Visual Guide to Low Blood Pressure

What Is It?

Your doctor may say you have low blood pressure when your numbers are
lower than 90 over 60. The medical term is "hypotension." But it isn't always a
problem. Unlike high blood pressure, doctors usually don't use a standard set
of numbers to figure out if you're ill. But if you also have symptoms like
dizziness and nausea, it could be a sign that your blood pressure is too low for
good health.

Measuring Blood Pressure

A cuff linked to a special device tightens around your arm to get two
measurements. The top number, or "systolic," notes the pressure your blood
makes against your artery walls when the heart beats. The bottom number, or
"diastolic," measures the pressure between beats, while the heart is relaxing
and filling with blood. You can get readings in your doctor's office or at home.

Symptoms

Your brain usually shows the first symptoms of hypotension. Besides dizziness
and nausea, your spirits might be low, you might lack energy, and find it hard
to think straight. Some people feel lightheaded enough to faint or notice cold,
clammy skin, faster breathing, blurry vision, or chest pain. If your low pressure
is caused by dehydration, you also might feel unusually thirsty. 

Cause: Expanded Blood Vessels

Sometimes your blood vessels widen. That means there's more space for blood
to spread out, which puts less pressure on the walls of those vessels. Some
drugs, especially a type called vasodilators, can cause this. So can spinal
injuries that damage certain nerves, serious bacterial infections, and allergic
reactions. Hormone problems like Addison's disease, which weakens the
adrenal glands, can also do it.

Cause: Less Blood

Less blood means less pressure on your veins and arteries. An injury might
cause you to bleed -- either outside your body where you can see it, or inside.
It might also happen if you don't get enough to drink, your blood vessels leak
fluid, or you have a blood condition called anemia. Sometimes your kidneys get
rid of too much fluid because of illness or certain drugs, like diuretics.
Cause: Heart Problems
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The more blood your heart pumps per minute, the higher your blood pressure.
Certain medications, along with hormone problems, heart damage, or misfiring
electrical signals, can make your heart beat too slowly, which lowers that
pressure. Or it could be that your heart is not as strong as it used to be
because of a heart attack, heart failure, or problems with the valves, and so
doesn't pump as much blood per beat.

Cause: Standing Quickly

Normally when you stand suddenly, your body sends a signal to your brain that
says "Hey! We just dropped a bunch of blood down to the legs and belly, and
we need to pump some more back upstairs before you get dizzy and pass out!"
But sometimes, your brain doesn't get the message quickly enough and you
start to feel lightheaded. You might even faint. Your doctor might call this
problem "orthostatic hypotension" or "vasovagal syncope."

Cause: Standing for Long Periods

After you're on your feet for a while, blood can start to pool in your legs. If
your brain doesn't tell your heart to pump enough to keep your blood pressure
up, it might drop low enough to make you dizzy and nauseous. You might even
pass out. Your doctor might call this "neurally mediated hypotension." Like a
bad relationship, the problem is poor communication, in this case, between the
heart and brain. 

Getting a Diagnosis

Once your doctor knows your symptoms, blood tests can help diagnose the
reason for your low blood pressure. An electrocardiogram, ultrasound, and
other tests check your heart health. The Valsalva maneuver observes nerve
signals that control your heart and blood vessels, and a "tilt table" test looks at
how your body responds to position changes.

Treatment

It depends on the cause. You may need to the treat the conditions that are
giving you low blood pressure. If medication is the problem, you may need to
change it or lower the dose, but always talk to your doctor first. Other drugs
can help increase your blood pressure if needed, and compression socks can
help push blood up from where it pools in your legs. If you don't have
bothersome symptoms, you might not need treatment.

Lifestyle Changes

You can help lessen the symptoms of low blood pressure at home.

 Add a bit more salt back into your diet, but check with your doctor first.
 Drink more water (unless your doctor has restricted your fluid intake). It
keeps your blood volume up, which raises blood pressure.
 Cut back on alcohol. It can dehydrate you and lower blood volume and
blood pressure.
 Eat multiple, small meals that are low-carb, instead of three big ones, if
your pressure drops after eating.

When to See a Doctor

If you feel confused or notice fast, shallow breathing, a weak, rapid pulse, and
cold, clammy skin, you may be in shock (extreme hypotension). Get to an
emergency room right away. But lower blood pressure numbers, especially
without other symptoms, aren't usually a sign of a big problem. Talk to your
doctor if you start to feel dizzy or lightheaded as well. 

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