Manifestations of low blood pressure vary widely, ranging from blurred vision to fainting spells. Often, this is not a random occurrence but a consequence of specific risk factors. Cardiologist Anna Robertovna Novikova shared insights with “Rambler” on the reasons behind blood pressure drops and methods for elevation without medication.
What Pressure Is Considered Low
An ideal arterial blood pressure reading is typically cited as 120/80 mmHg. Slight deviations below this can still be normal. However, when systolic (upper) pressure drops to 100 mmHg and diastolic (lower) pressure falls to 60 mmHg, this condition is referred to as arterial hypotension, or hypotonia.
“Arterial hypotension signifies a pressure reduction exceeding 20% from the norm. In Russia, the benchmark for hypotension in individuals over 25 is often considered to be below 105/60 mmHg, although international guidelines might present different numerical thresholds.”
Orthostatic, or postural. This occurs when blood pressure sharply decreases upon transitioning from a lying to a standing position. It is common in older adults when rising from bed or a chair. The American Heart Association points out that orthostatic hypotension is frequently observed in hypertensive patients receiving medication intended to treat high blood pressure.
Postprandial. This refers to a drop in blood pressure occurring after a meal, typically manifesting one to two hours later. It is seen more often in the elderly suffering from arterial hypertension (elevated blood pressure).
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Neuro-mediated. This type is more prevalent in younger individuals and children, though it can affect the elderly, such as Parkinson’s disease patients. Due to impaired communication between the heart and the brain, their pressure falls when they remain upright for extended periods.
“Broadly speaking, hypotension is classified as physiological, which does not impact bodily function, or pathological, which can disrupt hemodynamics (blood flow). The physician bases treatment strategy on this classification,” the cardiologist clarifies.
Causes
Blood pressure can fluctuate due to body position, food intake, medications, stress levels, physical condition, and certain diseases. Let’s look at the most frequent causes of low blood pressure.
Dehydration
A deficiency in water intake leads to a reduction in circulating blood volume, which can consequently lower blood pressure. Dehydration can result from taking certain medications (like diuretics), vomiting, fever, or strenuous physical exertion.
Improper Diet
An unbalanced diet deprives the body of sufficient nutrients. Low levels of Vitamin B12, folic acid, and iron hinder the production of erythrocytes (red blood cells), contributing to anemia. All these factors can precipitate arterial hypotension.
Chronic Diseases
Cardiovascular ailments can significantly influence blood pressure readings. Consequently, individuals with heart failure, bradycardia (a slow heart rate), valve dysfunction, or those recovering from a heart attack sometimes develop hypotension.
Low blood pressure can also stem from endocrine disorders. For instance, in Addison’s disease, the adrenal glands fail to produce cortisol, a hormone essential for normal heart and blood vessel function. Hypotension also arises in patients with diabetes or low blood sugar levels.
In rare instances, hypotension occurs alongside multiple system atrophy, a neurodegenerative disorder affecting the nervous system. Patients experience high blood pressure while lying down, which plummets upon standing. This specific type of hypotension is also termed the Shy–Drager syndrome.
Medications
Certain drugs can substantially reduce arterial blood pressure. Primarily, this includes all medications within the antihypertensive class: diuretics, alpha-blockers, and beta-blockers. Hypotension may also be induced by drugs for Parkinson’s disease, tricyclic antidepressants, and medications intended for erectile dysfunction, such as sildenafil (better recognized as “Viagra”).
Pregnancy
Hormonal shifts cause blood vessels to dilate rapidly, resulting in hypotension. This effect usually subsides within the first 24 weeks, after which blood pressure normalizes. Any changes noted during pregnancy must be communicated to a doctor.
Physical Activity
While exercise generally tends to raise blood pressure, the opposite can occur in individuals with orthostatic hypotension. As explained by the European Society of Cardiology, prolonged, static exertion focused on the lower body can cause blood to pool in the legs, leading to venous congestion. The return of blood to the heart diminishes, causing a temporary drop in pressure.
Genetic Factors
Specific genetic predispositions can increase the risk of developing orthostatic hypotension. The most studied involve mutations in the DBH and CYB561 genes, which impair the production of neurotransmitters, leading to lower blood pressure.
