91 55 blood pressure: Low Blood Pressure (Hypotension) Chart, Causes, Symptoms & Treatment
Low blood pressure: Simon Cowell’s health scare
Simon Cowell’s recent health scare is putting the spotlight on the flip side of high blood pressure.
While you may know hypertension is bad for your health — straining your heart and raising your risk of heart attack and stroke — low blood pressure, or hypotension, can come with its own dangerous consequences.
Cowell, the 58-year-old “America’s Got Talent” judge, suffered a concussion last week after he passed out and fell down a flight of stairs at his London home.
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“[Doctors] think I fainted because I had low blood pressure and so I have got to really take good care of myself to sort that out,” he told The Sun, a British newspaper.
“Sometimes we get a reminder that we’re not invincible and this was certainly mine. It was a huge shock.”
What’s the risk?
When you get your blood pressure checked, doctors like to see a lower reading, within certain limits — generally between 90/60 mmHg and 120/80 mmHg. But you could fall below the lower limit and still be healthy and feel fine.
With low blood pressure, the numbers are mostly irrelevant unless you have symptoms, said Dr. Sharonne Hayes, director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minnesota.
“Your heart loves a low blood pressure; your brain sometimes not so much,” Hayes told TODAY. “The challenge is that you need a certain amount of pressure to get the blood up to your brain.”
“The condition itself isn’t going to kill you, but if you’re on a subway platform and you get lightheaded and fall, you can hit your head or you can get hit by a train,” added Dr. Jennifer Haythe, co-director of the Women’s Center for Cardiovascular Health at Columbia University Medical Center in New York City.
Neither doctor is treating Cowell, but commented about the condition in general.
What are the symptoms of low blood pressure?
If your brain is not getting enough blood, you’ll feel woozy and lightheaded. You may sweat, have clammy skin or feel nauseous. You can get tunnel vision like you’re about to pass out or you may feel like everything is going black in front of your eyes.
Why do people experience low blood pressure?
There are several possible reasons.
Low blood pressure can be a temporary event for anyone. Often, people who stand for a long time — on a subway or in a church choir, for example — may experience hypotension and syncope, the clinical term for fainting.
Blood pressure can also drop for a few seconds when you stand up. If you work out hard and get dehydrated, your normal blood pressure can dip low enough to cause you to pass out, Hayes said.
Some people just naturally have low blood pressure. For others, it may be due to the medicines they’re taking.
More serious causes of low blood pressure include heart failure, severe infection and conditions where your autonomic nervous system is not working properly.
Who is a typical patient?
Low blood pressure is more common in young, thin, tall women, Haythe said. Hypotension is also common during the first 24 weeks of pregnancy.
How is it managed?
If it’s a temporary event, the best way to treat low blood pressure is to lie down, Hayes said.
If you have chronically low blood pressure and feel lousy with it, her first advice is to exercise regularly because that gets the muscles around the blood vessels to be more responsive. You should also take basic precautions, like standing up slowly when you get out of bed to avoid a sudden drop in blood pressure.
Patients also have to make sure they’re hydrated and even over-hydrated. Consuming lots of salt is actually good for low blood pressure because sodium in the diet helps your body hold on to the fluid that you take in. Hayes simply advises patients to drink tomato juice every morning.
Low blood pressure can also be managed with medications.
High blood pressure is a much more significant long-term risk to your health, both doctors said. With low blood pressure, they’re only concerned if people have symptoms.
“Low blood pressure is not usually a heart risk; it’s more of an injury risk,” Hayes said.
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Maintaining A Normal Blood Pressure in Seniors
Controlling blood pressure – the force of circulating blood on the walls of the arteries – is an important way to maintain good heart health in seniors. That’s especially important because the risk of high blood pressure and low blood pressure in elderly increases with age.
Avoiding high blood pressure, called hypertension, can help seniors prevent strokes, heart disease, kidney failure, vision problems and other serious health conditions. Preventing low blood pressure, called hypotension, can help seniors avoid dizziness, lightheadedness, falls and shock.
Know Your Numbers
Blood pressure readings contain two numbers, a top number and a bottom number. The top number is the most important for seniors, because it often rises despite the bottom number remaining low, a condition called isolated systolic hypertension.
