Hypotension vs Hypertension

What is Hypotension?

Hypotension usually refers to a blood pressure reading in which the top number (systolic blood pressure) is less than 90 millimeters of mercury (mm Hg) or the bottom number (diastolic blood pressure) is less than 60 mm Hg.

What one person considers hypotension may be normotensive to another. Low blood pressure sometimes causes no obvious symptoms, and sometimes it can cause dizziness and fainting. Sometimes, low blood pressure can be life-threatening.

What is Hypertension?

Simply put, blood pressure is "the pressure exerted on the walls of blood vessels when blood flows through them." There are two types of pressure: one is systolic pressure, which is the pressure produced when the heart contracts and pumps blood into the blood vessels. The value is relatively high; the other is diastolic pressure, which is the pressure produced when the blood vessels elastically recoil when the heart relaxes. pressure, the value is relatively low.

Why is Blood Pressure so important?

Because blood pressure represents the ability of blood to perfuse all parts of the body. If it is too high, it may cause the blood vessel wall to be unable to withstand the pressure and rupture, causing a stroke; or if it is too low, blood cannot perfuse to the body organs normally. , causing dizziness, weakness and other conditions.

What is the blood pressure standard?

To know the blood pressure standard, you must first learn to read blood pressure records. Generally, the unit of blood pressure recording is millimeters of mercury, written as mmHg. When measuring blood pressure, the blood pressure record will be written as "systolic blood pressure/diastolic blood pressure mmHg", for example [117/65 mmHg 】It is a complete blood pressure record.

According to the latest hypertension guidelines (The New Blood Pressure Guideline) released by the American Heart Association (AHA) in 2019, as long as the blood pressure is maintained below 120/80 mmHg and is not hypotensive (systolic blood pressure is lower than 90mmHg, or diastolic blood pressure is lower than 60mmHg), even the blood pressure standard range.

According to the latest high blood pressure guidelines in Taiwan, if the average blood pressure measured at home is greater than 130/80 mmHg, you are considered to have high blood pressure.

Low blood pressure can occur for many reasons, from dehydration to serious medical illness. It is important to identify the cause of hypotension so that it can be treated accordingly.

Hypotension Type

Hypotension can be divided into the following categories:

Orthostatic hypotension (orthostatic hypotension). This refers to a sudden drop in blood pressure when you go from sitting to standing or when you stand up after lying down. Triggers include dehydration, bed rest, pregnancy, certain medical conditions and some medications. This type of hypotension is common in older people.

Postprandial hypotension. This drop in blood pressure occurs 1 to 2 hours after eating. Postprandial hypotension is most likely to affect older adults, especially those with hypertension or autonomic nervous system disorders such as Parkinson's disease. Eating small, low-carbohydrate meals, drinking plenty of fluids, and avoiding alcohol may help relieve symptoms.

Neurally mediated hypotension. This type of hypotension refers to a drop in blood pressure after standing for a long time. It mostly affects young people and children. The cause may be poor information conduction between the heart and the brain.

Multiple system atrophy with orthostatic hypotension. This rare disorder, also known as Schadt-Schaud syndrome, affects the nervous system that controls involuntary functions such as blood pressure, heart rate, breathing and digestion. Very high blood pressure while lying down has been associated with this disorder.

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Hypotension Symptom

Symptoms of hypotension (low blood pressure) may include:

Blurred or declining vision

Dizziness or light-headedness

syncope

fatigue

difficulty concentrating

nausea

For some people, low blood pressure can be a sign of an underlying health problem, especially if the drop in blood pressure occurs suddenly or is accompanied by symptoms.

Sudden drops in blood pressure can be dangerous. A change of just 20 mm Hg (for example, a drop in systolic blood pressure from 110 mm Hg to 90 mm Hg) can cause dizziness and fainting. If blood pressure drops sharply due to non-stop bleeding, severe infection, or allergic reaction, it can be life-threatening.

Severe low blood pressure can lead to the medical condition of shock. Symptoms of shock include:

Confusion, especially in older people

clammy skin

Lightening of skin tone (pallor)

Shortness of breath, shortness of breath

Pulse is weak and rapid

When to see a doctor

Get emergency medical help if you develop severe low blood pressure or symptoms of shock.

