Exams And Tests For Low Blood Pressure
The key to diagnosis is a good history and physical examination. If low blood pressure is found incidentally and no other symptoms exist, then documenting the lower readings will help remind the healthcare provider during future visits.
If the patient is symptomatic, documenting risk factors and exploring potential causes requires a detailed history of the situation for example:
- when symptoms occur,
- associated complaints, and
- a thorough review of past illnesses and medications.
Physical examination may include postural vital signs. The patient has the blood pressure and pulse rate taken when laying flat and again when standing . If the blood pressure drops or the pulse rate increases, it may be an indicator of decreased intravascular volume from dehydration or bleeding. The rest of the examination will likely be directed by clues from the history, but may include palpation of the thyroid gland in the neck, listening to the heart and lungs, and examination of the abdomen and the extremities.
Blood tests may be done, again directed by findings in the history and physical examination.
An electrocardiogram may be performed if the low blood pressure is thought to originate in the heart or if there is chest pain or shortness of breath associated with the low pressure.
Consideration for further testing will depend upon the potential underlying cause of low blood pressure.
Usually, low blood pressure with no symptoms requires little intervention.
Orthostatic Hypotension And Low Blood Pressure
When standing quickly, it may take a second or two for the body to make adjustments to constrict blood vessels and push blood up to the brain. If there is a delay, then this time of relative low blood pressure may cause symptoms. It can be exacerbated or seen more often in patients who are pregnant, have diabetes, are dehydrated, or taking high blood pressure medications.
When To Contact A Doctor
Anyone who experiences worrying symptoms of shock should seek emergency medical attention.
People who experience mild but uncomfortable symptoms of low blood pressure may also want to talk with their doctor to discuss treatment options.
Anyone uncertain or uncomfortable about symptoms such as low blood pressure and high heart rate should see a doctor as well. A full diagnosis can help bring peace of mind and identify any underlying issues.
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How Can You Prevent Low Blood Pressure
You may be able to prevent hypotension by making changes to your lifestyle and diet, such as:
- Eating fewer carbohydrates and choosing small, healthy meals.
- Staying hydrated and avoiding alcoholic drinks.
- Rising slowly when youve been sitting or lying down.
- Taking a few deep breaths before you change position.
- Wearing compression stockings.
Is Low Blood Pressure A Problem
For some people, low blood pressure is a sign of good health. These are generally people who are very fit and who have a slow pulse. For other people, low blood pressure is a problem.
Often, people with low blood pressure can be expected to lead longer lives.
However, people who experience continuing symptoms of low blood pressure should see a doctor. Sudden, severe low blood pressure can be associated with serious medical conditions.
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When Blood Pressure Drops Too Low
Sometimes your blood pressure can fall beyond what’s expected after exercise. This can happen for a variety of reasons.
The type and duration of the exercise, how much water you lose through sweat and whether you exercise in the heat are factors that can lead to a drop in blood pressure. Rehydrating, particularly when exercising in hot and humid conditions, can make you less vulnerable, according to the Hemodynamics of Hypertension report.
But if your blood pressure frequently drops when you go from lying down to sitting up or from sitting to standing, you may have what’s called orthostatic or postural hypotension.
Age may be a cause of postural hypotension. When you sit or stand, blood pools in the legs they act like reservoirs. “As we get older, the system that sends blood back up slows down it’s not as efficient as it used to be, so you might feel dizzy while it’s adjusting,” says John A. Osborne, MD, PhD, a cardiologist who specializes in hypertension and preventive cardiology and medical director of State of the Heart Cardiology in Southlake, Texas. Your cooldown should help your body adjust.
The effect can be even more pronounced if you’re on more than one medication, such as an ACE inhibitor and a diuretic. That combination plus the natural drop in blood pressure from exercise can leave you feeling dizzy and even faint. That 5-to-10-minute cooldown after each and every exercise session becomes even more essential, according to the American Council on Exercise.
Low Blood Pressure And The Arterial Wall
The space within the intravascular space is variable, based upon the muscle tension in the walls of the arteries. Adrenalin increases tension and causes the arteries to narrow and support blood pressure. Acetylcholine dilates blood vessels and will lower pressure. Normally, the two are in balance.
- Loss of the sympathetic tone may occur with injuries to the spine and damage to the sympathetic trunk, resulting in dilation of the blood vessels and lowered blood pressure.
- Over stimulation of the vagus nerve can cause dilation of the blood vessels as well. A temporary, self-limiting situation called vasovagal syncope is often seen when a patient receives a noxious stimulus. This can be physical, like a broken bone, or emotional like a medical student seeing their first operation.
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Signs And Symptoms Of Hypertension
Often, kids and teens with pre-hypertension or stage 1 hypertension wont show any symptoms at all. If your child has stage 2 hypertension, she might experience one or more of the following symptoms:
- headaches
- abdominal pain
- breathing problems
An infant with stage 2 hypertension may seem irritable, not be feeding properly, or vomiting. Sometimes these infants are diagnosed with failure to thrive.