Prior to 2017, 140/90 or less was the recommended blood pressure for seniors age 65 to 79, with 145/90 or less recommended for people age 80 or older. But updated guidelines released by the American Heart Association and other organizations no longer give different recommendations based on age. According to the guidelines, the new normal blood pressure for seniors (and everyone else) is less than 120/80. Blood pressure is generally considered too low if it dips below 90/60.
What Causes High Blood Pressure in the Elderly
High blood pressure is the most common chronic condition among older adults. Factors that contribute to a senior’s risk include:
- Aging: As people age, their arteries may become stiffer, making it more difficult for blood to pass through and causing blood pressure to rise.
- Being overweight: Excess weight makes the heart work harder in order to pump blood throughout the body, which can raise blood pressure.
- Certain diseases: People with diabetes or chronic kidney disease are more likely to develop high blood pressure.
- Genetics: A family history of high blood pressure increases a person’s risk of developing it. A person’s race can also increase their risk. For example, African Americans are more likely to develop high blood pressure than others.
- Lifestyle habits: Nicotine use, a poor diet and lack of exercise increase a person’s risk of high blood pressure.
How to Lower Blood Pressure in the Elderly
Seniors don’t have to settle for life with hypertension. Making these changes can help lower high blood pressure:
- Quit smoking: People who smoke are more likely to have high blood pressure. It’s never too late to quit.
- Eat healthier: Eating lots of fruits and vegetables, as well as low-fat dairy products and whole grains, can help you lose weight and can lower your blood pressure. Eating less salt and less saturated fat and drinking less alcohol can also help.
- Exercise more: Seniors with high blood pressure should get at least 30 minutes of moderate exercise most days – if not every day – to help lose weight and lower blood pressure. Talk to your doctor about what kind of exercise is most appropriate.
- Take medication: If lifestyle changes alone aren’t enough to bring down your blood pressure, your doctor will prescribe medication as well. Taking blood pressure medication is very common. There are many different types available, including diuretics, beta blockers and ACE inhibitors. Seniors may need to try a few medications (as advised by their doctors), alone or in combination, to find what works best for them.
What Causes Low Blood Pressure in the Elderly
Low blood pressure in the elderly is less common than high blood pressure and is usually only considered a problem if it causes symptoms. If you feel faint, lightheaded or weak, it could be a sign that your blood pressure is too low and that you should call your doctor. Potential reasons for low blood pressure in the elderly include:
- A sudden rise: Standing up quickly is the most common cause of low blood pressure in the elderly.
- Prolonged bed rest: Inactivity can lead to low blood pressure.
- Meals: Seniors are more likely to experience low blood pressure after eating than younger people are.
- Dehydration: Losing too much water can cause blood pressure to take a nosedive.
- Certain health problems: Heart disease, Parkinson’s disease, diabetes, allergic reactions and infections increase the risk of low blood pressure.
- Medication: Sometimes medication for lowering high blood pressure can lower it too much, resulting in blood pressure that is too low. Other medications, including some that treat depression, Parkinson’s disease and erectile dysfunction, can also cause sudden drops in blood pressure.
How to Raise Blood Pressure in the Elderly
Hypotension can be treated. Making these changes can help raise low blood pressure in the elderly:
- Rise more carefully: Take time to slowly move from lying down to sitting, and from sitting to standing.
- Get more exercise: Moving more, and avoid long periods of sitting or standing still.
- Eat more slowly: Eating smaller meals more frequently, and taking time to finish them, can stop blood pressure from dropping too much.
- Add some salt: Just as people with high blood pressure benefit from lowering their salt intake, those with low blood pressure benefit from increasing theirs.
- Drink more water: This is especially important when it’s hot out or during illness.
- Talk to your doctor: If a health problem or medication is causing low blood pressure, your doctor can advise you about how to manage the situation.
Changing habits isn’t easy. But it’s worth it, because achieving and maintaining the recommended blood pressure can help you live a longer, healthier life.