Most health care providers consider blood pressure to be low only if it is causing symptoms. Occasional mild dizziness or lightheadedness can be caused by many things, such as being in the sun or staying in a hot pool for too long. It is important to make an appointment with a medical professional to get a correct diagnosis.

If your blood pressure readings are consistently low but you feel fine, your healthcare provider may only monitor you during routine health exams. It can be helpful to keep a record of when your symptoms started and what you were doing at that time.

Request an appointment

Hypotension Cause

Blood pressure is determined by the amount of blood pumped by the heart and the resistance to arterial blood flow. Blood pressure is measured in millimeters of mercury (mm Hg), and the result consists of two values:

Systolic blood pressure. The first (upper) number is the arterial pressure when the heart is beating.

diastolic blood pressure. The second (bottom) number is the arterial pressure when the heart is resting between beats.

The American Heart Association considers ideal blood pressure to be normal blood pressure. Ideal blood pressure is usually less than 120/80 mm Hg.

Blood pressure changes throughout the day, depending on:

body position

breathe

diet

drug

Physical conditions

pressure

time of day

Blood pressure is usually lowest at night and rises quickly after waking up. Certain health problems and the use of certain medications can cause low blood pressure.

Conditions that may cause hypotension

Medical conditions that may cause hypotension include:

Pregnant. Changes that occur during pregnancy cause blood vessels to dilate rapidly. Such changes may lead to a decrease in blood pressure. Hypotension is common in the first 24 weeks of pregnancy. Blood pressure usually returns to pre-pregnancy levels after delivery.

Heart and heart valve problems. Low blood pressure can be caused by heart attack, heart failure, valvular heart disease, and a very low heart rate (bradycardia).

Hormone-related disorders (endocrine disorders). Conditions that affect the parathyroid or adrenal glands, such as Addison's disease, may cause lower blood pressure. Hypoglycemia may cause low blood pressure, and sometimes diabetes may cause low blood pressure.

Dehydration. If the body is dehydrated, blood volume will decrease, possibly resulting in lower blood pressure. Fever, vomiting, severe diarrhea, excessive use of diuretics, and strenuous exercise can all lead to dehydration.

blood loss. Excessive blood loss (for example, due to injury or internal bleeding) can reduce blood volume in the body, causing a significant drop in blood pressure.

Severe infection (sepsis). When an infection in the body enters the bloodstream, it can cause a life-threatening drop in blood pressure (septic shock).

Severe allergic reaction. Symptoms of a severe allergic reaction include a sharp drop in blood pressure.

Nutrient deficiencies in the diet. Insufficient vitamin B-12, folate, and iron may cause the body to fail to produce enough red blood cells (anemia), causing low blood pressure.

Medications that can cause low blood pressure

Some drugs can cause low blood pressure, including:

Water pills (diuretics) such as furosemide (Lasix) and hydrochlorothiazide (Microzide)

Alpha blockers, such as prazosin (Minipress)

Beta blockers, such as atenolol (Tenormin) and propranolol (Inderal, Innopran XL, Hemangeol)

Parkinson's disease medications, such as pramipexole (Mirapex) or medications containing levodopa

Certain types of antidepressants (tricyclic antidepressants), including doxepin (Silenor) and imipramine (Tofranil)

Erectile dysfunction medications, including sildenafil (Revatio, Viagra) or tadalafil (Adcirca, Alyq, Cialis), especially when taken with the heart disease medication nitroglycerin (Nitrostat, Nitro-Dur, Nitromist)

Risk Factors

Anyone can develop hypotension. Risk factors for hypotension include:

age. A drop in blood pressure when standing or after eating occurs primarily in adults over 65 years of age. Neurally mediated hypotension primarily affects children and adolescents.

drug. Certain medications, including some antihypertensive drugs, can increase the risk of hypotension.

certain diseases. Parkinson's disease, diabetes, and certain heart conditions may increase the risk of low blood pressure.

complication

Potential complications of hypotension include:

Dizziness

weak

syncope

Fall injured

Severe hypotension can reduce the body's oxygen levels, which can lead to heart and brain damage.