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Hypotension, also known as low blood pressure, is when your blood pressure is lower than 90 for the top number (systolic) or 60 for the bottom number (diastolic). Low blood pressure can occur by itself or as a side effect from other health conditions.

When you get a blood pressure reading, it will appear as two numbers. Systolic blood pressure, the top number, is the pressure inside your arteries as blood flows through them after your heart beats. Diastolic blood pressure is the pressure in the arteries when your heart is at rest between beats. Normally, these numbers should be 120/80 or very close to it.¹

Types of Low Blood Pressure

There are several forms of hypotension based on the cause of it:^2,3

• Orthostatic: This is the most common form of hypotension, and it is caused after you stand after sitting or lying down. As you stand, you might get a headache or feel dizzy. Older age, pregnancy, Parkinson’s, and diabetes are risk factors for orthostatic hypotension. Older adults are the most at risk for this type of low blood pressure.
• Postprandial: Eating is what causes low blood pressure in postprandial hypotension. Older adults and individuals with autonomic dysfunction are more at risk for this type of low blood pressure.
• Neurally mediated: This type of hypotension occurs when there is an imbalance between the heart and the brain. It can occur after standing for a long period of time or when you have a strong emotional response such as being shocked or scared from an incident such as surgery.
• Severe hypotension: Hypotension from shock after a big event, such as an injury or infection.
• Shy-dander syndrome. Also known as multiple system atrophy with orthostatic hypotension, this is a rare nervous system disorder that affects involuntary functions such as heart rate, blood pressure, and breathing. Blood pressure levels will fluctuate and often change when someone lies down.

Causes of Hypotension

There are a few medical conditions that can be the cause of hypotension, including:^3,4

• Pregnancy. Many women within the first 24 weeks of pregnancy experience low blood pressure due to the changes in the blood vessels.
• Dehydration. Water is important for stabilizing the amount of blood in the body. When there isn’t enough water in the body, blood volume will drop. Dehydration can be caused by a lack of fluids, fevers, strenuous exercise, and vomiting, as well as medical conditions.
• Endocrine disorders. Endocrine disorders can cause a change in hormonal balance when they affect the parathyroid or adrenal glands. Addison’s disease, diabetes, and low blood sugar can all cause hypotension.
• Blood loss. Blood loss from surgery, an injury, internal bleeding, or major trauma can have a significant impact on blood pressure levels.
• Heart/valve conditions. Heart conditions such as heart attacks or heart failure may affect the body’s ability to circulate blood.
• Diet imbalance. Vitamin B-12, folate, and iron protect the body against anemia, a condition that can lower your blood pressure.
• Medications. Medications that are diuretics and treat high blood pressure can cause low blood pressure. Other drugs linked to hypotension include medications for Parkinson's disease, heart medications that are beta-blockers, alpha-blockers, antidepressants, erectile dysfunction drugs (specifically ones in combination with nitroglycerine), and water pills. Some over-the-counter medications may also affect blood pressure levels.
• Allergic reactions. A severe allergic reaction can cause blood pressure to lower. This usually occurs in people who have severe reactions to medications or animals such as bees. The reaction will usually be accompanied by hives, breathing difficulties, and itching.
• Septic shock (severe infection): When bacteria gets into the bloodstream, it can produce toxins that affect the blood vessels and lowers blood pressure.

Symptoms of Low Blood Pressure

Generally, there are no noticeable symptoms of low blood pressure, and many people don’t know they actually have an issue with it.

However, noticeable symptoms of hypotension include:⁵

• Dizziness
• Light-headedness
• Balance
• Blurred vision
• Confusion
• Heart palpitations
• Unsteadiness
• Nausea

Risk Factors

Some risk factors that increase your chance of hypotension include:⁶

• Age. 10-25% of seniors over 65 are estimated to have hypotension.
• Medications. Certain medications can put someone more at risk for low blood pressure.
• Medical conditions. Diabetes, Parkinson’s, and other medical conditions increase the chance of hypotension.

When to See a Doctor

Doctors generally recommend to rest and drink water if you experience symptoms of hypotension. You should avoid moving around when you have low blood pressure because you could be at risk for falls or injuries.

Usually, a single low blood pressure reading is not an immediate cause of concern. A doctor will monitor your blood pressure and check that it isn’t a recurring problem.

However, if you experience other medical concerns or problems, hypotension may be the sign of a larger medical issue. You should speak to your doctor if you want to know what causes low blood pressure in your case.

Extreme hypotension reactions that lead to shock, nausea, shallow breathing, or confusion should be taken to an emergency room immediately. Extreme hypotension can be deadly if left untreated.⁶

Treatments for Hypotension

Treatments for hypotension include:⁷

• Drink water
• Eat less salt
• Avoid alcohol
• Change prescription medications
• Get medications such as Fludrocortisone to treat low blood pressure
• Exercise regularly
• Avoid standing still for long periods
• Avoid hot water in showers or spas

Know the Warning Signs of Hypotension

If you suspect that you or a loved one has severe hypotension, contact your doctor for more information. They will be able to guide you and let you know the proper steps for treating low blood pressure.

To learn more about Saber Healthcare and the nursing and rehabilitation we provide, check out our locations and services we offer.

Saber Healthcare is an organization dedicated to providing consultant services to long-term care providers. This article is for informational purposes and is not meant to be seen as professional advice. Please consult with a medical expert before relying on the information provided.

Sources

1. Beckerman, James. “Understanding Low Blood Pressure -- the Basics.” WebMD. 14 June 2021. Accessed 30 August 2022. Link: https://www.webmd.com/heart/understanding-low-blood-pressure-basics
2. Erica Roth and C. Guthrie. Bernstein, Adam, ed. “Everything You Need to Know About Low Blood Pressure.” Red Ventures, Healthline Media. 22 November 2021. Accessed 31 August 2022. Link: https://www.healthline.com/health/hypotension
3. “Low Blood Pressure (Hypotension).” Mayo Foundation for Medical Education and Research (MFMER). 14 May 2022. Accessed 30 August 2022. Link: https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/symptoms-causes/syc-20355465
4. “Low Blood Pressure - When Blood Pressure Is Too Low.” American Heart Association. Last reviewed 31 October 2016. Accessed 31 August 2022. Link: https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/low-blood-pressure-when-blood-pressure-is-too-low
5. “Low blood pressure, also known as hypotension, is when you have a blood pressure level that is below the normal range.” Blood Pressure UK. Accessed 31 August 2022. Link: https://www.bloodpressureuk.org/your-blood-pressure/understanding-your-blood-pressure/what-is-low-blood-pressure/
6. “Hypotension (Low Blood Pressure).” Mercury Health. Accessed 31 August 2022. Link: https://www.mercy.com/health-care-services/heart-vascular/conditions/low-blood-pressure
7. Beckerman, James. “Understanding Low Blood Pressure -- Diagnosis and Treatment.” WebMD. 14 June 2021. Accessed 31 August 2022. Link: https://www.webmd.com/heart/understanding-low-blood-pressure-treatment