Normal Blood Pressure in Women | Hypertension for Women
Updated: Dec 18th, 2020
High blood pressure (“hypertension“) is largely treatable with lifestyle and medications, but only slightly over half of women with high blood pressure have their condition under control says a recent study from the American Heart Association (ADA). So what is normal blood pressure for women?
You can work to stay healthy by monitoring your numbers, considering healthy lifestyle changes, and following your doctor’s orders. Health tools such as Lark, which is provided free of charge by many health plans and includes guidance on blood pressure reduction and free tools to track it at home, can help you.
What Is High Blood Pressure?
Hypertension is higher-than-normal pressure in your blood vessels, as defined by the Mayo Clinic. The pressure is measured as the force of the blood against the wall of your blood vessels, usually your arteries, which carry oxygenated blood to your body organs and tissues.
Your blood pressure monitor will show your reading as two numbers. The top number is the systolic blood pressure (SBP). It reflects blood pressure when the heart is contracting, and is the higher of the two numbers. The bottom number is the diastolic blood pressure (DBP). It reflects blood pressure when the heart is relaxing, and is the lower of the two numbers.
These are the standard classifications for normal and high blood pressure.
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|Normal blood pressure||90/60 to under 120/80 mm Hg.|
|Prehypertension, or risk for hypertension||120-139/80-89 mm Hg|
|Stage 1 hypertension||140-159/90-99 mm Hg.|
|Stage 2 hypertension||over 160/100 mm Hg.|
If your systolic pressure and diastolic pressure are in two different categories, doctors consider the number that is in the higher category. For example, if your blood pressure is 135/91, your systolic blood pressure is in the prehypertensive range and your diastolic blood pressure is in the range of Stage 1 hypertension. Your measurement or 135/91 would place you in the category of Stage 1 hypertension.
Here is a chart to help you read your results:
|Systolic Blood Pressure (SBP)||Diastolic Blood Pressure (DBP)|
<120 mm Hg
<80 mm Hg
120-129 mm Hg
<80 mm Hg
|Hypertension Stage 1||
130-139 mm Hg
80-89 mm Hg
|Hypertension Stage 2||
Over 139 mm Hg
Over 89 mm Hg
Stage 1 and Stage 2 High Blood Pressure in Women
Stage 1 hypertension is when your blood pressure is 140-159/90-99 mmHg. You would also be considered to have stage 1 hypertension if your systolic blood pressure is 140-159 and your diastolic blood pressure is under 90, or if your diastolic blood pressure is 90-99 and your systolic blood pressure is under 140 as states Heart.org of the AHA.
Stage 2 hypertension is when your blood pressure is over160/100 mmHg, or if your systolic blood pressure is over 160, or if your diastolic blood pressure is over 100. Stage 2 hypertension puts you at higher risk for complications of high blood pressure than stage 1 hypertension does.
High blood pressure is not unique to women, it affects nearly 1 out of every 3 American adults according to the Centers for Disease Control (CDC), and another 1 out of 3 are pre-hypertensive and at risk for developing hypertension.
What Is Essential High Blood Pressure in Women?
Essential hypertension is also known as primary high blood pressure. Over 9 out of 10 cases of hypertension are essential, and this is the kind of hypertension most people are referring to when they talk about “hypertension” or “high blood pressure.” This kind of hypertension is the direct result of factors such as lifestyle choices or genetic factors. Related lifestyle factors can include the following.
- Being overweight
- Have a high-sodium diet or other poor dietary patterns
- Have a low-activity lifestyle
- Lack of sleep
In contrast to essential high blood pressure, secondary high blood pressure is high blood pressure that occurs due to the effects of another condition or medical cause, such as kidney disease, adrenal disease, or medications, such as some over-the-counter painkillers and oral contraceptive pills (birth control pills).
High Blood Pressure Symptoms in Women
The symptoms of hypertension depend on which kind you have and how severe it is. You may not have any signs of high blood pressure, or you could notice hypertension symptoms in your day-to-day activities.
2021 High Blood Pressure Clinical Guidelines
Hypertension clinical guidelines from the American Heart Association are comprehensive guidelines for healthcare professionals for the detection and treatment of high blood pressure in a wide range of patients. Included in the 2021 hypertension clinical guidelines are proper methods for measuring blood pressure, risks for hypertension, and hypertension treatment for different populations.
