What is low blood pressure. How is blood pressure measured. What are the symptoms of hypotension. What causes low blood pressure. How is low blood pressure diagnosed. What are the treatment options for hypotension.

What is Low Blood Pressure (Hypotension)?

Low blood pressure, also known as hypotension, is a condition where the arterial blood pressure is abnormally low. While a blood pressure reading of around 120/80 mmHg is considered ideal for a young, healthy adult, readings of 90/60 mmHg or lower are generally regarded as low blood pressure.

To understand low blood pressure, it’s essential to grasp how blood pressure works:

• Blood pressure is the force exerted by blood on artery walls as it circulates through the body.
• It’s measured in millimeters of mercury (mmHg).
• Two values are recorded: systolic pressure (when the heart beats) and diastolic pressure (when the heart rests between beats).

Recognizing the Symptoms of Low Blood Pressure

While low blood pressure doesn’t always cause symptoms, when it does, they can include:

• Dizziness
• Fainting (syncope)
• Light-headedness
• Blurred vision
• Palpitations
• Confusion
• Nausea
• General weakness

These symptoms often occur because insufficient blood is flowing to the brain and other vital organs. It’s important to note that not everyone with low blood pressure will experience symptoms, and treatment is only necessary if symptoms are present.

Types of Symptomatic Low Blood Pressure

Two common types of symptomatic low blood pressure are:

1. Postural or orthostatic hypotension: Occurs when blood pressure drops after a sudden change in position, such as standing up from a sitting or lying position.
2. Postprandial hypotension: Happens when blood pressure falls after eating.

Common Causes of Low Blood Pressure

Low blood pressure can result from various factors:

• Dehydration
• Blood loss
• Certain medications (e.g., diuretics, beta-blockers)
• Heart problems
• Endocrine disorders
• Neurological conditions
• Nutritional deficiencies
• Pregnancy

Understanding the underlying cause is crucial for effective management and treatment of hypotension.

Diagnosing Low Blood Pressure: What to Expect

Diagnosing low blood pressure typically involves:

• Blood pressure measurements
• Medical history review
• Physical examination
• Blood tests
• Electrocardiogram (ECG)
• Echocardiogram
• Stress tests
• Tilt table test (for orthostatic hypotension)

Your healthcare provider may use a combination of these methods to determine the cause and severity of your low blood pressure.

Treatment Approaches for Low Blood Pressure

The treatment for low blood pressure depends on the underlying cause and the severity of symptoms. Some common approaches include:

• Lifestyle changes (e.g., increasing fluid and salt intake, wearing compression stockings)
• Medication adjustments
• Treating underlying conditions
• Medications to raise blood pressure

Is medication always necessary for low blood pressure? Not always. If you have low blood pressure but don’t experience any symptoms, treatment may not be required. However, it’s essential to monitor your condition and consult with a healthcare provider if symptoms develop.

Living with Low Blood Pressure: Lifestyle Adaptations

For many people with chronic low blood pressure, making certain lifestyle changes can help manage the condition:

• Stay hydrated by drinking plenty of fluids
• Consume more salt (under medical supervision)
• Eat smaller, more frequent meals
• Stand up slowly from sitting or lying positions
• Avoid prolonged standing
• Exercise regularly to improve circulation
• Wear compression stockings
• Avoid alcohol and caffeine

How effective are these lifestyle changes? While individual responses may vary, many people find significant improvement in their symptoms by implementing these strategies. However, it’s crucial to work with a healthcare provider to develop a personalized management plan.

When to Seek Medical Attention for Low Blood Pressure

While low blood pressure isn’t always a cause for concern, there are situations where medical attention is necessary:

• Sudden, severe drops in blood pressure
• Fainting episodes
• Persistent or worsening symptoms
• Signs of shock (e.g., cold, clammy skin, rapid breathing, weak pulse)
• Low blood pressure accompanied by chest pain, shortness of breath, or irregular heartbeat

Should you go to the emergency room for low blood pressure? If you experience severe symptoms or signs of shock, seeking immediate medical attention is crucial. In less urgent cases, scheduling an appointment with your healthcare provider for evaluation is advisable.

The Impact of Age on Blood Pressure

As we age, our cardiovascular system undergoes changes that can affect blood pressure regulation:

• Arteries may become less elastic
• The body’s ability to respond quickly to blood pressure changes may decrease
• Risk of orthostatic hypotension increases

How does aging affect the management of low blood pressure? Older adults may need to be more vigilant about monitoring their blood pressure and adapting their lifestyle to prevent falls and other complications associated with hypotension. Healthcare providers may also adjust treatment approaches to account for age-related changes in the cardiovascular system.

