Hypotension

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• QHow is hypotension treated?

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  A Piedmont Heart Institute answered

  Treatment depends on the type of hypotension you have and how severe your signs and symptoms are. The goals of treatment are to relieve signs and symptoms and manage any underlying condition(s) causing the hypotension. Your response to treatment depends on your age, overall health, and strength. It also depends on how easily you can stop, start, or change medicines. In a healthy person, low blood pressure without signs or symptoms usually needs no treatment. If you have signs or symptoms of low blood pressure, you should sit or lie down right away. Put your feet above the level of your heart. If your symptoms don't go away quickly, you should seek medical care right away.

  Orthostatic Hypotension
  There are a number of treatments for orthostatic hypotension. If you have this type of low blood pressure, your doctor may advise making lifestyle changes such as:

  • Drinking plenty of fluids, like water
  • Drinking little or no alcohol
  • Standing up slowly
  • Not crossing your legs while sitting
  • Gradually sitting up for longer periods if you've been immobile (not able to move around much) for a long time due to a medical condition
  • Eating small, low-carbohydrate meals if you have postprandial hypotension (a form of orthostatic hypotension)

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

• QWhat is orthostatic hypotension?

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  A Piedmont Heart Institute answered

  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.

• QHow is hypotension diagnosed?

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  A Piedmont Heart Institute answered

  Hypotension is diagnosed based on your medical history, a physical exam, and results from tests. Your doctor will want to know:

  • The type of low blood pressure you have and how severe it is
  • Whether an underlying condition is causing the low blood pressure

  Diagnostic tests
  When a person is in shock, someone should call 9–1–1 right away because emergency treatment is needed.

  For other types of hypotension, your doctor may order tests to find out how your blood pressure responds in certain situations. The results will help your doctor understand why you're fainting or having other symptoms.

  • Blood tests - During a blood test, a small amount of blood is taken from your body. It's usually drawn from a vein in your arm using a thin needle. The procedure is quick and easy, although it may cause some short-term discomfort.
  • EKG (Electrocardiogram) - An EKG is a simple test that detects and records the heart's electrical activity. It shows how fast the heart is beating and the heart's rhythm (steady or irregular). An EKG also shows the strength and timing of electrical signals as they pass through each part of the heart.
  • Holter and event monitors - Holter and event monitors are medical devices that record the heart's electrical activity. These monitors are similar to an EKG. However, a standard EKG only records the heartbeat for a few seconds. It won't detect heart rhythm problems that don't occur during the test.
  • Echocardiography - Echocardiography is a test that uses sound waves to create a moving picture of your heart. The picture shows how well your heart is working and its size and shape.
  • Stress test - Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (or are given medicine if you're unable to exercise) to make your heart work hard and beat fast while heart tests are done.
  • Tilt table test - This test is used if you have fainting spells for no known reason. For the test, you lie on a table that moves from a lying down to an upright position. Your doctor checks your reaction to the change in position.

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

• QWhat are the symptoms of hypotension?

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  A Piedmont Heart Institute answered

  The signs and symptoms of hypotension are as follows:

  Orthostatic hypotension
  The signs and symptoms of orthostatic hypotension may happen within a few seconds or minutes of standing up after you've been sitting or lying down. You may feel that you're going to faint, or you may actually faint. Signs and symptoms include:

  • Dizziness or feeling lightheaded
  • Blurry vision
  • Confusion
  • Weakness
  • Nausea (feeling sick to your stomach

  These signs and symptoms go away if you sit or lie down for a few minutes until your blood pressure adjusts to normal.

  Neurally mediated hypotension
  The signs and symptoms of neurally mediated hypotension (NMH) are similar to those of orthostatic hypotension. They occur after standing for a long time or in response to an unpleasant, upsetting, or scary experience. The drop in blood pressure with NMH doesn't last long and often goes away after sitting down.

  Severe hypotension linked to shock
  In shock, not enough blood flows to the major organs, including the brain. The early signs and symptoms of reduced blood flow to the brain include lightheadedness, sleepiness, and confusion. In the earliest stages of shock, it may be hard to detect any signs or symptoms. In older people, the first symptom may only be confusion.

  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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• QWhat is the treatment for orthostatic hypotension?

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  A Piedmont Heart Institute answered

  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.
• QHow do I know if my blood pressure is too low?

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  A Sanjay Krishnan , Healthcare, answered on behalf of MDLIVE

  Symptoms of low blood pressure include light headedness, vision changes, passing out, or fatigue. Frequently in elderly people it can occur with changes in position. People on medications to help lower blood pressure are sometimes overmedicated and can have this problem as well. The only way of knowing for sure whether you have low blood pressure, is to monitor it. 

• QWhat is hypotension?

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  A Piedmont Heart Institute answered

  Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.
  Blood pressure is measured as systolic and diastolic pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.
  You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury-the units used to measure blood pressure.)
  mal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure lower than 90/60 mmHg.
  This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.
• QWho is at risk for hypotension?

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  A Piedmont Heart Institute answered

  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.
• QWhat causes low blood pressure?

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  A Sigma Nursing answered

  Low blood pressure, or hypotension (blood pressure less than 90/60), can be caused by the following: pregnancy; hormonal problems such as underactive/hyperactive thyroid, diabetes, or low blood sugar; over-the-counter medications; overdose of high blood pressure medications; heart failures; abnormal heart rhythm; widening of blood vessels; heat exhaustion; or liver disease.

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• QWhat are the best treatment options for low blood pressure?

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  A Sigma Nursing answered

  The best treatment for low blood pressure depends on the cause. If blood pressure is low due to blood loss then the best treatment would be replacement of fluids either via transfusion or infusion of fluids. Low blood pressure can also be treated with the following: increasing salt intake; increasing fluid intake; taking medications to raise blood pressure; or wearing compression stockings to increase blood return from the lower extremities, decreasing swelling and pooling of blood in the legs.