Symptoms
The majority of hypotensive symptoms are linked to insufficient blood supply. When less blood reaches tissues, fewer nutrients and less oxygen are delivered. This impairs or slows the functions of internal organs—eyes, brain, gastrointestinal tract—hence, low blood pressure can manifest with:
blurred vision,
dizziness,
fainting,
fatigue,
concentration difficulties,
stomach upset.
How to Raise Blood Pressure
Low blood pressure without accompanying symptoms may not require treatment. If hypotension negatively impacts quality of life, treatment and lifestyle adjustments are recommended.
Diet
Salt. Physicians typically advise limiting salt intake because sodium retains water, increasing circulating blood volume, which generally raises blood pressure. However, this effect of table salt can be advantageous for individuals experiencing hypotension.
Important Note. Individuals with arterial hypertension can still suffer hypotensive episodes. Before increasing salt consumption, consultation with a physician is essential.
Water. Fluids boost blood volume and help prevent dehydration, which is especially crucial when managing hypotension. Therefore, patients are advised to increase their water intake.
Coffee. For hypotensive patients, the Mayo Clinic suggests consuming one or two cups of strong coffee with breakfast, as caffeine elevates blood pressure. However, since it can cause dehydration, consuming plenty of water throughout the day is necessary.
Frequent Small Meals. To prevent post-meal pressure drops, it is beneficial to eat often but in small portions.
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Exercise
To strengthen the heart and blood vessels, aim for a minimum of 150 minutes of exercise per week. Combining both cardio and strength training is preferable.
For orthostatic hypotension, physical countermaneuvers can be practiced—exercises designed to prevent blood from pooling in the lower legs. For example, crossing the legs and tensing the muscles, or rocking back and forth, can help. The European Society of Cardiology suggests this can prevent fainting due to low pressure.
Medication
Orthostatic hypotension is managed with two drugs: midodrine and fludrocortisone. The former limits the ability of blood vessels to dilate, while the latter increases circulating blood volume. Since these drugs carry side effects, a physician must prescribe them and determine the appropriate dosage.
Home Remedies
Substances found in plants can indeed influence blood pressure. However, the efficacy and safety of such treatments are unproven. Consequently, contemporary clinical guidelines and international handbooks do not cite treatment with supplements or herbs.
“For physiological low blood pressure, lifestyle changes are the primary recommendation. Sleeping with an elevated pillow, wearing compression stockings, or bandaging the legs to prevent blood pooling are advised,” the doctor states. “Pathological hypotension, such as that resulting from massive bleeding or acute myocardial infarction, can be fatal and necessitates immediate medical attention.”
When to See a Doctor
Beyond low blood pressure itself, certain symptoms warrant a specialist consultation:
confusion,
nausea and vomiting,
dizziness,
fainting,
headache,
neck or back pain,
rapid heart rate or skipped heartbeats.
These could signal life-threatening conditions. For example, low blood pressure can be triggered by:
Sepsis, or blood infection. This occurs when bacteria enter the bloodstream, releasing toxins that damage vessels.
Anaphylactic shock. This is a critically dangerous and rapidly developing consequence of a severe allergic reaction.
Hemorrhage. Pressure drops due to reduced blood volume. Bleeding can be internal, developing without external signs or injuries.
Myocardial infarction (Heart Attack). Damage to the heart muscle reduces cardiac output (the volume of blood pumped by the heart per minute) and can cause rhythm disturbances, leading to immediate pressure drops.
Key Takeaways
Pressure below 105/60 mmHg is generally considered low. There are several forms of hypotension; orthostatic hypotension, characterized by a sharp drop upon standing, is more common in the elderly. Typical symptoms of low blood pressure include blurred vision, dizziness, nausea, stomach upset, and fainting. Treatment typically begins with lifestyle modifications: increasing water intake, sleeping with the head elevated, wearing compression stockings, and engaging in regular exercise. Medications are reserved for cases where these measures are insufficient and quality of life is compromised. Blood pressure can acutely plunge due to a heart attack, allergic reaction, sepsis, or internal bleeding; these situations demand emergency medical care.
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