Blood Pressure Monitoring in Older Adults

Regular blood pressure monitoring becomes increasingly important as we age. For older adults, this may involve:

• More frequent blood pressure checks
• Home blood pressure monitoring
• Keeping a blood pressure diary
• Regular check-ups with healthcare providers

Low Blood Pressure and Exercise: Finding the Right Balance

Exercise can be beneficial for managing low blood pressure, but it’s essential to approach it carefully:

• Start with low-intensity exercises and gradually increase intensity
• Stay hydrated before, during, and after exercise
• Avoid sudden changes in position during workouts
• Be aware of symptoms and stop if you feel dizzy or light-headed
• Consider exercising with a partner for safety

What types of exercises are best for people with low blood pressure? Low-impact activities such as walking, swimming, and cycling can be excellent choices. Strength training can also be beneficial, but it’s important to work with a healthcare provider or certified fitness professional to develop a safe and effective exercise plan.

The Role of Cardiovascular Exercise

Cardiovascular exercise can be particularly beneficial for improving blood pressure regulation:

• It strengthens the heart muscle
• Improves overall circulation
• Helps maintain a healthy weight
• Can reduce stress, which may impact blood pressure

Nutrition and Low Blood Pressure: Dietary Considerations

Diet plays a crucial role in managing low blood pressure. Key considerations include:

• Adequate salt intake (under medical supervision)
• Proper hydration
• Balanced meals to avoid postprandial hypotension
• Foods rich in vitamins B12 and folic acid
• Limiting alcohol consumption

Are there specific foods that can help raise blood pressure? While individual responses may vary, some foods that may help include:

• Salty foods (in moderation and under medical guidance)
• Foods high in vitamin B12 (e.g., eggs, beef, fortified cereals)
• Foods rich in folate (e.g., dark leafy greens, legumes)
• Licorice tea (consult with a healthcare provider before consuming regularly)

The Importance of Meal Timing and Portion Size

For people with low blood pressure, how and when you eat can be as important as what you eat:

• Eat smaller, more frequent meals to avoid large drops in blood pressure after eating
• Stay hydrated during meals
• Limit alcohol consumption, especially during meals
• Consider eating a small snack before bedtime to maintain blood pressure overnight

Low Blood Pressure and Pregnancy: What to Know

Low blood pressure is common during pregnancy, particularly in the first and second trimesters. While it’s usually not a cause for concern, it’s important to be aware of potential complications:

• Increased risk of dizziness and fainting
• Potential for decreased blood flow to the placenta
• Higher risk of orthostatic hypotension

How can pregnant women manage low blood pressure? Some strategies include:

• Staying well-hydrated
• Eating small, frequent meals
• Avoiding long periods of standing
• Rising slowly from sitting or lying positions
• Wearing compression stockings
• Regular prenatal check-ups to monitor blood pressure

When to Consult Your Healthcare Provider

While some degree of low blood pressure is normal during pregnancy, it’s important to seek medical attention if you experience:

• Severe dizziness or fainting
• Persistent headaches
• Vision changes
• Chest pain or difficulty breathing
• Severe nausea or vomiting

Medications and Low Blood Pressure: Potential Interactions

Certain medications can cause or exacerbate low blood pressure. These may include:

• Diuretics
• Alpha-blockers
• Beta-blockers
• Antidepressants
• Erectile dysfunction drugs
• Parkinson’s disease medications

What should you do if you suspect your medication is causing low blood pressure? Never stop taking prescribed medications without consulting your healthcare provider. Instead, discuss your concerns with them. They may adjust your dosage, change the timing of your medication, or switch you to an alternative treatment.

Monitoring Blood Pressure While on Medication

If you’re taking medications that may affect your blood pressure, regular monitoring is crucial:

• Keep a blood pressure diary
• Use a home blood pressure monitor as recommended by your healthcare provider
• Report any significant changes or new symptoms to your healthcare provider
• Attend all scheduled follow-up appointments

The Psychological Impact of Living with Low Blood Pressure

Living with chronic low blood pressure can have psychological effects that are often overlooked:

• Anxiety about potential symptoms or fainting episodes
• Frustration with lifestyle limitations
• Depression related to chronic symptoms
• Social isolation due to fear of symptoms in public

How can individuals cope with the psychological aspects of low blood pressure? Some strategies include:

• Joining support groups or online communities
• Practicing stress-reduction techniques like meditation or yoga
• Seeking counseling or therapy if needed
• Educating friends and family about the condition
• Focusing on what you can do rather than limitations

The Role of Stress Management

Stress can impact blood pressure, making stress management an important aspect of living with hypotension:

• Practice deep breathing exercises
• Engage in regular physical activity
• Ensure adequate sleep
• Consider mindfulness or meditation practices
• Maintain social connections and hobbies

Future Directions in Low Blood Pressure Research and Treatment

Research into low blood pressure continues to evolve, with several promising areas of study:

• Development of new medications specifically for chronic hypotension
• Improved understanding of the autonomic nervous system’s role in blood pressure regulation
• Exploration of potential genetic factors contributing to low blood pressure
• Advanced wearable technologies for continuous blood pressure monitoring
• Investigation of nutritional and lifestyle interventions for managing hypotension

What potential breakthroughs might we see in the treatment of low blood pressure? While it’s difficult to predict specific outcomes, ongoing research may lead to more personalized treatment approaches, better management strategies for orthostatic hypotension, and improved quality of life for individuals living with chronic low blood pressure.

