Low blood pressure / hypotension A condition of lower than normal arterial blood pressure Or have blood pressure values below 90/60 mm Hg (mmHg) in adults. For some people with hypotension. But no abnormal symptoms were found in the medical profession, still considered normal health and did not need treatment.
Usually, the heart is regularly pumping blood around the body through arteries, veins, and capillaries. By relying on the pressure within the blood vessels to help pump Which is measured in millimeters of mercury And can be divided into two values: the first (or upper) is called the systolic pressure (systolic pressure) is the pressure in the arteries while the heart is squeezing and the second (or lower). Called diastolic blood pressure (Diastolic Pressure) is the pressure in the arteries while the heart is relaxed. Adult blood pressureIt is between 90/60 mm Hg and 140/90 mm Hg, so if the blood pressure measurement is lower than 90/60 mm Hg. Thus causing hypotension But if the measured value is greater than 140/90 mm Hg or more, it is classified as hypertension.
In addition, low blood pressure.Also divided into several typesAccording to the characteristics of each period when the blood pressure is lowered, for example, orthostatic hypotension occurs whenSudden changes in posture from sitting or lying to standing up. Or from a lying position to a sitting position Low blood pressure after eating a large meal (Postprandial Hypotension) Neurally mediated hypotension or severe low blood pressure leading to shock.
Symptoms of low blood pressure
People with hypotension naturally not likely to develop any symptoms. But for those who have already had high blood pressure Although it may not be below the mean, normal blood pressure is considered an uncommon condition that requires treatment. Hypotension is sometimes the result of insufficient blood supply to the brain or an abnormality in the body resulting in a drop in blood pressure. Patients may experience symptoms as follows.
- Dizziness, dizziness, fainting
- Not poised
- Can’t see clearly
- Heart palpitations
- Fatigue, easily tired
- Shallow and shortness of breath
- Cold body, pale skin, chills
These symptoms are usually temporary. For patients with mild symptoms, it can get better too.Drinking a lot of water, stop doing activities for a while, and gradually sit back or lie down for a while But if it is often orMore severe, should seek medical attention To examine and determine the cause of the symptoms This could be the result of other abnormalities and death.
Causes of low blood pressure
Low blood pressure can be caused by a number of reasons. Since life habits Taking medicine To the consequence of the disorder of other health problems, the common cause of low blood pressure.May come from
- heredity May contribute to hypotension in the offspring if parents are found to have hypertension Which is likely to be inherited
- age Blood pressure will vary from day to day.Usually it tends to rise with older age.
- Taking medicine Certain medications can cause hypotension, such as diuretics, beta blockers, which treat heart disease. Parkinson’s disease medications Tricyclic Antidepressants (TCA) Drugs to treat erectile dysfunction. In some cases, it is more likely that other drugs are taken in combination with drugs, alcohol, or high blood pressure medications.
- Dehydration When the body is lostSwim a lot Such as the excretion of water through the skin in the form of sweating, vomiting or diarrhea.
- Illness or health problems Congenital diseases, disorders that occur with the body Or a condition that requires prolonged rest in bed May lead to lower blood pressure such as
- Anemia Caused by the amount of hemoglobin (Hemoglobin) that is an important substance in the blood is lower than normal or a small number of red blood cells. Due to the large blood loss from severe injury Dehydration and electrolysis Internal bleeding Can result in low blood pressure
- Abnormalities related to the work of the heart Such as bradycardia (Bradycardia) a heart valve problem Acute myocardial infarction Heart failure As a result, the heart is unable to pump the amount of blood that the body needs.
- Autonomic nervous system disorders People with disorders or diseases related to the autonomic nervous system (Autonomic Nervous System), which controls many functions within the body. And control the width and narrow of blood vessels May result in low blood pressure conditions such as Parkinson’s disease.
- Problems with the endocrine system Such as hypothyroidism Impaired adrenal glands Low blood sugar levels, orIn some cases, it may be from diabetes.
- Miscommunication between the heart and brain May cause some types of hypotension. Neurally Mediated Hypotension is an arterial hypotension caused by prolonged standing. Causing the body to send a signal to the brain that hypertension is too high But actually the body has low blood pressure. As a result, the brain commands the heart to slow down the heart rate. The blood pressure is lower than before.
- Severe injury or shock Low blood pressure can be caused by severe injury andWound up Especially those who lost large amounts of blood. In some cases, shock was due to serious injury. Can cause low pressure It is also caused by severe infections. Or severe allergic reactions such as
- Severe sepsis in the blood stream (Septic Shock / Toxic Shock Syndrome) is caused by a bacterial infection entering the bloodstream. Causing fluid in the body to flow from the blood vessels into the surrounding tissues
- Allergic shock (Anaphylactic Shock) is an acute allergic reaction. Causes the body to produce a chemical called histamine in large quantities, causing breathing problems, hives, itching, swelling of the throat, as well as a rapid drop in blood pressure.
- Cardiogenic shock causes the heart to not pump enough blood to the body. It usually occurs in acute myocardial infarction.
