DEFINITION Hypotension also commonly known as low blood

DEFINITION Hypotension, also commonly known as low blood pressure is a condition in which blood pressure in the arteries gets abnormally low. People with hypotension may experience symptoms when their blood pressure drops below 90/60.

CAUSE • Our blood pressure varies throughout the day. There are various factors that cause this fluctuation. Body positions, the level of stress, physical condition, medications, eating and drinking habits are a few factors responsible for low blood pressure. Blood pressure usually decreases when you are asleep and as you wake up, it sharply rises.

1. Dehydration: • Inadequate water in the body can cause weakness, fatigue and dizziness and thus, can lead to a drop in the blood pressure level. 2. Cardiovascular problems: • A few heart conditions can also lead to low blood pressure. In some scenarios, the condition can get worse and cause low heart rate (bradycardia), heart valve problems, heart

3. Pregnancy: • Pregnancy may also lead to drop blood pressure level. Due to the internal bodily changes during pregnancy, blood pressure is likely to decline. But this condition is usually considered normal. After the child birth, blood pressure again goes to normal. 4. Loss of blood: • In case of a major injury which causes blood loss or internal bleeding, one may experience

5. Endocrine problems: • Thyroid conditions, low blood sugar levels and, in some cases, diabetes are responsible for triggering low blood pressure. 6. Infection: • This usually happens in case of serious infection like septicaemia and can lead to a lifethreatening condition which is also referred to as septic shock

7. Nutrient deficiency: • Lack of Vitamin B-12 and folate can cause low blood pressure. This is due to the reason that these nutrients are essential to produce red blood cells and their deficiency can lead to drop in blood pressure levels. 8. Allergic reaction: • Serious allergic reactions like anaphylaxis can trigger health conditions such as breathing problems, hives, itching and a swollen throat.

9. Low salt intake: • Sodium is an essential electrolyte that helps in maintaining water in and around the cells. Insufficient consumption of sodium may lead to low blood pressure as this may disrupt the blood pressure levels.

Types of hypotension Orthostatic • Orthostatic hypotension is the drop in blood pressure that occurs when you transition from sitting or lying down to standing. It is common in people of all ages. • As the body adjusts to the position change there may be a brief period of dizziness. This is what some people refer to as “seeing stars” when

Postprandial • Postprandial hypotension is a drop in blood pressure that occurs right after eating. It is a type of orthostatic hypotension. Older adults, especially those with Parkinson’s disease, are more likely to develop postprandial hypotension.

Neurally mediated • Neurally mediated hypotension happens after you stand for a long time. Children experience this form of hypotension more often than adults. Emotionally upsetting events can also cause this drop in blood pressure. Severe • Severe hypotension is related to shock. Shock occurs when your organs do not get the blood and oxygen they need to function properly. Severe hypotension can be life-threatening if not

SYMPTOMS 1. Fainting in case of syncope 2. Nausea 3. Lack of concentration 4. Fatigue 5. Blurred vision 6. Dizziness or lightheadedness

Extreme hypotension can result in a lifethreatening situation. The signs and symptoms of this condition includes: 1. Rapid pulse rate 2. Weakness 3. Feeling of confusion, which mainly occurs in elderly people 4. Pale skin colour 5. Rapid, shallow breathing

DIAGNOSIS EVALUATION • Blood pressure monitoring. • Blood tests. • Electrocardiogram (ECG or EKG). This noninvasive test detects irregularities in your heart rhythm or heart structure, and problems with the supply of blood and oxygen to your heart muscle.

• Stress test. A stress test is performed while you’re exercising, such as walking on a treadmill • Tilt table test. A tilt table test evaluates how your body reacts to changes in position. You’ll lie on a flat table that tilts to raise the upper part of your body, which simulates the movement from a horizontal to standing position. Your blood pressure is taken frequently as the table is tilted.

MANAGEMENT • Stay hydrated by drinking more water throughout the day. • Drink less alcohol. • Increase your salt intake slightly because sodium raises blood pressure. • Eat smaller, healthy meals and limit carbohydrates

• Wear compression stockings. • Get up slowly after you’ve been sitting or lying down. • Avoid standing for long periods of time. • Sit up and breathe deeply for a few minutes before getting out of bed.

MEDICINES: • Fludrocortisone, which increases blood volume. • Midodrine, which increases blood pressure.