Low blood pressure: Why does it occur, what are its symptoms? How to treat hypotension?

Hypotension, as low blood pressure is technically referred to, is not a disease in the true sense of the word.

What is blood pressure in a nutshell

Blood pressure is created during heart activity when blood is expelled - expelled into the bloodstream. It is actually the pressure of the flowing blood acting on the wall of the arteries.

It is divided into systolic  (sTK) and diastolic blood pressure (dTK).

Systolic blood pressure is the highest value of pressure and occurs when blood is expelled into the body's bloodstream. Conversely, diastolic pressure is present when the heart is released. It is the lowest blood pressure.

On the pressure gauge or in the medical documentation we see the representation of the pressure in units of mmHg (millimeters of mercury), the older designation torr. Higher, ie systolic pressure is written before the slash 120/80 - after the slash diastolic.

According to Wikipedia, in 1896, the doctor Scipione Riva Rocci published a work on measuring blood pressure with a sphygomanometer. The method was improved by Nikolai Korotkov, a Russian surgeon, after whom Korotkov's phenomena are also named.

What is low blood pressure and what are its values?

The term chronic arterial hypotension refers to long-term low blood pressure, the value of which is less than 100/60 mmHg. We also know the transient - short-term state, a drop in blood pressure, which usually manifests itself in dizziness, fainting or syncope - collapse.

Hypotension is said to have no primary cause in its primary, essential form. Conversely, secondary hypotension is a symptom and consequence of some other disease.

Also read articles on blood pressure: 
Blood pressure values ​​are given in the table
High blood pressure - hypertension

Another way to divide hypotension into:

• orthostatic hypotension
• habitual hypotension

The basic difference is shown in the table

In a larger proportion, women have low blood pressure. The effect of hormonal and nervous regulation is expected.

Normal and low blood pressure values ​​in the table

Lower normal blood pressure  and normal blood pressure  are reported in favor of the prevention of cardiovascular disease. 
Examples are atherosclerosis, ischemic heart disease, myocardial infarction or stroke.

However, lower values ​​and very low blood pressure cause acute problems. These complicate everyday life. In the long run, the chronic occurrence of low-pressure values ​​is a threat to health.

It is the cause of muscle weakness, fatigue, inefficiency or neurological problems. The reason is insufficient blood flow to cells, tissues and organs. 

It is also necessary to think about the increased risk of injury for apostasy  - short-term loss of consciousness.

Similarly, hypertension causes various health complications.

The cause of chronic low blood pressure in the primary form is not fully understood. The importance of a hormonal or nervous regulation disorder is attached.

As already mentioned, women are more susceptible to this species.

Alternatively, there is a sudden change in position behind the acute decrease. The body is unable to react quickly enough to adjust its blood circulation. The brain does not get enough blood.

Such orthostatic hypotension is known mainly in the morning after waking up, long-term lying down, or vice versa, after a long standstill.

A person's head becomes tangled or collapses. Subsequently, the CNS blood flow is stabilized and the victim is taken over. The risk of syncope is injury.

Postprandial hypotension - a decrease in systolic blood pressure after a meal of 20 mmHg. Transient state of pressure reduction after food intake. The exact cause is not known, a multifactorial basis is assumed. It is more common in the elderly.

Very often, low blood pressure and medication cause it. Examples are antihypertensives, ie drugs for high blood pressure, but also drugs used in the treatment of chronic heart failure  (beta-blockers, ACE inhibitors, vasodilators, diuretics) or tricyclic antidepressants.

People take more drugs than they should, they overdose  - intentionally but also unintentionally. They forget that they have already taken one dose of medication.

Other secondary causes of low blood pressure:

• inappropriate treatment, poorly set therapy (by the patient or doctor)
  • even with an overshot attempt to reduce your high blood pressure
• neurological causes - diseases of the CNS (central nervous system) or PNS (peripheral nervous system, spinal cord)
  • multiple sclerosis
  • Parkinson's disease
  • diabetic neuropathy
  • organic CNS damage
  • autonomic vegetative dysfunction
  • brain tumors
  • inflammatory polyneuritis (Guillain - Barré syndrome)
• alcoholism
• vitamin deficiency
• malnutrition, anorexia, bulimia
• dehydration  and insufficient drinking regime
• endocrine system disorders (thyroid or adrenal glands)
• stress
• pregnancy

Hypotension can also arise on the basis of acute shock states, which directly endanger a person's life:

• hemorrhagic shock
• traumatic shock
• anaphylactic shock
• burn shock
• cardiogenic shock
• hypovolemic shock in severe dehydration

Hypotension causes reduced blood flow to cells, tissues, and therefore organs. It most often manifests itself as muscle weakness, general fatigue, a person is spinning around the world, he has a problem with concentration.

There is a risk of complications. As is the case with long-term severe hypotension.