These guidelines help guide healthcare practices, and can be related to patient reimbursement and healthcare coverage. The tenth revision of the International Statistical Classification of Diseases and Related Health Problems, or ICD-10, is the set of codes used to designate specific health conditions and allow for reimbursement through health insurance programs.
High Blood Pressure Risk Factors for Women
Since you are unlikely to have symptoms of hypertension, it is good to learn the factors of risk so you have some idea for yourself You should contact your healthcare provider if you have prehypertension or high risk for hypertension. Even if your risk is low, you should find your blood pressure so you have a baseline to work from so you can stay healthy in the future.
Non-Modifiable Factors for High Blood Pressure
The risk factors for high blood pressure include both genetic factors as well as modifiable factors, or factors that can be controlled. These are the factors you cannot control.
|Family history||You are more likely to develop high blood pressure if your parents or siblings did.|
|Age||Your risk increases as you get older.|
|Race||African Americans are more likely to get high blood pressure and complications from it.|
Modifiable Risks for High Blood Pressure in Women
Modifiable risk factors for hypertension are factors that you can control. Learning about these can help you identify areas in your life where you could change some things to lower high blood pressure or lower your risk for high blood pressure.
These are some lifestyle-related issues for hypertension.
|Obesity||Extra weight requires extra blood volume to circulate oxygen to your tissues, which causes extra pressure in your blood vessels. A BMI of 30 or over corresponds to a weight of 180 lb. for someone who is 5’6” or 209 lb. for someone who is 5’10.”|
|Lack of physical activity||Your heart must work harder to pump blood through your body, and force on your arteries is higher.|
|A high-sodium, low-potassium diet||Sodium, which is mostly found in salt, raises blood pressure by increasing water retention and blood volume, while potassium has the opposite effect.|
|Use of tobacco||Smoking and chewing tobacco raise blood pressure and damage your arteries.|
|Excessive alcohol consumption||Moderate consumption of red wine can be good for your heart in some cases, but alcohol abuse over time can raise blood pressure.|
Hypertension at Work
There has been some attention towards high blood pressure at work. It makes sense, since work can be stressful. Even a job you love can take time away from your family and leisure time while demanding effort and enforcing tight deadlines. Worse, jobs could involve unpleasant coworkers, unrealistic workloads, and high-pressure bosses.
Hypertension Prevention and Treatment
Many of the strategies for hypertension prevention and treatment are similar. They focus on healthy lifestyle changes and behaviors. The following strategies can be good for your blood pressure.
- Losing extra weight
- Increasing hypertension diet quality.
- Increasing physical activity.
- Avoiding tobacco use.
- Getting enough sleep.
- Managing stress.
- Monitoring blood pressure.
Losing Extra Weight
Extra weight is a major risk mofifier for hypertension. While weight loss is difficult for many people, it can be easier to focus on small goals. Losing just a little bit of extra weight can help, since each kilogram (2.2 lb.) can lead to a 1-point decrease in blood pressure stated a recent Harvard Study.
Small changes can help you lose weight over time.
- Drink more water. It helps reduce hunger!
- Fill your plate with non-starchy vegetables, since they are low-calorie and filling.
- Consider lower-calorie swaps, such as fatty meats for skinless poultry and fish.
- Bake, grill, roast, or steam instead of fry.
- Limit high-calorie, low-nutrient foods such as desserts, butter, and fried foods.
Weight-loss support can keep you motivated and on track. When you have a health coach available to you 24/7, you can depend on help when you need it for handling cravings and staying motivated. Lark health coach also tracks your weight and progress towards weight goals, and offers advice for good food choices for weight loss.
Increasing Diet Quality for Women
Most Americans get too much sodium and not enough potassium, and that can be a blood pressure-raising combination. Shifting the balance can help lower blood pressure by a few points. These choices can help you change the balance to get more potassium and less sodium.
Good foods for women watching thei blood pressure:
- Consume more beans, vegetables, fruit, fish, and yogurt.
- Watch processed and prepared foods, such as canned foods, snack foods, processed meats, and frozen foods.
