Low blood pressure (hypotension) — guide.

What low blood pressure is

Arterial hypotension means low blood pressure, generally below 90/60 mmHg, which becomes clinically relevant when it produces symptoms such as dizziness, blurred vision, weakness or fainting (lipothymia). Unlike hypertension, chronic, asymptomatic hypotension, encountered mostly in young women and athletic individuals, is usually benign and does not require treatment. However, it becomes important when it appears suddenly, in the elderly, or in connection with medications, dehydration, hemorrhage or cardiac conditions, because the decrease in blood flow to the brain can cause falls and injuries. Identifying the cause is essential for determining whether investigations are needed.

Types

Orthostatic — a drop when moving from lying down to standing up. Common in the elderly.

Postprandial — after a meal, especially one with carbohydrates.

Neurocardiogenic — fainting from emotional stress, heat, prolonged standing.

Secondary — medications (antihypertensives, diuretics, antidepressants), dehydration, anemia, endocrine diseases (Addison), cardiac diseases.

Treatment

Non-pharmacological measures:

• Abundant hydration 2-3 L/day, mineral salts.
• Slightly increased salt intake (the opposite of in hypertension).
• Coffee/tea in the morning (caffeine).
• Compression stockings on the calf.
• Small and frequent meals (avoids postprandial hypotension).
• Getting up slowly from bed (sitting for 1 min before putting your feet on the floor).
• Raising the head of the bed 10-15 cm at night.

Rx medication — for persistent cases: fludrocortisone, midodrine.

OTC supplements

• Licorice (licorice root) — mild blood-pressure-raising effect, but beware of interactions.
• Ginseng, rhodiola — adaptogens.
• Magnesium, B vitamins in case of deficiencies.
• Electrolyte drinks.

Medical evaluation

Chronic asymptomatic hypotension in a young woman with no medical history — benign. Hypotension with fainting, newly developed in an elderly person, or following medications — requires evaluation (ECG, echocardiogram, Holter, blood glucose).

Medical disclaimer: the information in this guide is for informational purposes and does not replace the advice of a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.