Low blood pressure (hypotension) is usually harmless and not an expression of serious diseases. Typical complaints here are mostly cold feet and hands, dizziness and fatigue. In some cases, fainting spells or impaired consciousness may also occur. Nevertheless, a doctor should be consulted to clarify all eventualities. In addition, the doctor can give valuable advice on what the affected person can do to combat low blood pressure. To differentiate in a low blood pressure from a low pulse.
What is low blood pressure (hypotension)?
Low blood pressure (hypotension in medical terms) is defined as an arterial blood pressure systolic below 100 mmHg, which is determined via a blood pressure measurement on the upper arm. The lower value (i.e., diastolic) is not significant for the diagnosis. In Germany, significantly more women are affected than men. Young and slim women in particular suffer from so-called essential or idiopathic hypotension. There is no underlying organic or other traceable cause. However, every low blood pressure should be clarified, since dangerous diseases can also be hidden behind it. Often, a thorough questioning (anamnesis) already points the way, supplemented by long-term blood pressure measurements over 24 hours, orthostatic tests (reaction of the blood pressure to standing up quickly, e.g., tilt table or shell tone test) and blood tests (e.g., representatives of adrenal cortical function, blood salts and certain hormones).
Causes
Usually, the cause of low blood pressure is idiopathic, i.e., not specifically identifiable. A genetic and constitutional cause (tall stature, slender habitus, weak vascular system) is suspected. Athletes also have a physiologically reduced blood pressure due to adaptation processes of the heart. In addition, disturbances in the fluid balance (e.g. due to insufficient intake, diarrhea, vomiting or due to medication, including “water tablets” and antihypertensives) or a low-salt diet (because salt binds water) have a favorable effect. Secondary hypotension (i.e. low blood pressure due to another illness) occurs, for example, in the case of pronounced cardiac insufficiency (heart failure), because the blood can no longer be pumped as effectively. There are, in turn, a wide variety of causes for cardiac insufficiency, the most common of which are coronary vascular disease (disruption of blood flow to the heart leading to a heart attack), cardiac arrhythmias and pulmonary embolism. Metabolic diseases (e.g., hypothyroidism and diabetes mellitus) can also cause low blood pressure. Likewise, any kind of shock causes threatening hypotension (e.g., in allergies, bleeding, or sepsis), usually by causing the vessels to dilate, causing the blood to literally pool. Less commonly, (usually autoimmune) adrenocortical insufficiency (including Addison’s disease) and neurologic diseases (especially Parkinson’s disease and multiple sclerosis) are causative.
Symptoms, complaints, and signs
A very common symptom of low blood pressure is dizziness. The brain is not supplied with enough blood and so, in addition, ringing in the ears, fatigue and visual disturbances can also occur. That is, it becomes black before the eyes, or one sees “asterisks”. In the case of impaired consciousness or fainting, it becomes dangerous if there is a risk of falling or if the person is driving a car while the blood pressure is much too low. The body tries to fight against the lack of blood flow, which increases the pulse rate. Low blood pressure can also occur when changing position quickly from lying to standing. The blood pools in the legs and the body needs some time to rebalance the blood pressure. Headaches can have many causes, but they can also be another sign of hypotension; the cause here is insufficient blood flow to the head. Cold hands and feet or tightness in the chest are also called with low blood pressure, because the blood is directed to the heart or brain, respectively, and thus other parts of the body are supplied less. Even people who normally have no problems with low blood pressure can be affected on hot days, because the body sweats and loses a lot of fluid. Here, of course, it helps to drink a lot to rebalance the fluid balance.
Course of the disease
In addition to measuring blood pressure, the doctor often checks the pulse to get an overall picture of the blood circulation.Hypotension is often completely asymptomatic. If low blood pressure is noticed, it usually takes the form of weakness, cold, pallor and dizziness or “blacking out” before the eyes with a tendency to faint (syncope). These complaints are usually annoying but harmless. Only the consequences of possible falls are critical, in which (especially in older people) serious injuries are possible. To the advantage of people with low blood pressure, it has been shown in many studies that hypotension is rather beneficial to health and can even increase life expectancy.
Complications
Low blood pressure as such is usually harmless, although its symptoms can be dramatic. In most cases, hypotension is congenital and harmless. However, it is also often a symptom of an underlying condition. Most complications associated with hypotension, however, are not the result of low blood pressure, but result from the progression of the underlying disease. For example, hypotension occurs in heart disease, venous insufficiency, hormonal imbalances, or severe fluid loss in various conditions, among others. Although low blood pressure causes such symptoms as dizziness, ringing in the ears, flickering of the eyes or even shortness of breath, they usually pass without complications. However, severe dizziness can sometimes lead to falls, which in unfavorable cases can result in injuries. In addition to dizziness, chronic low blood pressure is also accompanied by permanent fatigue. Fatigue and lack of concentration are often the cause of general poor performance. In the long term, this can lead to depression. Also dangerous are the frequent sleep disturbances, which in the long term can cause chronic organic or mental illnesses. Although there are generally no immediate complications with low blood pressure, the risk of the heart and brain being undersupplied with blood increases in older and previously ill patients. The risk for falls, as well as injuries from falls (fractures), also increases with age.