Participating in Clinical Trials

For those interested in contributing to the advancement of low blood pressure research, participating in clinical trials may be an option:

• Discuss the possibility with your healthcare provider
• Research ongoing trials through reputable sources like ClinicalTrials.gov
• Understand the potential risks and benefits before participating
• Ensure the trial is conducted by a reputable institution or organization

By participating in clinical trials, individuals can play a crucial role in advancing our understanding and treatment of low blood pressure, potentially benefiting themselves and others with the condition.

Low blood pressure (hypotension) | NHS inform

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1. 1.

   About low blood pressure

2. 2.

   Symptoms of low blood pressure

3. 3.

   Causes of low blood pressure

4. 4.

   Diagnosing low blood pressure

5. 5.

   Treating low blood pressure

About low blood pressure

Low blood pressure – sometimes referred to as hypotension – is a condition where the arterial blood pressure is abnormally low. Blood pressure is a measure of the force that your heart uses to pump blood around your body. 

The heart

The heart is a muscle that is designed to pump a constant supply of blood around the body. When your heart beats, it pushes the blood around your body through blood vessels called arteries and capillaries. When your heart rests in between beats, the blood flows back to your heart through a network of veins and capillaries. 

Blood pressure 

Blood pressure is a measure of the force of the blood on the walls of the arteries as the blood flows through them. It is measured in millimetres of mercury (mmHg).

When your blood pressure is measured, two measurements are recorded during a single heartbeat. The two measurements are known as the systolic pressure and the diastolic pressure.

• systolic pressure – is the pressure when your heart beats and squeezes blood into your arteries. At this stage, the pressure in your arteries is at its highest. 
• diastolic pressure – is the pressure when your heart rests in between beats and the blood flows back to your heart through your veins. At this stage, the pressure in your arteries is at its lowest

Your blood pressure reading will be given as two numbers, with your systolic reading first, followed by your diastolic reading. If your systolic blood pressure is 120 mmHg, and your diastolic blood pressure is 80 mmHg, your blood pressure is 120 over 80, which is commonly written as 120/80.

The highs and lows

As a general guide, the ideal blood pressure for a young, healthy adult is between 90/60 and 120/80. If you have a reading of 140/90, or more, you have high blood pressure (hypertension). This puts you at greater risk of serious health conditions, such as strokes or heart attacks.

Low blood pressure is also known as hypotension. People with a reading of around 90/60, or less, are commonly regarded as having low blood pressure. Some people who have low blood pressure experience symptoms as a result of it. There may be an underlying cause that could need treatment.

Symptoms of low blood pressure

On its own, low blood pressure (hypotension) does not always cause symptoms. If you have low blood pressure and you do not have any symptoms, you do not require treatment.

However, low blood pressure can sometimes mean that there is not enough blood flowing to your brain and other vital organs. As a result, you may experience some of the following symptoms:

• dizziness 
• fainting (a sudden, temporary loss of consciousness)  
• light-headedness 
• blurred vision 
• palpitations (a rapid or irregular heartbeat)
• confusion 
• nausea (feeling like you are going to be sick)
• general weakness

If you experience the symptoms of hypotension after changing positions (for example, standing up), it is known as postural – or orthostatic – hypotension. If you experience these symptoms after eating, it is known as postprandial hypotension.

Postural or orthostatic hypotension

Postural or orthostatic hypotension occurs when your blood pressure falls after a sudden movement. For example, you may feel dizzy or faint after changing posture, such as sitting up from a lying position, or standing up from a sitting position. This may cause you to lose your balance and fall over. You may also feel light-headed, have blurred vision, or lose consciousness.

The symptoms of postural or orthostatic hypotension should only last a few minutes as your blood pressure adjusts to your new position. This type of low blood pressure tends to affect people more as they get older when it can lead to more frequent falls. Similar symptoms may also occur after exercise.

Postprandial hypotension

Your blood pressure can sometimes decrease (fall) after eating, causing dizziness, light-headedness, fainting and falls. This condition, known as postprandial hypotension, tends to occur more often in older people, particularly in those who have high blood pressure, or a condition such as Parkinson’s disease, or diabetes.

After a meal, your intestines need a large amount of blood for digestion. Your heart rate increases and the blood vessels in other parts of your body constrict (narrow) to help maintain blood pressure. If your heart rate does not increase enough, or if your blood vessels do not constrict enough to maintain blood pressure, your blood pressure will fall. This can then cause symptoms.

