Hypotension

Hypotension

Clinically known as hypotension, low blood pressure (LBP) may indicate signs of underlying health problems. While its common for some people to always have hypotension, severe drops in your blood pressure can deprive your body of oxygen and result in damage to vital organs. Sudden drops may be caused by heart failure, loss of blood, an allergic reaction called anaphylaxis or sepsis, a life-threatening blood infection. Doctors define a reading below 90/60 as low blood pressure. You may become dizzy or even faint if your pressure falls below this reading. As you get older, you are more likely to develop either high or low blood pressure. Medications that help treat high blood pressure may actually cause you to have low blood pressure.

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    Shock is a medical emergency that occurs when blood pressure drops drastically. Shock is a physical condition that may be triggered by problems with the heart leading to cardiogenic shock; blood vessel dilation causing distributive or vasodilatory shock; or blood volume levels that are so low it leads to hypovolemic shock. Toxic poisoning can cause septic shock and allergic reactions can lead to anaphylactic shock. Shock can affect other organs including the heart, liver, brain and kidneys. If left untreated, shock can cause irreversible damage and even death.

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    Orthostatic hypotension is a sudden fall in blood pressure that occurs when a person assumes a standing position. It may be caused by hypovolemia, a decreased amount of blood in the body, resulting from the excessive use of diuretics, vasodilators, or other types of drugs; dehydration; or prolonged bed rest. The disorder may be associated with Addison's disease, atherosclerosis (build-up of fatty deposits in the arteries), diabetes, and certain neurological disorders including Shy-Drager syndrome and other dysautonomias. The symptoms that generally occur after sudden standing include dizziness, lightheadedness, blurred vision, and syncope (temporary loss of consciousness).

    This answer from the National Institute of Neurological Disorders and Stroke has been reviewed and/or edited by Dr. William D. Knopf.

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    When orthostatic hypotension is caused by hypovolemia due to medication, the disorder may be reversed by adjusting the dosage or discontinuing the medication. When the condition is caused by prolonged bed rest, improvement may occur by sitting up with increasing frequency each day. In some cases, physical counter-pressure such as an elastic hose or a whole-body inflatable suit may be required. Dehydration is treated with salt and fluids.

    This answer from the National Institute of Neurological Disorders and Stroke has been reviewed and/or edited by Dr. William D. Knopf.

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    Doctors often can successfully treat hypotension. Many people who have the disorder live normal, healthy lives.

    If you have low blood pressure, you can take steps to prevent or limit symptoms, such as dizzy spells and fainting.

    If you have orthostatic hypotension, get up slowly after sitting or lying down. Eat small, low-carbohydrate meals if you have postprandial hypotension (a form of orthostatic hypotension).

    If you have neurally mediated hypotension, don't stand for long periods. Also, drink plenty of fluids and try to avoid unpleasant or scary situations. Learn to recognize symptoms and take action to raise your blood pressure. Children who have NMH often outgrow it.

    Other lifestyle changes also can help you control low blood pressure.

    Ask your doctor about learning how to measure your own blood pressure. This will help you find out what a normal blood pressure reading is for you. Keeping a record of blood pressure readings done by health professionals also can help you learn more about your blood pressure.

    This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

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    Blood transfusion: If blood loss causes low blood pressure, a blood transfusion can help increase blood pressure.

    Drink plenty of fluids: Drinking more water may help raise blood pressure because fluids increase blood volume. Drinking adequate amounts of water also helps prevent dehydration, a common cause of hypotension.

    Avoid consuming alcohol: Alcohol is dehydrating, and it may lower blood pressure. These effects may occur even if a person drinks in moderation. Therefore, patients with hypotension are encouraged to avoid consuming alcohol.

    Stand up slowly: If hypotension occurs when a person stands up after sitting or lying down, it may help to take several deep breathes before getting up. Sleeping with the head slightly elevated may also reduce symptoms.

    If a person develops symptoms of hypotension after standing for a long period of time, it may help to cross the thighs. This puts pressure on the blood vessels and may improve blood pressure. As a result, blood flow from the legs to the heart may increase.

    Compression stockings: Compression stockings, which are often used to relieve pain and swelling of varicose veins, may help prevent blood from pooling in the legs. As a result, symptoms of hypotension may be reduced.

    Medications: When there is no known cause of hypotension, medications may be prescribed to increase a person's blood pressure. For instance, a medication called fludrocortisone is often used to treat postural hypotension, which occurs when a patient stands up after sitting or lying down. This drug, which is classified as a mineralcorticoid, increases extracellular fluid and plasma volume and sensitizes blood vessels to the vasoconstrictive effect of norepinephrine. Other drugs, such as midodrine (Orvaten® or ProAmatine®), pyridostigmine (Mestinon®, Mestinon Timespans®, Mytelase Caplets®, Prostigmin®, or Regonol®), erythropoietin, and nonsteroidal anti-inflammatory drugs (NSAIDs), are sometimes prescribed either alone or in combination with other drugs to increase blood pressure.

    You should read product labels, and discuss all therapies with a qualified healthcare provider. Natural Standard information does not constitute medical advice, diagnosis, or treatment.

    Copyright © 2012 by Natural Standard Research Collaboration. All Rights Reserved.

