While there are more discussions around hypertension or high blood pressure, given its direct association with cardiovascular risks, we ought to consider hypotension, commonly known as low blood pressure (BP), too. This is a medical condition where the force of blood against the walls of your arteries is lower than normal and can trigger several health complications.

Systolic pressure is the top number in your blood pressure monitor. This indicates the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number, showing the pressure in your arteries while your heart is filling with blood. If your BP is 120/80 millimeters of mercury (mm Hg) or lower, it’s considered normal. When this reading goes below 90/60 mm Hg, a person is said to have hypotension. Low BP can reduce the supply of oxygen and nutrients to your brain and other essential organs and send the body into a shock.

What are the causes of low BP?

1) Not many know this but dehydration is a common cause as insufficient fluid intake can lead to reduced blood volume, causing a drop in BP.

2) Heart problems such as extremely low heart rate (bradycardia), heart valve issues or a recent heart attack can also lead to low BP.

3) Endocrine issues like adrenal insufficiency, thyroid disorders and low blood sugar levels (hypoglycemia) can cause hypotension.

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4) Severe infections, known as septicemia, can cause a sudden drop in BP, leading to septic shock. Blood loss due to injury, surgery, or internal bleeding can rapidly reduce blood volume and cause low BP.

5) Certain medications like antidepressants, diuretics, and alpha-blockers can also lower BP.

6) Neurological disorders such as Parkinson’s disease, multiple system atrophy, and autonomic neuropathy can affect the body’s ability to regulate BP.

What are the signs and symptoms?

Symptoms can vary but often include dizziness or lightheadedness, especially when standing up from a sitting or lying position (orthostatic hypotension). Fainting can also occur. Other symptoms may include blurred vision, fatigue, nausea, lack of concentration, cold and clammy skin, and rapid or shallow breathing.

How to manage hypotension?

1. Hydration: Drinking an adequate amount of water daily to avoid dehydration, a known trigger.

2. Balanced diet: Consuming a diet rich in fruits, vegetables, lean proteins and whole grains can contribute to overall cardiovascular health.

3. Avoid alcohol: Excessive alcohol consumption can lead to dehydration and lower BP.

4. Gradual position changes: When moving from a lying or sitting position to a standing one, be slow and steady to prevent orthostatic hypotension.

5. Compression stockings: These can help prevent blood from pooling in the legs and reduce orthostatic hypotension symptoms.

6. Medication adjustment: If low BP is due to medications, your healthcare provider may adjust your dosage or prescribe alternative medications.

7. Medical treatments: In severe cases, intravenous fluids, medications to increase blood pressure, or other interventions may be necessary.

What if you have a sudden drop from high BP to low BP?

A sudden drop from high BP to low BP, often termed as a “BP crash,” can occur due to various reasons. Abruptly stopping certain high BP medications can cause a rapid drop in BP. Prolonged high BP can lead to fluid loss, causing a sudden decrease in blood volume and BP. Conditions like septicemia or anaphylaxis can also cause a sudden drop in BP, leading to shock.

Symptoms include severe dizziness, fainting, confusion, rapid or weak pulse and a cold, clammy skin.

Assess the person’s vital signs and level of consciousness, position them flat with elevated legs if possible and call emergency medical services if needed. Continuously monitor their BP, pulse rate and breathing while providing comfort and reassurance. Inform medical responders about any potential causes or recent changes in medications. Follow medical instructions and seek post-emergency follow-up for further evaluation and management.