Changing The Body’s Position
Blood pressure can vary throughout the body due to the direct action of gravity. When a person is standing, blood pressure is higher in the legs than in the head, much in the way that the water pressure at the bottom of a swimming pool is higher than that at the top. When a person lies down, blood pressure tends to be more equal throughout the body.
When a person stands up, blood from the veins in the legs has a harder time getting back to the heart. As a result, the heart has less blood to pump out, and blood pressure may temporarily drop throughout the body. When a person sits down or lies down, blood can more easily return to the heart, and cardiac output and blood pressure may increase. Elevating the legs above the level of the heart can increase return of blood to the heart, which increases cardiac output and raises blood pressure.
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How Is The Mean Arterial Pressure Regulated
Mean arterial pressure is regulated by changes in cardiac output and systemic vascular resistance, which refers to the resistance to blood flow by all of the systemic vasculature. Systemic vasculature includes vessels and capillaries.
Cardiac output is determined by stroke volume and heart rate. Stroke volume is determined by an agent that can alter the force of muscular contractions. It is also impacted by the effects of what cardiac specialists refer to as afterload on stroke volume. If there are changes in the volume of blood, it can alter the afterload. Afterload is something that can happen as we age. Stiff and thick arteries are more common in seniors due to degeneration, so there is less contraction in the ventricle. When stroke volume decreases, less blood is being injected from the heart with each contraction.
Renal function, including the handling of sodium and water, can also impact blood volume. Additionally, there are situations where the diameter of vessels can change, having an impact on cardiac output too.
The ability of a blood vessel wall to expand and contract with changes in pressure is an important feature of arteries and veins.
When Low Blood Pressure Is An Emergency
If you frequently experience symptoms of low blood pressure, such as dizziness or fainting spells, you should consult a doctor. While low blood pressure, itself, usually isn’t fatal, there are serious medical situations where it is considered an emergency, and you should go to the hospital.
“The likelihood of dying from low blood pressure is low unless it is related to another disease process,” Weinberg says.
For example, a blood infection, or , can result in low blood pressure. Sepsis occurs when the chemicals released by the body to fight an infection trigger widespread inflammation, resulting in blood clotting that reduces blood flow to vital organs, such as your heart, kidneys, and brain. This can progress to septic shock and very low blood pressure, which may be fatal, and should be treated immediately.
Low blood pressure can also be affiliated with Addison’s disease a disorder in which the adrenal glands do not produce enough cortisol, a hormone that helps your body respond to stress. Lack of cortisol production can cause addisonian crisis, which is characterized by low blood pressure and can be fatal without proper treatment.
The treatment for low blood pressure varies depending on the cause. In severe cases, someone might need intravenous therapy to deliver fluids into the veins and raise blood pressure. In critical situations, such as septic shock, doctors may use drug therapies either orally or through an IV to quickly raise blood pressure.
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What Is Low Diastolic Blood Pressure
Your blood pressure is the force inside your blood vessels when your heart beats and relaxes. This force is measured in millimeters of mercury and is represented as two numbers.
The upper number, called your systolic pressure, is measured when your heart beats. The lower number, called your diastolic pressure, is measured when your heart relaxes between beats.
High blood pressure can increase your risk of heart disease or stroke, but low blood pressure can also be a problem.
The medical term for low blood pressure is hypotension. If you have hypotension, your systolic pressure measurement is under 90 mm Hg and your diastolic number is under 60 mm Hg. Doctors have started to raise concerns specifically about diastolic blood pressure below 60.
Some people can have low diastolic pressure even when their systolic pressure is typical. This condition is called isolated diastolic hypotension. Low diastolic blood pressure may be particularly dangerous for your heart.
Unlike the rest of your body, which receives blood when your heart pumps, the muscles of your heart receive blood when your heart relaxes.
If your diastolic blood pressure is too low, your heart muscles wont get enough oxygenated blood. This can lead to weakening of your heart, a condition called diastolic heart failure.
You may be at higher risk of this type of heart failure if you have coronary heart disease, which is narrowing of your heart arteries.
Heart Disease & Hypotension
Although each and every individual will, at some point in their lives, experience a drop in blood pressure for one reason or another, certain conditions can cause prolonged periods of hypotension that can become dangerous if left untreated. Unfortunately, there are several types of heart problems that may cause low blood pressure, in addition to other more widely associated symptoms of heart disease.
Low blood pressure may be a potential complication of the following heart conditions:
As a consequence of the aforementioned medical issues, a patients heart may not be able to circulate enough blood to meet your bodys needs, provoking low blood pressure.
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Postural Or Orthostatic Hypotension
Postural or orthostatic hypotension occurs when your blood pressure falls after a sudden movement. For example, you may feel dizzy or faint after changing posture, such as sitting up from a lying position, or standing up from a sitting position. This may cause you to lose your balance and fall over. You may also feel light-headed, have blurred vision, or lose consciousness.