Causes of low blood pressure

Throughout the day, your blood pressure can vary by between 30-40 mmHg (both systolic and diastolic) depending on what you are doing. Having a stressful week at work, the temperature outside, and even what you had for lunch could affect your blood pressure reading. 

Each time that you have your blood pressure measured, it is important that the test is carried out under similar conditions to ensure that the results are consistent. If you have a low blood pressure reading, your GP will first consider the everyday causes that might have affected it, before considering the possible underlying causes.   

Everyday causes

Many factors have a daily, or sometimes even hourly, effect on your heart and circulation. Below are things that could affect your blood pressure and, in some cases, may cause low blood pressure.

• The time of day – your blood pressure falls overnight so it will be low in the morning. 
• Your age – typically, blood pressure rises as you get older, although postural, or orthostatic, and postprandial hypotension are also more likely in the elderly. 
• How stressed or relaxed you are – if you are stressed, your heart will beat faster and your blood pressure will increase, and the opposite if you are relaxed. 
• How much exercise you do – initially, exercise will raise your blood pressure, but if you are healthy and exercise regularly, your blood pressure will be low when you are resting. 
• Your temperature – if you are cold, your heartbeat will slow down, and your blood pressure will fall. 
• If you have recently eaten – blood will be used for digesting food in your stomach, so the blood pressure elsewhere in your body will fall.  

Underlying causes 

If your blood pressure is still considered low after taking into account everyday factors such as those listed above, there may be another cause. Some possibilities are explained below. 

Medication 

Some medication may cause hypotension as a side effect. This tends to be orthostatic, or postural hypotension (low blood pressure when you stand up or change position). Examples of medication that can cause hypotension include:

• beta-blockers – these may be prescribed after a problem with your heart or hypertension (high blood pressure) 
• alpha-blockers – these are prescribed to lower blood pressure for people with hypertension 
• some antidepressants 

Your GP will discuss any possible side effects with you when prescribing medication. While you are taking medication, your blood pressure will be carefully monitored if you are considered to be at risk of hypotension.  

Serious illnesses or conditions

If you have an acute (short-term) illness, your blood pressure will be measured regularly because it is a good indicator of the severity of your illness. A heart condition, such as heart failure or a heart attack, can also cause low blood pressure, as your heart may not be able to pump blood around your body. 

Autonomic disorders

Autonomic disorders affect your autonomic nervous system and they can cause hypotension. Your autonomic nervous system is part of your nervous system (the network of cells that carry information around your body). It controls the bodily functions that you do not actively think about, such as sweating, digestion and the beating of your heart. 

The autonomic nervous system also controls the widening and narrowing of your blood vessels. If there is a problem with it, your blood vessels could remain too wide, causing low blood pressure. In particular, autonomic disorders tend to cause orthostatic hypotension.

Some examples of autonomic disorders are:

• diabetes mellitus – a long-term (chronic) condition caused by too much glucose (sugar) in the blood, 
• Parkinson’s disease – a chronic condition that affects the way the brain coordinates body movements 
• multiple system atrophy – a disorder that causes the brain signals to the muscles and limbs responsible for movement to deteriorate.  

Adrenal glands

The adrenal glands are two small glands that are located just above your kidneys. They produce hormones that control your blood pressure and maintain the balance of salt and water in your body. One of the hormones they produce is called aldosterone, which is responsible for controlling the amount of salt in your body.

If your adrenal glands become damaged – for example through an infection or a tumour – the production of aldosterone may be reduced, resulting in a loss of salt from your body. This can cause dehydration which, in turn, leads to low blood pressure. 

If a problem with your adrenal glands is diagnosed, it can be treated by increasing the amount of aldosterone in your body. This could also be a symptom of Addison’s disease (a condition in which the adrenal glands cannot produce enough of the hormones cortisol and aldosterone). Addison’s disease can also be treated with medication. 

Serious injuries and shock

Low blood pressure can also be caused by serious injuries or burns, particularly if you have lost a lot of blood. This can mean that there is less blood being pumped around your body. Low blood pressure can also occur if you go into shock after having a serious injury.

Other kinds of shock are described below.

Septic shock and toxic shock syndrome

Septic shock and toxic shock syndrome are caused by bacterial infections. The bacteria attack the walls of the small blood vessels, causing them to leak fluid from the blood into the surrounding tissues. This causes a significant drop in blood pressure (severe hypotension).

Anaphylactic shock

Anaphylactic shock, or anaphylaxis, is caused by an allergic reaction to something – for example, a wasp sting or a peanut. During an allergic reaction, your body produces a large amount of a chemical called histamine, which causes your blood vessels to widen and leads to a sudden, severe drop in blood pressure.

Cardiogenic shock

Cardiogenic shock occurs when your heart cannot supply enough blood to your body, so your blood pressure drops. This can happen during a heart attack.