- Limit prepared foods, such as fast food and deli salads.
- Cut out salty foods, such as salty sauces and dressings, cheese, and pickles.
- Vitamin C: in vegetables and fruit.
- Vitamin D: in fortified milk and fatty fish.
- Fiber: in vegetables, beans, nuts, whole grains, and fruit.
- Calcium: in dairy products, dairy substitutes, and leafy greens.
Sodium and potassium may be the nutrients you hear about most often for blood pressure, but other nutrients can also help keep your numbers in check.
As you think about boosting good nutrients, you can also think about limiting the bad ones.
- Choose lean meats and fish instead of fatty cuts.
- Choose lower-fat dairy products.
- Swap olive oil, avocados, and nut butters for butter, shortening, and lard.
- Take fruit instead of baked goods or ice cream for a sweet treat.
- Look for whole grain versions instead of opting for refined cereal and white bread, pasta, and rice.
The Dietary Approaches to Stop Hypertension, or DASH, from the CDC is a meal plan that can help you get more of the blood pressure-lowering nutrients and less of the blood pressure-raising villains. A clinical trial found that the DASH diet can lower blood pressure within weeks.
It is higher than the average diet in vegetables, fruit, and dairy products. It is lower than the average diet in added sugars, refined starches, and red meat.
You can follow a DASH diet by including the following foods in your regular plan:
- 6 1-ounce servings of grains per day – focus on whole grain options.
- 4 to 5 servings of vegetables per day.
- 4 to 5 servings of fruit per day.
- 2 to 3 servings of low-fat dairy products per day.
- Up to 6 1-ounce servings of lean meat, poultry, or fish per day.
- 4 servings per week of nuts and seeds.
- 2 to 3 servings per day of healthy fats and oils.
This may seem like a lot to remember, but you do not need to do it on your own. Lark health coach can help you follow a DASH-style diet while considering your individual lifestyle. The app encourages healthier choices on a daily basis.
Increasing Physical Activity
Exercise lowers blood pressure by nearly 10 mm Hg, so adding exercise to your regular schedule can help prevent or treatment hypertension. The general recommendation for aerobic exercise is to get at least 30 minutes of moderate-intensity exercise at least 5 days a week, or at least 15 minutes of vigorous-intensity exercise at least 5 days per week.
You can try:
- Walking or jogging
- Bicycling indoors or on a stationary bike
- Using an elliptical, stair climbing, or rowing machine
- Taking aerobics or other group fitness classes
- Swimming or doing water aerobics
You can also improve general health and lower blood pressure by incorporating strength training into your routine at least twice a week. Weights such as dumbbells, barbells, and weight machines can work, but so can body weight exercises, resistance bands, and medicine balls.
Starting and especially maintaining an exercise program can be challenging, but you can set yourself up for success.
- Make it fun to stay motivated. Keep trying until you find something you love. It could be walking, but it could be something as unexpected as circus classes for exercise.
- Involve others. Get a friend to join you so you are less likely to skip your workout, and more likely to complete the whole thing.
- Add it your schedule and keep the commitment, just like you do with brushing your teeth, attending important meetings at work, and getting your children to their activities.
- Use a smartphone app such as Lark. This health coach can motivate and remind you to get active, help you set and achieve activity goals, and track your activity.
According to the National Heart, Lung, and Blood Institute of the NIH, you can get started with an exercise program if you are generally healthy. However, you should check with your healthcare provider first if you are over 50, have a heart condition or another health condition, or have a family history of heart attacks.
Avoiding Tobacco Use
Smoking can increase your risk for hypertension, not to mention heart problems, hypertensive crisis, stroke, cancer, and other conditions. A study published in the Journal of the American Heart Association (AHA), found that normotensive smokers who quit smoking for a week reduced their blood pressure by nearly 4 points systolic and 2 points diastolic. Avoiding chewing tobacco and secondhand smoke can also lower blood pressure or risk for hypertension.
Getting Enough Sleep
Sleep is more than just a luxury or an escape. It is a necessary component of a healthy lifestyle if you want to lower risk for conditions including diabetes, obesity, heart disease, and blood pressure. Even a night of sleep deprivation can interfere with your body’s ability to control blood pressure, and being chronically short on sleep can increase hypertension risk.
