Hypotension: Causes, Treatments, and Resources
What is Hypotension
Hypotension is categorized as severely low blood pressure. Blood pressure is the strength of blood while it pushes against the arterial walls as blood is pumped out by the heart. Any blood pressure that is lower than 90/60mmHg falls under the classification of hypotension.
Symptoms of Hypotension
The principle symptom of hypotension is dizziness. If blood pressure gets dangerously low, it can cause fainting as well as the onset of seizures. Other symptoms of hypotension include irregular heartbeat, chest pains, headaches, dysuria, dysphagia, upper back and neck pains, severe fatigue, and shortness of breath.
Going from a sitting or lying position to a standing position often brings out symptoms of low blood pressure. The development of lightheadedness, dizziness, or fainting upon standing caused by low blood pressure is called orthostatic hypotension. Normal individuals are able to compensate rapidly for the low pressure created by standing with the responses discussed previously and do not develop orthostatic hypotension.
When there is insufficient blood pressure to deliver blood to the coronary arteries, a person may develop chest pain or even a heart attack.
When insufficient blood is delivered to the kidneys, the kidneys fail to eliminate wastes from the body, for example, urea and creatinine, and increases in their levels in the blood occur.
Shock is a life-threatening condition where persistently low blood pressure causes organs such as kidney(s), liver, heart, lung, and brain to fail rapidly.
Causes of Hypotension
Hypotension can be the result of blood vessels expanding, changes in hormonal balance, side effects of certain medications, for example, medications used to treat men who suffer from erectile dysfunction, endocrine and heart problems, and anemia. Hypovolemia which is a severe decrease in blood plasma volume in the body; decreased cardio output, which can be the cause of bradycardia; myocardial infarction and congestive heart failure; excessive vasodilation; and inadequate restriction of the resistance blood vessels, are other known causes of hypotension.
20 Quick Facts About The Causes of Hypotension
1. Dehydration is common among patients with prolonged nausea, vomiting, and diarrhea.
2. Moderate or severe bleeding can quickly deplete an individual’s body of blood, leading to low blood pressure or orthostatic hypotension.
3. Severe inflammation of organs inside the body such as acute pancreatitis can cause low blood pressure.
4. Weakened heart muscle can cause the heart to fail and reduce the amount of blood it pumps.
5. Pericarditis is an inflammation of the pericardium. Pericarditis can cause fluid to accumulate within the pericardium and compress the heart, restricting the ability of the heart to fill and pump blood.
6. Pulmonary embolism is a condition in which a blood clot in a vein breaks off and travels to the heart and eventually the lung.
7. Bradycardia can decrease the amount of blood pumped by the heart.
8. An abnormally fast heart rate (tachycardia) also can cause low blood pressure.
9 . Medications such as calcium channel blockers, beta blockers, and digoxin (Lanoxin) can slow the rate at which the heart contracts.
10. Medications used in treating high blood pressure can excessively lower blood pressure and result in symptomatic low blood pressure especially among the elderly.
11. Water pills such as hydrochlorothiazide furosemide can decrease blood volume by causing excessive urination.
12. Medications used for treating depression, such as amitriptyline, Parkinson’s disease, such as levodopa-carbidopa, erectile dysfunction, such as sildenafil, vardenafil, and tadalafil when used in combination with nitroglycerine, can cause low blood pressure.
13. Alcohol and narcotics also can cause low blood pressure.
14. Vasovagal reaction is a common condition in which a healthy person temporarily develops low blood pressure, slow heart rate, and sometimes fainting.
15. Postural hypotension is a sudden drop in blood pressure when an individual stands up from a sitting, squatting, or supine position.
16. Micturition syncope is a temporary drop in blood pressure and loss of consciousness brought about by urinating.
17. Adrenal insufficiency, for example, due to Addison’s disease, can cause low blood pressure.
18. Septicemia is a severe infection in which bacteria enter the blood.
19. Anaphylaxis is a potentially fatal allergic reaction to medications such as penicillin, intravenous iodine used in some X-ray studies, foods such as peanuts, or bee stings
20. Another form of postural hypotension occurs typically in young healthy individuals. After prolonged standing, the individual’s heart rate and blood pressure drop, causing dizziness, nausea, and often fainting.
Treatments for Hypotension
For individuals suffering from hypotension, there are many treatments available that can assist with the elevation of blood pressure. The treatment recommended by medical professionals depends on the cause of hypotension. Individuals who suffer from asymptomatic hypotension, low blood pressure that does not carry symptoms, rarely need treatment. If it is not asymptomatic, meaning that symptoms are present in an individual, then the treatment depends on the root underlying cause of hypotension.
If a medical professional is unable to determine a cause of hypotension, medications are often prescribed to raise an individual’s blood pressure level. One medication that is used is fludrocortisone, especially in instances of postural hypotension when low blood pressure occurs after an individual stands up after lying down or sitting down for an extended period of time. Fludrocortisone is classified in the mineralcorticoid family of drugs, known for increasing plasma volume and extracellular fluid and sensitizes blood vessels to the vasoconstrictive effect of norepinephrine. Other medications that are prescribed on their own or in arrangement with other medications to raise blood pressure include midodrine, pyridostigmine, nonsteroidal anti-inflammatory medications, and erythropoietin.
If hypotension is caused by a harsh allergic reaction, known as anaphylaxis, epinephrine is given to the individual to elevate blood pressure. Epinephrine expands the breathing tubes and compresses blood vessels, increasing blood pressure. In more serious cases of anaphylaxis, individuals may be admitted to an emergency room to monitor their blood pressure and get breathing support to further open up breathing tubes.
If blood pressure is the cause of hypotension, than the treatment of choice is to give the individual a blood transfusion to try to raise blood pressure. If hypotension is caused by sepsis, the treatment to be given is through intravenous fluid and antibiotics as soon as possible. Intravenous methods are used to eliminate bacteria and elevate blood pressure.
Another treatment used to increase blood pressure in individuals suffering from hypotension is just to change certain lifestyle habits. First of all, drink at least eight glasses of water every day. Water can elevate blood pressure because the addition of water increases the volume of blood in an individual’s body and can prevent dehydration, which can lead to hypotension. Second of all, an individual should increase the amount of salt in their diet. This is especially beneficial for individuals who have hypotension without an underlying cause. However, older individuals should speak with a medical professional prior to increasing salt intake because it can cause heart failure. Third, eat smaller meal portions. If an individual experiences hypotension after a meal, then having smaller portions can decrease the likelihood of hypotension. Decreasing the quantity of carbohydrates eaten daily can also prevent the onset of hypotension as meals that are low in carbohydrates create smaller declines in systolic blood pressure. Another treatment that is also beneficial for individuals suffering from asymptomatic hypotension is drinking a caffeinated beverage to elevate blood pressure. However, as this can cause health problems in the future, it is not recommended as an ongoing treatment. Lastly, avoid alcoholic beverages. The ingredients in alcoholic beverages lower blood pressure and can cause hypotension.
Resources about Hypotension
MediniceNet information about hypotension
Mayo Clinic: Low blood pressure (hypotension)
NIH.gove
What Is Hypotension?: Hypotension (HI-po-TEN-shun) is abnormally low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.
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