When should you see a doctor?
Basically, low blood pressure is not a worrisome condition. The person affected can normally live his or her life independently with this blood pressure without serious complications. Through the consumption of caffeine-containing products and regular participation in sports activities, it is possible to stimulate blood circulation. Especially after waking up, targeted workouts have a stimulating effect on blood pressure. Also helpful are spicy meals. A visit to the doctor is necessary if the known self-help measures are not effective and the low blood pressure becomes a life-threatening condition. Consultation with a physician can be sought if the patient is suffering from a high level of discomfort or indisposition. If there is severe fatigue, rapid exhaustion or a deficit of attention, there is a need for action. If daily obligations cannot be performed adequately or the general quality of life declines, the inconvenience should be discussed with a physician. If interpersonal conflict situations or professional quarrels arise as a result of the reduced drive, a doctor may be able to provide relief with his or her options. If the affected person experiences increased dizziness or the risk of accidents in everyday life increases, a doctor should be consulted. In the case of falls, gait unsteadiness and low physical as well as mental resilience, it is advisable to seek the help of a doctor.
Treatment and therapy
As a rule, low blood pressure is treated by general measures. In this regard, regular exercise (in moderate amounts, such as swimming or gymnastics), compression treatment (through stockings, for example, because the pressure on the veins provides more volume to the arterial blood system) or alternating showers (always stopping with cold water) are easy and effective to integrate into everyday life. Since salt retains more water in the body and can thus also increase volume, a diet rich in salt is recommended. Either the food can be enriched with more salt or, for example, broth can be drunk. If these measures are unsuccessful, medications (so-called sympathomimetics) can also be used. However, these should be the last line of treatment, since the effectiveness of lifestyle changes is high and the drugs have not insignificant side effects.
Aftercare
Unlike hypertension, hypotension does not cause any damage to health. Nevertheless, many people find the symptoms of low blood pressure distressing. Therefore, follow-up care is important to restore the feeling of well-being. To improve well-being, it is advisable to start each mobilization to another level gently. This means, when getting up from a sitting position, first activate the muscle pump of the calves and then slowly straighten up. Especially when rising from a lying position, gradual straightening over a short sitting episode is recommended. Since most activities in today’s world are performed while sitting or standing, sufferers should wear orthopedic class two compression stockings. At night, many sufferers find it helpful to keep their legs slightly elevated. This allows more blood to return from the lower extremities and regulates blood pressure into the normal range. As a result, many people not only sleep better but also get up more quickly. Targeted exercise sessions of about 30 to 60 minutes about three days a week can strengthen blood vessels and normalize blood pressure. A minimum daily fluid intake of two liters also has a positive effect on the cardiovascular system. Many sufferers also report a benefit from circulatory training. Alternating showers, massages and climatic stimuli such as soft saunas and ice pools strengthen the veins and can permanently raise blood pressure into a comfortable range.
Outlook and prognosis
Low blood pressure is usually associated with a good prognosis for the patient. There are two reasons for this at once. One is that hypertension is harmless in many cases and has no disease value. Adolescents and young women in particular often have low blood pressure, which often disappears spontaneously. Often there are reasons for low blood pressure during puberty or menopause, which are hormonal and do not persist in the long term. Even when hypotension occurs in people who are very sensitive to the weather in this context, it not infrequently normalizes on its own, without those affected having to take any special measures. The second reason for the good prognosis with regard to low blood pressure is that the patient can often significantly influence his or her hypotension through behavioral changes in everyday life. These include exercise and drinking enough fluids, which alone are often enough to raise low blood pressure back to normal levels. Hypotension is also usually associated with an exceptionally good prognosis in terms of possible consequences. While high blood pressure can be associated with a host of complications for the cardiovascular system, the hypotensive patient is almost only at risk of injury if fainting occurs. Otherwise, however, the outlook for patients with low blood pressure is usually very good.
Here’s what you can do yourself
Various measures can be taken to stimulate blood pressure without further medical attention. Sports activities and specific workouts to stimulate circulation are particularly helpful. The movement of the fingers, hands as well as feet lead to better blood circulation and increase blood pressure. Several times a day, the affected person can easily perform short exercise sequences in which he alternately tenses and loosens the muscles of the fingers and toes. In addition, regular sporting activities should be carried out as a matter of principle. This improves the general well-being and promotes the activity of the circulation. However, overloading and excessive physical activity should be avoided. Running, swimming, cycling or various ball sports increase blood pressure. The frequency and intensity of the selected sports are to be aligned with the current physical conditions, so that no further illnesses occur. In addition, it is possible to stimulate the circulation by consuming food and stimulants. Products containing caffeine or meals with hot spices promote cardiac activity. Depending on taste and gusto, the existing eating habits can be changed. Especially at the beginning of the day or in the further course of the day, the consumption of caffeinated foods is recommended. However, it should be stopped in good time before nighttime sleep. In the case of spicy food, adequate fluid intake should be ensured afterwards.