Many adults fall short of their recommended amounts of sleep, but you can take steps to get adequate shut-eye.
- Have a consistent bed-time.
- Follow a relaxing pre-bed routine.
- Be sure your bedroom is dark, quiet, and cool.
- Avoid phone, computer, and TV screens 30 minutes before bed.
- Use a health coach that also tracks sleep.
Managing Stress for Women
You may not be surprised to learn that stress can contribute to increases in blood pressure, both in the moment and over time. Stress from jobs, relationships, financial pressures, and other aspects of life can be harmful. Some of it is unavoidable, but the good news is that research suggests that how you respond to stress affects how much harm the stress does.
Learning to manage stress can be well worth it. These are some common and helpful approaches:
- Exercise regularly
- Relax with stretching, massage, or a hot bath
- Use deep breathing techniques
- Talk yourself through it
- Phone a friend
It can be hard to learn how to manage stress, but practice helps. Lark health coach can also help by letting you identify when you are stressed and offering suggestions for staying calm and in control in the moment.
Monitoring Blood Pressure in Women
Taking regular blood pressure readings can help you keep blood pressure down. Those readings act as reminders to keep up with your healthy lifestyle and any medications. They also let you learn patterns, so you can easily know if something is wrong and it is time to contact your healthcare provider.
If you have hypertension, taking blood pressure twice a day can be burdensome because it is hard to remember, but you can get help. Your Lark health coach can remind you and automatically store your measurements so you can see trends and share them with your doctor.
In addition, your healthcare provider might prescribe hypertension medications if you are unable to control your blood pressure with these lifestyle strategies.
Getting Help for Hypertension Prevention and Treatment
Lark Hypertension, for example, is a health coach for essential hypertension treatment. It offers help for a variety of approaches to support healthy blood pressure.
- Support and tracking for weight loss
- Healthy diet information and advice
- Physical activity tracking and tips
- Stress reduction strategies
- Healthy sleep tips and tracking
- Reminders to measure blood pressure, and storage of your data
- Medication reminders
- Help connecting with a healthcare professional if your blood pressure is out of range
High blood pressure may be “the silent killer,” but you can stand up loud and clear against it. Take charge of your blood pressure by knowing your risks, doing what you can to prevent and control hypertension, and working with your healthcare provider.
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Best Hypertension Management Health Coach App
You are putting in the work, so you deserve to maximize the benefits. A weight loss health coach app can help you do just that. A health coach app serves all the functions of a regular coach: informing, motivating, guiding, cheering, and organizing. The best weight loss health coach app:
- Informs you about healthy ways to lose weight and incorporate healthy behaviors into your lifestyle.
- Motivates you to keep setting and chasing new goals.
- Guides you through your weight loss journey in your own way.
- Cheers your successes, your efforts, and, should you fall short of your goals for a time, your renewed dedication.
- Organizes by encouraging you to log your food, activity and weight, and storing that information.
Blood pressure goals may need to change with age
What are the new normal blood pressure goals, and how have they changed for the elderly? Controlling high blood pressure is a good thing—unless you are a frail older person. Then it might be harmful. That’s the surprising finding of a study of more than 2,000 seniors published online in the Archives of Internal Medicine.
Make no mistake: high blood pressure is a definite health hazard. It damages arteries in the heart, kidneys, and throughout the body, leading to heart attack, heart failure, stroke, kidney failure, and other serious health problems. That’s why many doctors recommend aggressive steps for lowering high blood pressure.
But as we are learning about other conditions, a one-size-fits-all approach doesn’t work. What is right for controlling blood pressure in a 50-year-old might not work for a frail 80-year-old.
Blood pressure for aging seniors and elderly
Researchers looked at information collected as part of the U.S. National Health and Nutrition Examination Survey. People participating in it had their blood pressure checked; they also took a walking test that measured how long it took them to cover 20 feet. Based on this test, researchers divided the participants into three groups: those who finished the 20-foot walk in under eight seconds, those who took longer than that, and those who weren’t able to complete the walk.
