Is your body tense?

watch out

While many of us have heard of the term hypotension, its causes and why it happens are not entirely known. Hypotension is essentially low blood pressure and is mostly seen in elderly, obese and diabetic patients.

When the systolic blood pressure – pressure in the arteries when the heart pumps blood to various organs – is less than 90 millimetres of mercury on the sphygmomanometer (mm Hg), or when the diastolic pressure – pressure in the arteries when the heart rests between beats – is less than 60 mm Hg, the patient is diagnosed of hypotension. However, blood pressure is considered low only when noticeable symptoms are present.

Hypotension is treatable but it is important to find out what is causing the condition so that it can be treated properly. In some people, low blood pressure can signal an underlying problem, especially when it drops suddenly or is accompanied by symptoms like dizziness or lightheadedness, fainting (syncope), inability to concentrate, blurred vision, nausea, cold, clammy, pale skin, rapid, shallow breathing, fatigue, depression and thirst.

So, if you think you might be experiencing hypotension, it is important that you stop what you’re doing, sit or lie down and drink some water.

Causes

There are a variety of causes that can lead to hypotension from lifestyle choices to medication or an underlying health condition. As blood pressure varies during the day, it is important that you check with your doctor if you notice any abnormal changes.

Dehydration is a major cause of hypotension, while weak heart muscles are another. The latter causes your heart to fail and reduces the amount of blood it pumps into the arteries. Deficiency in vitamin B12 and folate can lead to anaemia, which in turn can cause hypotension.

Problems in the endocrine system like hypothyroidism, parathyroidism, adrenal insufficiency, low blood sugar and diabetes can also cause low blood pressure.
 
Treating hypotension

Underlying medical conditions like hormonal imbalance or heart problems need to be treated immediately to address hypotension. For most people, however, chronic low blood pressure can be effectively treated with diet and lifestyle changes. Initially, your doctor may advise you to increase your blood pressure by making these simple changes in your life:

Maintain a salt-rich diet.
Increase or decrease your intake of caffeine depending on medical advice.
Drink lots of non-alcoholic fluids.

Have a minimum of eight glasses of water a day. Sports drinks that are high in sodium and potassium may be recommended.

Drink more fluids during hot weather and while sick with a viral illnesses like cold or fever.

Apart from these, it is important to have your doctor evaluate your prescription of over-the-counter medication to identify if any of them may be causing your symptoms. To keep hypotension at bay, one must ensure the following: 

Get regular exercise to promote healthy blood flow.
Get up slowly from prostrate or sitting position.
To improve circulation, pump your feet and ankles a few times before standing up. Then, proceed slowly.

When getting out of bed, sit upright on the edge of the bed for a few minutes before standing. Elevate your head rest at night by five to 20 degrees. This can be done by either placing bricks or blocks under the head of bed.

If you get dizzy while taking a bath, sit down. It may be helpful to keep a chair or a stool in the shower in case you need to rest. To help prevent injury, use a non-slip chair or stool designed for use in showers and bath tubs.

Avoid heavy lifting and straining while on the toilet and prolonged exposure to hot water in the shower and at spas.

To avoid problems with hypotension and lessen episodes of dizziness after meals, try eating smaller, more frequent meals. Also, rest after eating. Avoid taking low blood pressure drugs before meals.

(The author is chairman, cardiology, Max Super Speciality Hospital, New Delhi)