The symptoms of postural or orthostatic hypotension should only last a few minutes as your blood pressure adjusts to your new position. This type of low blood pressure tends to affect people more as they get older when it can lead to more frequent falls. Similar symptoms may also occur after exercise.
Symptoms Of Low Blood Pressure In Elderly Individuals
As long as you feel OK, a low blood pressure reading is generally nothing to worry about. Doctors are not usually concerned about a low BP in otherwise healthy individuals.
So, when is blood pressure too low? You should see your healthcare provider if you experience hypotension symptoms such as:
- Dizziness
- Confusion or inability to concentrate
- Nausea
- An irregular or rapid heartbeat
- Weakness
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How Is Low Blood Pressure Diagnosed
Your doctor will ask about your symptoms and take your blood pressure by placing a blood pressure cuff around your upper arm. The cuff will tighten on your arm, and the monitor will measure your systolic and diastolic pressure. A blood pressure reading of 90/60 mm Hg is considered low blood pressure.
Low blood pressure may be a sign of an underlying condition, so your doctor will try to determine what caused your blood pressure to drop. Depending on your medical history and symptoms, your doctor may also check your heart using an echocardiogram, electrocardiogram, or stress test. Your doctor may also perform blood tests to check for:
- Hormonal imbalances.
When To Worry About Low Blood Pressure
We all know that high blood pressure can be dangerous. But what about low blood pressure
Also called hypotension, low blood pressure is not a problem if youre healthy and show no signs or symptoms of the condition. However, abnormally low blood pressure can cause problems such as dizziness and fainting and can be a sign that other serious conditions, such as heart disease, are present.
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Causes Of Overall Low Blood Pressure
There are several common causes of overall hypotension, which would include a low diastolic number.
Medications
- Overtreatment of high blood pressure. For some people, especially people over age 60, lowering systolic blood pressure below 120 may cause diastolic pressure to fall below 60.
- Other medications. Many medications besides those for blood pressure can cause hypotension. They include:
- drugs used to treat erectile dysfunction
Medical conditions
- Heart problems. Heart valve problems, heart failure, and a very slow heart rate can lead to hypotension.
- Dehydration. If you dont take in enough fluids, your blood pressure can fall dangerously low. This may happen if youre taking a diuretic and lose more fluids than you take in.
Treatment for low diastolic blood pressure largely depends on the type of hypotension. Your doctor will assess this closely to determine the appropriate treatment plan.
What Can You Do To Help Relieve Symptoms Of Low Blood Pressure
Depending on the type of low blood pressure you have, you may be able to relieve some of your symptoms by:
- Eating a healthy diet with fewer carbohydrates and smaller meals.
- Drinking more water and avoiding alcohol.
- Getting up slowly after youve been sitting or lying down.
- Focusing on breathing a few times before you change position.
- Wearing compression stockings.
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Diagnosis Of Low Blood Pressure And High Pulse Rate
A condition involving low blood pressure and high pulse rate is often transient in nature and not likely to be diagnosed during a routine doctors visit. However, if it is due to an underlying condition, it may be reproducible through testing or have certain markers that can be identified. The following are various testing modalities that help doctors reach a diagnosis.
- Blood testing: Can provide information about blood constituents, disease markers, and other abnormalities that can affect overall health.
- Electrocardiogram : Measures the electrical activity of the heart and can identify arrhythmia such as atrial fibrillation.Echocardiogram: An imaging test that allows doctors to view the size, shape, and relative function of the heart.
- Cardiac stress test: With the use of a treadmill and ECG, the heart can be stressed to varying degrees, looking for changes in heart rate and blood pressure.
- Tilt table test: Allows for careful measurement of the heart rate and blood pressure in response to varying degrees of tilt while laying down on a table. It is often used to investigate the causes of repeated and unexplained fainting.
What Are The Side Effects Of The Treatment For Low Blood Pressure
There are no side effects for the lifestyle and dietary changes that can treat hypotension.
The medications used to treat hypotension have several side effects, some of which may be serious. Fludrocortisone can make certain infections worse, so its essential to discuss this medication with your doctor. The most common side effects from fludrocortisone are:
- Increased risk of infection.
The most common side effects from midodrine are:
- Numbness or tingling.
- Goosebumps and chills.
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What Can I Do For Myself
There are other things you can do for yourself to help with your symptoms.
- Wear supportive elastic stockings . They put extra pressure on your legs which helps to improve circulation and raise your blood pressure. For some people this can be enough, but speak to your GP first because they arent suitable for everyone.
- Stand up slowly from sitting or lying down. You can try other simple movements to get the blood flowing before you stand up, such as straightening and bending your legs.
- Avoid standing for long periods of time.
- Drink enough water throughout the day, around 2 litres, so you dont get dehydrated.
- Eat little and often throughout the day. This avoids low blood pressure after eating.
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