Low blood pressure or hypotension is when your blood pressure drops to an abnormal level where the systolic pressure is below 90 while the diastolic pressure is below 60. There are different possible causes why a person’s blood pressure levels drop. It may be due to dehydration, allergies, blood loss, etc.
Its severity may also range from person to person. Some cases may not involve any symptoms, others may feel dizzy or lightheaded, and it can be life-threatening to other people. It’s crucial to know the root cause of hypotension to get the proper treatment for you. If left with no cure, it’ll lead to complications such as fainting and injuries from falls.
Types of Low Blood Pressure
There are different types of hypotension. Knowing these will help you and your doctor determine what treatment is best for you.
Orthostatic Hypotension
Prevalent in older adults, this happens when your blood pressure suddenly drops after standing up from a sitting position or when you lie down. The drop in blood pressure can either be due to severe dehydration, pregnancy, prolonged bed rest, health condition, or medication. Fortunately, this type of hypotension may only last for about a few seconds or minutes.
Neurally Mediated Hypotension
This type of hypotension happens to both children and adults. It’s characterized by a drop in blood pressure levels after standing for long periods or being in a hot environment.
Neurally mediated hypotension is caused by the miscommunication of the heart and the brain, known as the fainting reflexes. This happens because as a person stands without moving for an extended period, gravity causes the blood to stay on the legs giving less blood flow to the brain. In this case, the heart will try to beat faster to encourage blood flow, but because of the abnormal flow of blood, the brain will signal the heart to beat slower.
Postprandial Hypotension
Unlike orthostatic and neurally mediated hypotension, this type of hypotension happens after eating. This is when an abnormality in the blood flow occurs as the heart tries to pump the blood for the digestive system to work. Postprandial hypotension is common in older adults with Parkinson’s disease or high blood pressure. Fortunately, you can alleviate its symptoms by eating small amounts of food with fewer carbs.
Multiple System Atrophy With Orthostatic Hypotension
This is a rare type of hypotension which is also known as the Shy-Drager Syndrome. It affects the part of the nervous system that controls involuntary actions in our body such as breathing, digestion, and heart rate.
Causes and Risk Factors
Possible causes of hypotension include the following:
- Pregnancy
- Prolonged bed rest
- Anaphylactic shock
- Septic shock
- Blood loss (due to injuries from accidents)
- Vitamin and mineral deficiencies
Some factors can also increase your risk of hypotension like:
Age - The older you get, the more at risk you are of getting hypotension. According to the latest statistics, about 20% of people aged 65 and above suffer from postural hypotension.
Medications - Certain medications such as diuretics and alpha-blockers can trigger hypotension. Other medications include:
- Blood pressure medications (Benicar, Valsartan)
- Erectile dysfunction medications (Cialis, Viagra)
- Diuretics (Hydrochlorothiazide, Lasix)
- Alpha-blockers (Minipress, Tenormin)
- Beta-blockers (Inderal, Innopran XL)
- Parkinson’s disease drugs (Levodopa, Mirapex)
- Anti-depressants (Silenor, Trofranil, Cymbalta)
Health conditions - Underlying health conditions like diabetes and Parkinson’s disease can increase the risk of hypotension as well.
Symptoms
If you notice the symptoms listed below, it’s most likely a sign of low blood pressure.
- Nausea with or without vomiting
- Dehydration
- Fatigue
- Fainting
- Dizziness/Lightheadedness
- Difficulty concentrating
- Depression
For severe cases of hypotension, you may experience:
- Weak, rapid pulse
- Shallow but rapid breathing
- Pale and cold skin
- Disorientation/confusion
Report to your doctor immediately if you are experiencing the symptoms of low blood pressure as it requires immediate medical attention.
Treatments
Before getting treatment, your doctor will conduct a series of tests to confirm hypotension. These tests will also determine what type of hypotension you have. Medical tests include:
- Blood tests
- ECG
- Echocardiogram
- Tilt table test
- Stress test
After confirming you have low blood pressure, your doctor may prescribe any of the following drugs:
- Midodrine - This drug is responsible for activating receptors in your arteries and veins.
- Fludrocortisone - This primarily aims to increase sodium levels in your kidneys which will, later on, improve your blood pressure.
Prevention Tips
Your doctor may also advise some lifestyle changes that will help prevent a drop in blood pressure levels. Some practices include:
Drinking Plenty of Water
People taking diuretics and other medications that trigger low blood pressure can also cause dehydration. Drink plenty of water to replenish lost fluids and maintain normal amounts of body fluids.
Eat Smaller Meals
After we eat, our heart puts in the effort to pump blood into our digestive system, but as we age, this process becomes weaker. Eating large meals will exhaust the blood flow and might result in low blood pressure. The best way to address this is to eat smaller amounts of food, especially for people aged 65 and above.
Avoid Alcoholic Drinks
Alcohol drinking can also cause low blood pressure, that’s why it’s crucial to take it in moderation or better yet break the habit.
Increase Salt Intake
Sodium can contribute to increased blood pressure levels. Increasing salt in your diet is good if you have low blood pressure, but it should still be taken in moderation as too much sodium also causes high blood pressure. Talk to your doctor about the ideal amount of sodium intake for you.
Get Regular Blood Sugar and Thyroid Checkups
High blood sugar and existing thyroid conditions can also contribute to hypotension. Try monitoring your blood sugar levels throughout the day so that you can control your sugar intake. Doctors also advise patients to get regular checkups to get the right treatments for these conditions and prevent hypotension.
Wear Compression Socks
Compression socks or stockings are helpful in preventing blood from pooling in your legs and triggering low blood pressure. This is most appropriate for people with orthostatic and neurally mediated hypotension.
Treat Infections
Bacterial, viral, or fungal infections involving blood must be treated as they can trigger hypotension.
In conclusion, Low blood pressure or hypotension can happen to people of any age but is more prevalent among elderly people. Though some cases of hypotension don’t require urgent medical attention, it’s still important to be aware of the practices that can prevent hypotension from happening. I hope this article gave you a better understanding of hypotension in elderly people.