Other causes

Other possible causes of low blood pressure are:

• Rare nerve conditions – if the nerves in your legs are affected, you may experience a severe drop in blood pressure when you stand up (postural or orthostatic hypotension). 
• Increasing age – as you get older, your arteries can become stiffer. If they do not constrict (get smaller), your blood pressure may drop, particularly when you stand up. 
• Pregnancy – during the early to mid stages of pregnancy, low blood pressure is fairly common. 
• Prolonged bed rest – low blood pressure may possibly occur as a result of moving less and having overall less nervous system activity. 
• Dehydration – low blood pressure may occur following particularly severe dehydration from vomiting and diarrhoea because the lack of water and salt in your body will reduce the volume of your blood. 
• Your genes – some research has suggested that low blood pressure is genetic. If your parents have low blood pressure, it is possible that you could inherit it from them.

Diagnosing low blood pressure

Low blood pressure (hypotension) can be easily diagnosed by measuring your blood pressure. 

Measuring blood pressure

A blood pressure reading is taken using two measurements. The first measurement is known as systolic, which is the pressure in your arteries when your heart contracts and pushes the blood around your body. The second measurement is known as diastolic, which is the pressure in your arteries when your heart refills with blood in between heartbeats. Both systolic and diastolic blood pressures are measured in millimetres of mercury (mmHg).

Sphygmomanometer

Your GP, or practice nurse, will use a device known as a sphygmomanometer to measure your blood pressure. This device has an inflatable cuff and a scale of mercury, like a thermometer, as a pressure gauge. The cuff is placed around your upper arm and inflated to restrict the flow of blood in your arm. The air is then slowly released from the cuff. 

Your GP or practice nurse will watch the mercury pressure gauge and listen to your blood flow in the main artery of your arm using a stethoscope. Upon hearing your heart beat, the systolic pressure will be recorded. When the sound disappears, the diastolic pressure will be recorded.

Alternatively, a digital sphygmomanometer may be used. This measures your pulse using electrical sensors and takes blood pressure readings automatically. Blood pressure testing kits are also commercially available.

After you have had your blood pressure taken, your GP or nurse will give you your systolic reading first, followed by your diastolic reading. If your systolic blood pressure is 120 mmHg and your diastolic blood pressure is 80 mmHg, you will be told that your blood pressure is 120 over 80, which is commonly written as 120/80.

What is low blood pressure?

As a general guide, low blood pressure is a reading of 90/60 or less. However, it is not necessary for both your systolic and diastolic readings to be in this range for it to be considered low blood pressure. For example, a reading of 80/65 would be considered low because the systolic number is in the low range, and 100/55 would also be considered as low because the diastolic number is in the low range. 

If you have low blood pressure according to this guide, you do not need to worry. Having low blood pressure is considered healthy as it protects you from the risks and diseases of high blood pressure. You will only need to have treatment if you are experiencing symptoms as a result of your low blood pressure.

Postural or orthostatic hypotension

If your symptoms of low blood pressure mostly occur when you change position (postural or orthostatic hypotension), then your blood pressure may be measured before and after you move. For example, your blood pressure may be measured while you are sitting down and again while you are standing up.

Depending on what your seated blood pressure was, if your systolic reading drops by between 15-30 mmHg when you stand up, you may have orthostatic hypotension. 

Underlying causes

Your GP or practice nurse will usually be able to diagnose low blood pressure very easily. However, determining the reason for low blood pressure can be more difficult.

If you have an underlying condition that is causing low blood pressure, it is likely that you will have other symptoms as well. You should discuss these with your GP who may recommend that you have further tests.

Treating low blood pressure

If you have low blood pressure (hypotension), but you do not have any symptoms, you do not require treatment. If you are experiencing symptoms, your GP will try to establish the underlying cause of your hypotension in order to determine what treatment is necessary.  

Medication

If you are taking medication, and your GP suspects that it may be causing low blood pressure, they will probably recommend a change of medication or alter your dose. This includes medication to treat high blood pressure (hypertension) and medication to treat Parkinson’s disease.

Your blood pressure will be monitored while you are taking medication and any changes will be noted by your GP or practice nurse. If you are experiencing side effects from taking medication, you should discuss this with your GP. 

Underlying illnesses or conditions 

If your GP suspects that a disorder – such as a heart condition, adrenal gland failure or a nerve condition – is causing your low blood pressure, you may be referred to hospital for further tests and treatment.

If adrenal gland failure is found to be causing your low blood pressure, your GP may prescribe fludrocortisone to replace the missing hormone, aldosterone. This will usually be in tablet form and will need to be taken for life.

If a nerve condition is causing your low blood pressure, it can be more difficult to treat. You may be prescribed medication in order to help stimulate your nervous system.

Fluids and salt

Dehydration – when the water and salt content of your body is reduced – can cause low blood pressure. Increasing your fluid and salt intake can easily treat this. Ensuring that you drink enough fluid – at least eight glasses a day – will help with hypotension. This is because more fluids will increase the volume of your blood, and having more blood in your arteries will increase your blood pressure.

