cases are treatable if diagnosed early, so it’s important not to delay a doctor’s visit if you’re suspecting you have hypotension.

Acute disorders like sepsis, anaphylaxis, and hemorrhage are more dangerous. They can cause severely low blood pressure which, if not treated, can lead to circulatory shock, and deprive the brain, heart, and other organs of oxygen, ultimately causing death.

FAQs

Is there a treatment for low blood pressure?

You will probably only be treated for low blood pressure if it is causing symptoms or if your blood pressure drops suddenly. Depending on various factors, such as your age and the type of low blood pressure, your doctor may recommend one or more of the following: diet, lifestyle changes, and/or medications.

What is dangerously low blood pressure?

If low blood pressure causes a lack of blood flow to the body's organs, they begin to fail. This can lead to stroke, heart attack, kidney failure, and intestinal ischemia (decreased blood supply to the small and large intestines). Shock and death are the final result of prolonged dangerously low blood pressure.

When is low blood pressure an emergency?

Seek immediate medical help if you have a rapid pulse, shallow breathing, and cold or clammy skin. These symptoms may be a sign of shock, which is a medical emergency. Sepsis, anaphylaxis, and bleeding can all quickly lead to shock.

If my blood pressure is low, should I still take my blood pressure medication?

Do not stop taking your medicine unless you are told to do so. Stopping blood pressure pills suddenly can cause potentially serious side effects. If you don't take your blood pressure pills as prescribed, you may increase your chances of having a heart attack, stroke, kidney failure, or other complications.

How to know if you have low blood pressure?

If you have symptoms of low blood pressure, you should see your doctor to have your blood pressure checked. You can also find out that you have low blood pressure by regularly checking it at home. The signs of low blood pressure can be similar to those of other diseases. Therefore, it is important to see your doctor for monitoring.

If you are experiencing severely low blood pressure, learn about your triggers and try to avoid them. You can manage and prevent low blood pressure by understanding and learning about the problem. And, if you are prescribed medication, take it as directed to raise your blood pressure and avoid potentially dangerous complications.

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Sources:

• https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/symptoms-causes/syc-20355465
• https://www.healthline.com/health/hypotension#symptoms
• https://my.clevelandclinic.org/health/diseases/21156-low-blood-pressure-hypotension
• https://www.webmd.com/heart/understanding-low-blood-pressure-basics
• https://my.clevelandclinic.org/health/articles/21464-low-blood-pressure-when-to-seek-emergency-care

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