What are the other names for this Condition? (Also known as/Synonyms)

• Low Blood Pressure

What is Hypotension? (Definition/Background Information)

• Hypotension (or Low Blood Pressure) is a condition that occurs when one’s blood pressure is abnormally low. It is defined as having a blood pressure that is lower than 90/60 mmHg. Due to the reduced blood pressure in Hypotension, different parts of the body may not receive adequate blood supply
• Blood pressure refers to the force that is exerted on the arteries by blood. This force is generated by the pumping of blood by the heart. The normal blood pressure of an individual is around 120/80 mmHg
• There are three main types of Hypotension:
  • Orthostatic Hypotension: It occurs after a sudden change in one’s body position
  • Postprandial Hypotension: It is type of Orthostatic Hypotension that occurs after a meal
  • Neurally-Mediated Hypotension: It occurs when there is a miscommunication between the brain and heart
• The risk factors for Hypotension include the use of certain medications, diseases and disorders, and heart conditions. Hypotension can also be caused by dehydration and old age among other factors
• The signs and symptoms of Hypotension include dizziness, confusion, and blurry vision. Severe Low Blood Pressure can cause organ damage from oxygen deprivation
• The treatment of Hypotension includes addressing the underlying cause of the condition, increasing salt and water intake, and the administration of certain medications. The prognosis for Hypotension is usually excellent with treatment

Who gets Hypotension? (Age and Sex Distribution)

• Hypotension can be generally seen across a wide age group affecting both males and females
  • Adults over the age of 65 are more likely to develop Orthostatic and Postprandial Hypotension
  • Children and young adults are more likely to be affected by Neurally-Mediated Hypotension
• It can affect people of all racial and ethnic backgrounds

What are the Risk Factors for Hypotension? (Predisposing Factors)

The general risk factors for Hypotension may include:

• Use of medications for high blood pressure
• Use of diuretics (water pills)
• Conditions such as Parkinson’s disease, diabetes, and some heart conditions
• Being immobile for long periods
• Pregnancy
• Being outdoors, exposed to hot weather for an extended period of time

Additional risk factors for Orthostatic Hypotension include:

• Heart conditions such as heart attack, heart valve disease, bradycardia (very low heart rate), and heart failure
• Anemia - low levels of hemoglobin in blood
• Severe infection or untreated infections can increase the risk
• Thyroid disorders: Untreated thyroid disorders can increase the risk for Hypotension
• Uncontrolled diabetes
• Pulmonary embolisms (clots in the lung)
• Medications such as calcium channel blockers, angiotensin II receptor blockers, beta blockers, and nitrates
• Anxiety and depression medication

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hypotension? (Etiology)

The cause of Hypotension can vary and is dependent upon the subtype of Hypotension.

• Orthostatic Hypotension may be caused by:
  • Dehydration; when the body loses excess water than it takes in
  • Age: Older adults generally cannot manage blood pressure changes as well as younger adults
• Postprandial Hypotension may be caused by:
  • A lot of blood goes to the intestines after eating a meal in order to digest the food that was consumed
  • A constriction (tightening) of blood vessels and increased heart rate follow this, in order to maintain blood pressure
  • In older adults, this mechanism does not work as well as it should, leading to a drop in blood pressure
• Neurally-Mediated Hypotension may be caused by:
  • Poor communication between the brain and body on blood pressure levels
  • The brain slows the heart rate in order to stabilize the blood pressure

Additionally, Hypotension has been linked with shock. Shock occurs when blood pressure levels drop abnormally and is unable to return to normal levels. Shock is a medical emergency and needs to be treated immediately. It may occur when:

• Bacteria enter the bloodstream and release a toxin such as during a septic shock
• The body loses a large amount of blood or fluid, termed hypovolemic shock
• Heart defects or abnormalities that lead to decreased blood pumping, termed cardiogenic shock
• Relaxation of the arteries (vasodilatory shock)

What are the Signs and Symptoms of Hypotension?

The signs and symptoms of Hypotension may include:

• Dizziness, lightheadedness, and fainting
• Blurry vision
• Confusion
• Weakness
• Fatigue and sleepiness
• Nausea and vomiting

The signs and symptoms of any underlying condition may be observed.

How is Hypotension Diagnosed?

Hypotension may be diagnosed by the following tools:

• Thorough analysis of medical history and complete physical exam
• Checking the vital signs including the temperature, pulse rate, rate of breathing, and blood pressure
• Basic metabolic panel blood test: The test measures sugar and electrolyte levels, as well as fluid balance and kidney function
• Blood cultures for infection
• Urinalysis by testing of urine samples
• Electrocardiogram (ECG): It is a test used to detect the electrical activity of heart
• Echocardiography: It is a test that helps create a motion picture of the heart through sound waves

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hypotension?

The complications from Hypotension may include:

• Physical injury (through falls) caused by dizziness, weakness, or fainting
• Potential organ damage due to oxygen starvation: A severe drop in blood pressure will prevent oxygenated blood from reaching vital organs
• Heart attack
• Stroke
• Kidney failure

How is Hypotension Treated?

Diagnosing and establishing the underlying cause and treating the source of Hypotension is the first step towards treating the condition. Hypotension may be treated through the following measures:

• Hypotension caused by medications is treated by altering the dosage or discontinuing the particular medicines
• Using more salt in one’s diet
• Drinking sufficient quantities of water and other fluids to prevent dehydration
• Use of compression stockings to prevent blood pooling
• Fludrocortisone: It is a drug that increases the volume of blood in the body
• Use of vasopressor/antihypotensive agents, such as midodrine, to prevent the blood vessels from expanding

How can Hypotension be Prevented?

The following steps may be considered in preventing some cases of Hypotension:

• Drinking more fluids to increase blood volume
• Getting up slowly after lying down or after being seated, if one has Orthostatic Hypotension
• Avoiding standing for long periods of time
• Avoidance of alcohol
• Using compression stockings to improve blood flow

What is the Prognosis of Hypotension? (Outcomes/Resolutions)

• The prognosis for Hypotension is generally good, since the condition can be treated successfully in most cases
• Many individuals with the condition can lead normal healthy lives following treatment
• Some severe cases of Hypotension may require immediate medical intervention to prevent potential organ damage

Additional Relevant Useful Information for Hypotension:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/heart-center/