While people who have high blood pressure are usually advised to restrict their salt intake, if you have low blood pressure, you may be advised to include more salt in your diet. Your GP will be able to advise you about how much additional salt you need, and whether you can add salt to your usual food, or if you need to take salt tablets.

General advice

The following general advice will help to limit your symptoms of your hypotension, particularly postural or orthostatic hypotension. 

• Stand up gradually, particularly first thing in the morning. It may also be useful to try some other physical movements first to increase your heart rate and the flow of blood around your body. For example, stretching in bed before you get up, or crossing and uncrossing your legs if you are seated and about to stand.  
• Wear support stockings – sometimes called compression stockings. These are tight-fitting elastic socks or tights. They provide extra pressure to your feet, legs and abdomen, which will help stimulate your circulation and increase your blood pressure. 
• Raise the head of your bed or use extra pillows under your head. This will increase the flow of blood in your body and will also make it easier when you need to get up.  
• Avoid caffeine at night and limit your alcohol intake – this will help you to avoid dehydration, which can cause low blood pressure. 
• Eat small frequent meals, rather than large ones – this will help you to prevent postprandial hypotension (low blood pressure after you have eaten). Lying down after eating or sitting still for a while may also help. 

Very few people are prescribed medication for hypotension. The symptoms of hypotension can be usually be treated by making these small changes to your lifestyle and, in particular, by increasing your fluid and salt intake.

If medication is necessary, it will usually be medicines to expand the volume of your blood, or to constrict (narrow) your arteries. By increasing your blood, or decreasing your arteries, your blood pressure will increase, as there will be more blood flowing through a smaller space. 

Why Blood Pressure Cuff Size Matters

People who get their blood pressure checked with a cuff that’s much too tight or too loose on their upper arm won’t get an accurate reading — and may get misdiagnosed as a result.

By Lisa Rapaport

March 11, 2022

Everyday Health Archive

Fact-Checked

Nearly half of U.S. adults have high blood pressure, according to the American Heart Association. Getty Images

Blood pressure cuffs really aren’t one-size-fits-all. To the contrary, a recent study suggests that people who get their blood pressure checked with a cuff that’s the wrong size for their arm circumference may have undetected hypertension or get incorrectly diagnosed with this condition.

Like people, blood pressure cuffs come in many sizes. The American Heart Association (AHA) recommends that the length of the bladder that wraps around patients’ upper arms be 75 to 100 percent of their arm circumference for a snug but not excessively tight fit. Cuffs for a “regular” size adult might get accurate readings for a person with an arm circumference of around 27 to 34 inches, according to the AHA, but it would be inaccurate for somebody with a much smaller or larger size.

Many previous studies have noted inaccurate blood pressure readings made with ill-fitting manual blood pressure cuffs that clinicians pump by hand to compress around the upper arm, but new research presented at the AHA’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022 suggests that inaccuracies also occur with newer, automated blood pressure monitors.

“Accurate blood pressure measurement depends on proper patient preparation, positioning, measurement technique, and individualized selection of cuff size,” says Tammy Brady, MD, PhD, the lead author of the new study and the medical director of the pediatric hypertension program at Johns Hopkins University in Baltimore.

Nearly half of U.S. adults have high blood pressure, according to the AHA. This is defined by the AHA as a systolic blood pressure (the “top number,” which measures the pressure blood exerts against artery walls when the heart beats) of at least 130 mmHg (millimeters of mercury), or a diastolic blood pressure (the “bottom number,” which measures the pressure blood exerts in the arteries when the heart rests between beats) of at least 80 mmHg.

For the study, researchers compared blood pressure readings for 165 adults who had separate measurements done with both a “regular” adult-size cuff and with a cuff appropriately sized for their arm circumference.

Overall, 30 percent of the study participants had hypertension, according to their systolic blood pressure.

Slightly more than two in five people in the study had obesity. When these people who required an extra-large blood pressure cuff had measurements done with a “regular” adult size cuff, this inaccurately increased their systolic blood pressure readings by an average of 19.7 mmHg and their diastolic blood pressure readings by an average of 4.8 mmHg.

In 39 percent of these cases, people with obesity were misdiagnosed with hypertension as a result.

Similarly, people who needed a “small” blood pressure cuff had hypertension that went undetected in 22 percent of cases when their measurements were done with a “regular” adult size cuff. When these people who needed a smaller cuff had measurements with a “regular” cuff, this inaccurately decreased their systolic blood pressure readings by an average of 3.8 mmHg and their diastolic blood pressure readings by an average 1.5 mmHg.

“The degree of under- or overestimation depends on the size discrepancy of the cuff to the size of the arm, and can be substantial,” says Jordana Cohen, MD, an assistant professor of medicine and epidemiology at the University of Pennsylvania Perelman School of Medicine in Philadelphia, who wasn’t involved in the new study.

