From the Guidelines
Low blood pressure (hypotension) can cause several recognizable symptoms when blood pressure drops below 90/60 mmHg, including dizziness or lightheadedness, fainting (syncope), blurred vision, fatigue, weakness, nausea, confusion, and cold, clammy skin. These symptoms occur because insufficient blood flow reaches vital organs, particularly the brain. According to the most recent and highest quality study 1, low blood pressure can result from various underlying physiological processes, including vasodilation, hypovolaemia, bradycardia, and low cardiac output. The treatment of hypotension should be based on the presumed underlying causes, and may include the use of vasopressors, intravascular fluid administration, anticholinergic agents, or positive inotropic agents. Some people may experience rapid, shallow breathing, depression, or thirst, and if these symptoms occur regularly, especially with fainting, medical attention should be sought. The symptoms of low blood pressure can be managed by addressing the underlying cause, and may include increasing fluid intake, adjusting medications, adding more salt to the diet, wearing compression stockings, or taking medications that increase blood pressure. It is essential to identify the underlying cause of low blood pressure to provide effective treatment and prevent complications. In some cases, low blood pressure can be a sign of an underlying medical condition, such as dehydration, blood loss, heart problems, endocrine disorders, severe infections, or nutritional deficiencies. Therefore, it is crucial to seek medical attention if symptoms of low blood pressure persist or worsen over time. The management of low blood pressure should prioritize the patient's overall health and well-being, and may involve a multidisciplinary approach to address the underlying cause and prevent long-term complications. Key considerations in the management of low blood pressure include:
- Identifying the underlying cause of hypotension
- Providing adequate fluid intake and electrolyte balance
- Adjusting medications to minimize hypotensive effects
- Using compression stockings or other supportive devices to improve circulation
- Monitoring blood pressure and adjusting treatment as needed
- Addressing underlying medical conditions that may be contributing to low blood pressure.
From the Research
Symptoms of Low Blood Pressure
The symptoms of low blood pressure can be caused by various factors, including certain medications. Some studies have investigated the relationship between antihypertensive drugs and the risk of hypotension and related events.
- Hypotension and related events, such as syncope, falls, and fractures, can be associated with the use of certain antihypertensive medications, including alpha-blockers 2.
- The use of alpha-blockers has been shown to increase the risk of hypotension and hypotension-related events, particularly in older adults 2, 3.
- Combinations of certain antihypertensive medications, such as angiotensin-converting enzyme inhibitors (ACE-Is) and diuretics, or ACE-Is and nitrates, can also increase the risk of orthostatic hypotension-related syncope in older adults with dementia 3.
- Diuretics, which are commonly used to treat hypertension, can also cause hypotension as a side effect, particularly when used in combination with other antihypertensive medications 4, 5.
- Beta-blockers, another class of antihypertensive medications, can also cause hypotension, although the risk may be lower compared to other classes of medications 6, 5.