This can be the cause of organic damage to the nervous system, ie the brain. The CNS is less congested over a long period of time, which harms him.

In 1960, physicians George Milton Shy and Glenn Albert Drager associated orthostatic hypotension with degenerative CNS damage. 
They described it as multisystem atrophy - MSA.
A rare disease

General symptoms of hypotension:

• fatigue
• weakness
• muscle weakness
• headache
• dizziness (vertigo), dizziness, feeling drunk
• cold skin, especially of the hands and feet
• cold limbs
• cold sweat
• excessive sweating
• visual disturbances, such as blurred vision, blackness in front of the eyes
• flashes in front of the eyes
• tinnitus or noise in the ears, other unpleasant sounds in the ears
• fast heartbeat (tachycardia) and palpitations
• rapid breathing - hyperventilation
• tras
• tingling in the body, tingling in the limbs
• feeling cold, chills
• or, conversely, hot flashes
• fear to anxiety
• the feeling of falling away
• fainting
• syncope, collapse - apostasy
• short-term loss of consciousness
  • if unconsciousness persists, another cause must be considered

A history of hypotension is taken. Man describes his difficulties and the symptoms lead to a diagnosis. Of course, other examinations are also important.

Blood pressure measurement is the basic examination method. However, just one measurement is not enough. Several independent measurements are needed to confirm the diagnosis of hypotension.

For repeated measurements, the value will be lower than TK 100/60 mmHg .

During the internal examination, a 24-hour pressure measurement , the so-called Pressure Holter , is also selected . An ECG test can reveal a heart rhythm disorder, which can also lead to a decrease in blood pressure. ECG Holter - 24 hour recording can also be performed .

Laboratory examination of blood or urine, X-ray, ECHO, sonography is added. More detailed CT or MRI in differential diagnosis and search for the primary cause.

Lower normal pressure is a better option and is welcome in the prevention of cardiovascular disease . Even in the long run, it is not a risk for complications.

This form of blood pressure is mostly found in young girls and women.

Causes of menstrual pain or blood loss have been attributed to adolescent girls and younger women. Conversely, in the elderly, the main reason is dehydration or taking medication for hypertension.

Examples of common problems are general or muscular weakness , fatigue , feeling  sick , fainting , collapse .

Caution and warning signs of collapse:

• sudden weakness
• dizziness
• black in front of the eyes or other visual impairment
• noise in the ears, whistling, pressure
• problem with posture - knee break
• until falling off

If these symptoms occur, it is best to lie down . If it's in a public place , it may be enough to kneel and bend your head between your knees . Sit down at least. At very low blood pressure, a sitting position may not be enough.

After syncope - the condition usually falls off after a few seconds or minutes.

In the long run, there is a consequent risk of developing neurological problems. These result from chronically reduced perfusion, ie blood flow to cells, tissues and organs.

Prevention and other measures in hypotension

In addition to the above treatment, it is good to remember that in case of low blood pressure, adjustment of life regime or diet will also help.

What will help with low blood pressure:

1. diet
   • smaller portions and more often - load less stomach and digestive system
   • reduction of heavy meals high in fat and protein
   • an increase in salt intake may not be desirable but is mentioned as one option, it should be common sense
   • adherence to a drinking regime
   • drink a glass of water before getting out of bed
   • orange or grapefruit juice have an invigorating effect
   • reduction of alcohol intake
   • coffee or black tea has a diuretic effect, which can induce hypotension
2. nutritional supplements
   • vitamin C
   • vitamin B ₁₂
   • folic acid B₉
   • pantothenic acid B ₅ 
3. sufficient physical activity
   •  swimming, cycling, dancing, hiking
   • movement in the fresh air
   • in limiting physical condition and other diseases of walking outdoors
4. adequate rest and sleep
   • stress avoidance
   • reduction of workload
5. showering with alternating cold and hot water
   • alternating cold and hot water flow
   • from the limbs towards the heart
   • finished with cold water

Our tip: read the article How to fight low blood pressure in the magazine Zdravotéka.

Low blood pressure during pregnancy

The period of pregnancy means various changes for a woman's body, such as hormonal ones. In addition, the pregnant woman's cardiovascular system is under increased stress.

It usually starts at the beginning of pregnancy and then in recent weeks.

Sleeping on your back can also be a problem. An increase in the uterus, fetus and a change in the conditions in the abdominal cavity can put pressure on large blood vessels. When lying on the back, there is an oppression of the inferior vein. It worsens the return of blood to the heart.

It is called lower vena cava syndrome - in the 3rd trimester of pregnancy, it is recommended to lie on the left side.

A pregnant woman may experience the following symptoms :

1. acceleration of cardiac activity, tachycardia
2. heart beat
3. drop in blood pressure to drop out
4. sweating
5. pallor
6. nausea

In addition to the pregnant woman, the fetus is also endangered - due to the impaired blood supply to the fetus.