To avoid this problem and get your blood pressure checked with a cuff that fits, you should ask your provider to measure the circumference of the middle of your upper arm, Dr. Brady advises. You should also do this yourself before you buy a blood pressure monitor for home use.

“If a cuff pops off when being inflated or if the device provides multiple error messages while you’re trying to obtain a blood pressure, that might be a sign the cuff is too small,” Brady says.

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Low blood pressure – Hypotension, how to increase blood pressure? – Health World

What is low blood pressure?

Normal blood pressure ranges from 90/60 to 120/80 mmHg. If the pressure readings are less than 90/60, the pressure is considered low. This condition is called hypotension.

Each person has his own normal (working) pressure, so hypotension is usually called pressure, which is 20% lower than the working one. Many (most often thin women) live with hypotension for years and feel great. Doctors believe that these people are lucky – they are less likely to suffer from cardiovascular diseases.

Symptoms of low blood pressure

• Headache in the temples, sometimes headache in the back of the head or in the forehead is the most common symptom of low blood pressure. This symptom is directly related to circulatory disorders of the cerebral vessels.
• Dizziness, both sudden and after a sudden change in body position, especially in the morning, are also characteristic symptoms of low blood pressure. Usually dizziness is accompanied by darkening of the eyes, noise in the head, sometimes even fainting. Therefore, people with low blood pressure are not recommended to get out of bed abruptly.
• Feeling of weakness, fatigue, inactivity. Such people get tired very quickly, this is especially acute at the end of the working day – attention and memory decrease, the person becomes absent-minded, irritable, and he has mood swings. It is very difficult for them to be in the same position for a long time, for example, standing in line or washing dishes.
• Hypotension is often accompanied by vegetative disorders – sweating of the palms and feet, violations of thermoregulation – a decrease in temperature to 35.8 – 36 C, sometimes there may be a feeling of incomplete inspiration or shortness of breath during physical exertion.

What to do with low pressure?

If your blood pressure is consistently low but you feel good, there is no need to do anything. If you are concerned about nausea, dizziness or fainting, you need to consult a general practitioner in St. Petersburg.
The frequent occurrence of low blood pressure symptoms may indicate the presence of various diseases. In order to identify the cause, doctors conduct various examinations: ultrasound of the heart, blood vessels, ECG, FGDS. The therapist can refer to narrow specialists: a cardiac surgeon, a gastroenterologist, an endocrinologist, a neurologist. It is important to find out the true cause, because the method of treatment depends on the diagnosis.

General recommendations for hypotension:

• Drink plenty of fluids and salt. In summer, a person quickly loses water and minerals.
• Drink coffee, tea or cocoa. Drinks with caffeine give a good effect, though short-term.
• Avoid stuffiness, extreme stress or fright.
• Maintain a good mood.
• Perform simple exercises that are useful for hypotension: sit in a cross-legged position, clench and unclench your fists, work with a manual expander.

What to do if there is a sudden drop in pressure?

First, you need to take a supine position. If there is no way to lie down, you must definitely sit down and tilt your head as low as possible, between your knees. This position will ensure the flow of the required amount of blood to the brain and well-being will immediately improve.

Secondly, you should immediately drink a glass of water or, best of all, strong sweet tea. When fainting, you can revive him with a bottle of essential oils or ammonia. It is necessary to bring the bottle to the nose and lightly smear the whiskey. These measures will help in the shortest possible time to normalize blood pressure and bring a person back to normal.

Consequences of low blood pressure

• In children and adolescents, hypotension often occurs due to rapid growth, a malfunction occurs in the autonomic nervous system. As a result, when you change your posture or bend over, you get dizzy, fainting, which leads to injuries and accidents. In this case, physical activity is recommended – running, swimming, walking is better. Children usually outgrow the problem and hypotension goes away on its own.
• Hypotension in adulthood, especially in atherosclerosis, can cause ischemic stroke. In addition, with hypotension, angina pectoris and atherocardiosclerosis rapidly progress.
• Low blood pressure during pregnancy can even cause loss of the baby. Such expectant mothers should follow the doctor’s recommendations: walk more in the fresh air, have good sleep and nutrition.

Last update: 06/17/2021

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Low blood pressure: how to live with it?

Understanding how dangerous low blood pressure is and whether it is urgent to “raise” it.

What is low blood pressure, is it dangerous and how to turn it into normal – Oksana Dikur, a therapist and cardiologist at the Rassvet clinic, tells Women’sHealth readers.

What is low blood pressure anyway?

Blood pressure is the force with which blood presses against the walls of the arteries. At the moment when the heart contracts, the pressure is highest – it is called the upper, or systolic. In the interval between heartbeats, the pressure in the vessels drops – it is called lower, or diastolic.

Normal blood pressure ranges from 90/60 to 120/80 mmHg. The numbers 90 and 120 are systolic, and 60 and 80 are diastolic. If scores are less than 90/60, the pressure is considered low. This condition is called hypotension.