Also, normal blood pressure can change throughout the day. This will depend on many factors such as current activities, stress, food temperature, time of the day. All affect the blood pressure values
Diagnosis of low blood pressure
It is important to know the type and severity of the hypotension the patient has. This includes conditions that may be associated with low blood pressure. For accurate treatment planning
Usually your doctor will ask about your medical history. Abnormal symptoms that occur General physical examination Then the patient’s blood pressure will be checked that it is normal or not. And check for shock Which is a rather dangerous condition
In addition, in cases with severe symptoms Has symptoms recurring And taking care in the first place does not improve symptomsAdditional investigations may be required according to the patient’s condition. And the doctor’s discretion to determine the cause, such as
- Blood Tests The examination process is short and simple. The patient will lie or sit. To collect blood samples for laboratory testing Which makes information about many parts of the blood Including anemia Or low blood sugar levels Which is one of the reasons that can lead to low blood
- Cardiac autonomic nervous system examination with adjustable bed (Tilt Table Test) The doctor will place the patient on a dedicated examination table designed to adjust the slope. To monitor the patient’s blood pressure while changing posture.
- Electrocardiogram (Electrocardiogram: EKG) Testing of the heart’s electrical signals for each heart rhythm that they are regular or irregular.
- 24-hour ECG recording (Holter and Event Monitors) It is a record of the work of the heart throughout the period of 24 hours.With machineSmall and easy to carry. Thus allowing the patient to perform other activities normally so that abnormalities are easily detected.
- Heart performance check while exercising (Stress Test) This is to check the work of the heart while exercising. This is because some heart abnormalities are easily detected when the heart is working harder and pumping more. Which is stimulated by exercise
- Autonomic Nervous System Examination It is a measure of changes in the heart rhythm during certain activities. To measure the change in blood pressure, for example while the patient takes a deep breath Or dip your handsInto cold water
- 24 Hour Urine Test The doctor will have the patient collect urine during a 24-hour period in a packaged container before returning it to the doctor. To be used for laboratory analysis In the meantime, urine should be kept in a cool place.
Treatment of low blood pressure
The aim of treatment is to focus on helping patients regain control of blood pressure and alleviate other symptoms that may have different responses to treatment. According to many factors such as age, health, physical strength or drug use.Depend onIt is mainly related to the type of hypotension and severity of symptoms.
People with mild and healthy hypotension can control their hypotension by following these general guidelines:
- If symptoms are due to low blood pressure Should sit, rest or lie down as soon as symptoms appear. By trying to raise your feet higher than heart level
- Moving physically regularly Especially in the morning of the day To increase the heart rate in which blood is pumped throughout the body, such as stretching every morning before getting up to do other activities of the day, may include twisting, etc.
- Avoid standing tFor a long time To prevent hypotension caused by poor communication between the heart and brain (Neutrally Mediated Hypotension).
- Wear socks that help increase pressure (Support Stockings / Compression Stockings), which are socks made of stretch fabric. Flexible and tight To help the circulatory system and increase blood pressure But should consult a doctor before use Because it may not be suitable for all patients
- Do not drink caffeinated beverages at night. And limit the consumption of alcoholic beverages Because it may induce more hypotension
- Avoid eating one large meal. But should share the food little by little in each meal
But in the event that the patient has hypotension due to severe injury or shock. It is necessary to get a saline solution and get the cause urgently from a doctor. Including patients who have severe symptoms and are persistent, they should see a doctor. To receive the correct treatment by additional methods such as
- Saline administration (IV Fluids) Patients with hypotension due to dehydration and electrolysis, loss of blood, or sepsis. Intravenous fluids may be given to help raise blood pressure.
- Treat the cause of low blood pressure If your doctor suspects that low blood pressure is due to a disorder or underlying disease Patients may need additional investigations and specific treatment for the specific disease, such as those with abnormal hormonal hypotension. May need to be examined by a hormone specialist. And treatment with hormone replacement therapy
- Drug treatment If suggested behavioral therapy and intravenous administration do not relieve symptoms. The doctor will decide which drug group should be appropriate for the patient based on the cause of blood pressure. Which can be treated with many groups of drugs such as
- Alpha adrenergic receptor agonists Improves blood pressure And reduce symptoms from low blood pressure
- Steroid Help prevent the loss of minerals in the body. Increased fluid intake and blood pressure
- Drugs to increase blood pressure (Vasopressors) It works to squeeze the blood vessels smaller Increased blood flow to the brain And reduce symptoms from other low blood pressure conditions
- Antidiuretic hormone drugs (Antidiuretic Hormone) Help control blood pressure and reduce frequent waking up to urinate in the middle of the night.
- Antiparkinson Drugs Helps to raise blood pressure and reduce symptoms from other low blood pressure.
ComplicationsOf low blood pressure
Mild hypotension may pose the greatest risk of falls. And can be so severe that the hip fracture or spinal fracture Especially in the elderly And as a result, the ability to move more difficult Having additional health problems
But in patients with lower pressure that causes severe symptomsmayCausing the body to lack oxygen causing damage to the heart, brain or other organs And may lead to death if not treated in time.
Prevention of low blood pressure
Each type of hypotension has a different cause. Prevention may not be able to do its best. But can help reduce the risk by following the recommendations below.
- Drink enough clean water each day. To prevent dehydration and increase the blood volume
- Avoid drinking alcohol Because it may cause the body to lose more water
- Choose foods that are wholesome and complete with nutrients. Focus on fruits and vegetables, whole grains, lean meats.
- Getting up or sitting down shouldn’t change your posture too quickly.
- Check blood pressure regularly.
- Eat the right amount of food at each meal. Eat several smaller meals and avoid high carbohydrate foods such as potatoes, rice, pasta and large amounts of bread to prevent a sudden drop in blood pressure.After pick upFood