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    A primary care doctor or specialist may diagnose and treat hypotension. The type of specialist most commonly involved is a cardiologist (heart specialist).

    Other specialists also may be involved, such as surgeons, nephrologists (kidney specialists), neurologists (brain and nerve specialists), or others.

    This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

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    General: If a person has symptoms of hypotension, the goal is to determine the underlying cause. A doctor may perform one or more of the following tests to reach a diagnosis.

    Blood tests: Blood tests may be performed to determine if an infection is present in the blood. They are also used to detect possible endocrine problems, such as low blood sugar levels, an underactive or overactive thyroid gland, or adrenal insufficiency. Blood tests may also determine if the patient has vitamin B-12 or folate deficiencies and/or anemia.

    Electrocardiogram (ECG, EKG): An electrocardiogram may be performed to detect abnormalities in the heart's rhythm or structure. It can also detect problems with the supply of blood to the heart muscle. During the procedure, small electrode patches attached to the person's chest, arms, and legs. These electrodes transmit information about the electrical activity of the heart to a monitor.

    Stress test: A stress test may also be performed to determine how blood pressure changes when the heart is working harder than normal. This test may make it easier for a doctor to diagnose hypotension. During the test, the patient either exercises (often on a treadmill) or is given medication to make the heart work harder. Small electrodes are placed on the patient's chest to monitor the electrical activity of the heart. The patient's blood pressure may also be monitored. People with hypotension will have lower blood pressure during a stress test than healthy people who undergo a stress test.

    Tilt-table test: Patients who have postural hypotension or neutrally mediated hypotension may undergo a tilt-table test. During the test, the patient lies on a table that is tilted to raise the upper part of the body. The patient's blood pressure is measured during the test to determine how the body reacts to changes in position.

    You should read product labels, and discuss all therapies with a qualified healthcare provider. Natural Standard information does not constitute medical advice, diagnosis, or treatment.

    Copyright © 2012 by Natural Standard Research Collaboration. All Rights Reserved.

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    ADeb Cordes, Cardiac Care Nursing, answered on behalf of Honor Society of Nursing (STTI)
    Hypotension means low blood pressure. You may run a low blood pressure and experience no signs or symptoms. If you begin to experience any of the following symptoms it may mean that your blood pressure is too low and you will need to seek medical attention. The following signs/symptoms may be experienced if your blood pressure is too low. Nausea, dizziness, blurred vision, pale and clammy skin, rapid shallow breathing, a feeling that you might pass out or faint.
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    Hypotension can affect people of all ages. However, people in certain age groups are more likely to have certain types of low blood pressure.

    Older adults are more likely to have orthostatic and postprandial hypotension. Children and young adults are more likely to have neurally mediated hypotension.

    People who become dehydrated or volume depleted due to many reasons are at risk for hypotension.

    People who take certain medicines, such as high blood pressure medicines, are at higher risk for low blood pressure. People who have central nervous system disorders (such as Parkinson's disease) or some heart conditions also are at higher risk for low blood pressure.

    Other risk factors for hypotension include being immobile (not being able to move around very much) for long periods and pregnancy. Hypotension during pregnancy is normal and goes away after birth.

    This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

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    Hypotension that causes symptoms may be a sign of an underlying health condition. Sometimes, hypotension may even indicate a serious and/or life-threatening problem, such as a widespread infection. Below are some of the most common causes of hypotension.

    • Allergic reaction (anaphylaxis): A life-threatening allergic reaction, called anaphylaxis, often causes a sudden and dramatic drop in blood pressure. Additional symptoms may include itching, hives, difficulty breathing, swelling of the throat and tongue, stomach cramps, nausea, and diarrhea. This reaction may occur in response to medications, herbs, supplements, foods (such as peanuts), bee stings, or other severe allergies.
    • Blood loss: Sudden hypotension may occur if a person loses a lot of blood from a serious injury, internal bleeding, or complications during surgery. The severity of hypotension depends on how much blood is lost.
    • Dehydration: Dehydration may lead to hypotension. Even mild dehydration may cause symptoms, such as lightheadedness, dizziness, and weakness. Severe dehydration may lead to a life-threatening complication, called hypovolemic shock. This condition occurs when a decreased blood volume in the body causes a sudden drop in blood pressure. As a result, the body's tissues and organs do not receive enough oxygen. If left untreated, hypoyolemic shock may be fatal within a few minutes to hours.
    • Heart problems: Several heart problems, including an extremely low heart rate (called bradycardia), heart valve problems, heart attack, and heart failure, may lead to hypotension. These conditions prevent the body from circulating enough blood to tissues and organs.
    • Medications: Many drugs can cause low blood pressure, including diuretics, blood pressure-lowering drugs, heart medications (such as beta blockers or calcium channel blockers), drugs used to treat Parkinson's disease, tricyclic antidepressants, erectile dysfunction drugs (such as Viagra®), narcotics, and alcohol. Other medications (prescription and over-the-counter) may lower blood pressure when they are taken in combination with blood pressure-lowering drugs.

    You should read product labels, and discuss all therapies with a qualified healthcare provider. Natural Standard information does not constitute medical advice, diagnosis, or treatment.

    Copyright © 2012 by Natural Standard Research Collaboration. All Rights Reserved.

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