Is low blood pressure dangerous?

Many – most often thin women – live with hypotension for years and feel great. Doctors believe that these people are lucky: they are less likely to suffer from cardiovascular diseases.

However, if the pressure suddenly drops below normal levels, unpleasant symptoms may appear:

• blurred vision;
• dizziness;
• fainting;
• nausea or vomiting;
• drowsiness;
• feeling of weakness.

As a rule, at a young age, the health risk is not associated with low blood pressure itself, but with the reasons for which it falls. The exception is fainting. “This is the most alarming symptom, since it often leads to injuries and accidents,” says Oksana Dikur, internist, cardiologist at the Rassvet Clinic . – If hypotension is accompanied by loss of consciousness, you should definitely consult a doctor.

But for the elderly, lowering blood pressure can be really dangerous. Moreover, a drop in diastolic pressure is more dangerous than a decrease in systolic.

“This can lead to poor blood supply to the kidneys and brain, and increase the risk of stroke and kidney failure,” explains Oksana Dikur.

What causes hypotension?

If you suddenly change your body position

Get up quickly or, for example, sit up abruptly in bed. This is called orthostatic hypotension. When a person assumes a vertical position, blood rushes to the legs and abdomen under the influence of gravity, and the pressure in the vessels drops. In order to raise blood from the legs and normalize blood pressure, the autonomic nervous system increases the heart rate and constricts blood vessels.

Healthy people do not experience discomfort because this mechanism works very quickly. But in some cases, the autonomic nervous system fails. As a result, the pressure drops, the blood does not have time to rise from the legs, the brain lacks oxygen, and symptoms of hypotension appear. This happens, for example, in pregnant women, in people with certain diseases like diabetes, and in every fifth elderly person.

Sometimes healthy people experience similar sensations, for example, due to heat, and there is nothing to worry about. But if your head is spinning every time you change your posture, you need to see a doctor.

If you eat

After eating, the blood rushes to the gastrointestinal tract, and to prevent the pressure from dropping too much, the autonomic nervous system constricts the blood vessels and increases the heart rate. However, in about a third of older people, it cannot cope with such a load. This condition is called postprandial hypotension. If this happens, you need the help of a doctor.

If you grow too fast

As you might guess, the problem most often occurs in children and adolescents: due to rapid growth, a malfunction occurs in the autonomic nervous system. As a result, when changing posture or bending over, symptoms such as dizziness and fainting appear. This is called nerve-mediated hypotension. Children usually outgrow the problem, and hypotension goes away on its own.

But sometimes nerve-mediated hypotension is a sign of serious neurological diseases. In this case, a person needs the help of a doctor.

If you get sick

Blood pressure may drop in people who are dehydrated, those who have experienced shock, diabetics, patients with arrhythmia and heart failure. In this situation, doctors seek to cure or control the disease that leads to hypotension.

If you take certain medications

Sometimes hypotension is a side effect of anti-anxiety drugs, diuretics, pain relievers, or blood pressure pills. In order to solve the problem, the doctor, as a rule, only needs to adjust the dose of the medicine.

What if it is vegetovascular dystonia?

Vegetovascular dystonia is a non-existent diagnosis that people like to put on the territory of the former USSR. If the doctor is trying to write off low pressure on the IRR, it is worth finding another specialist who will find out why you are really unwell.

How to turn low blood pressure into normal?

If the pressure is constantly below normal, but you feel well, nothing needs to be done. If you are concerned about nausea, dizziness or fainting, you need to consult a doctor.

You can’t figure it out on your own: low blood pressure can be a symptom of a variety of diseases, and in order to find out the true cause, you need to take tests and undergo an examination. This is very important because the method of treatment depends on the diagnosis.

But there are also general recommendations that should be followed in case of hypotension:

Give up psychoactive substances

Alcohol, tobacco and smoking mixtures, which are used, for example, in hookahs, can lower blood pressure. In addition, drugs that are prescribed to the patient for completely different purposes sometimes have an effect on blood vessels. Therefore, if you are taking medications or dietary supplements, you must inform your doctor about them.

Drink plenty of fluids and salt

In summer, a person quickly loses water and minerals. An adequate amount of water significantly reduces the risk of developing hypotension.

Avoid situations that provoke hypotension

Blood pressure can drop due to stuffiness, extreme stress or fright, as well as standing for a long time, standing up abruptly, or eating very large meals.

Sit or lie down at the first sign of hypotension

Only get up if you feel better.

Wear compression stockings

This recommendation only applies to pregnant women. Your doctor will help you choose the right option.

Do simple exercises

Helpful for hypotension:

• sit cross-legged;
• strain the muscles of the arms, clenching and unclenching fists;
• to work with a manual expander.

In general, exercise increases the return of blood to the heart and raises blood pressure levels. Therefore, regular aerobic exercise and light strength training reduce the likelihood of developing hypotension.