Blood pressure goals
Normal blood pressure is a systolic pressure of less than 120 and a diastolic pressure of less than 80. Systolic pressure (the upper number in a blood pressure reading) refers to pressure in the arteries when the heart beats. Diastolic pressure (the lower number) measures pressure in the arteries between heart beats. But when and how to treat blood pressure to reach a particular goal will depend on multiple factors, such as your age and other cardiovascular risk factors.
Among elderly adults, higher systolic blood pressure (the top number of a blood pressure reading) was linked to a greater likelihood of dying over the five-year study only among faster walkers. Among the participants who couldn’t even walk 20 feet, those with high blood pressure were less likely to have died.
“Older frail adults might benefit from slightly higher blood pressure,” study author Michelle Odden, a public health epidemiologist at Oregon State University, told HealthDay. “As the blood vessels get more stiff with age, it may be necessary to have more pressure to keep blood pumping to the central organs, like the brain and heart.”
It’s also possible that using multiple medications drive down blood pressure in frail older adults may do more harm than good. That’s because all medications have side effects, and these side effects may have a greater impact on older, frail adults than their healthier counterparts.
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What a Sudden Drop in Blood Pressure Means
Sudden drops in blood pressure can occur for any number of reasons, some of which may be incidental and of no real concern, while others may the sign of a potentially life-threatening condition.
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Sudden drops in blood pressure are often recognized by symptoms ranging from mild lightheadedness and fatigue to severe heart rhythm problems and respiratory distress.
Although low blood pressure (hypotension) is easily diagnosed with a blood pressure cuff (sphygmomanometer), the underlying cause of sudden, severe drops may require extensive investigation, including a physical exam, lab tests, cardiac monitoring, and imaging studies.
Blood pressure is measured by millimeters of mercury (mmHg). Hypotension is usually defined as a systolic (upper) value of 90 mmHg and a diastolic (lower) value of 60 mmHg. Normal blood pressure is closer to 120/80 mmHg.
Generally speaking, the lower and faster the blood pressure drops, the greater the risk and severity of symptoms. The extent of the drop in pressure also plays a role.
If, for example, you have high blood pressure (hypertension) and the pressure suddenly drops to below 90/60 mmHg, you are more likely to experience overt symptoms than if it were to drop from, say, 110/70 mmHg.
A sudden drop in blood pressure can manifest with symptoms as the decreased blood flow starves the body of the oxygen and nutrients that it needs to function. Common signs include:
- Lack of Concentration
- Blurred Vision
A plethora of other symptoms may be involved—including chest pain, shortness of breath, irregular heartbeat, hives, fever, indigestion, and vomiting—but these tend to be associated with the condition that caused the drop in the first place.
Extreme hypotension can severely deprive the brain and vital organs of oxygen and nutrients, leading to shock. Shock can progress rapidly and typically manifests with:
- Extreme weakness
- Extreme anxiety
- Rapid heart rate
- Weak pulse
- Rapid, shallow breathing
- Profuse sweating
- Increased thirst
- Cold, clammy skin
Call 911 or go to your nearest emergency room if signs of shock develop. If left untreated, shock can lead to permanent organ damage, cardiac arrest, and even death.
Sudden hypotension can be broadly categorized by the underlying causes, some of which can overlap, making the diagnosis more difficult.
Hypovolemia, a term used to describe reduced blood volume, is the most common cause of hypotension. It results from either excessive loss of fluids or insufficient intake of fluids.
Common causes of hypovolemia include:
- Starvation or fasting
- Severe diarrhea or vomiting
- Excessive use of diuretics (“water pills”)
- Kidney failure
- Severe pancreatitis (causing the leakage of fluid into the abdominal cavity)
- Blood loss, leading to hemorrhagic shock
Hypovolemic shock occurs when you lose more than 20% of your blood volume for any reason. A loss at this level makes it impossible for the heart to pump a sufficient amount of blood through the body.
Decreased Cardiac Output
Even if blood volumes are normal, there are conditions that can reduce the body’s ability to pump blood. The condition, known as decreased cardiac output, can occur as a result of a heart problem, endocrine (hormonal) dysfunction, and certain medications. Sudden changes in cardiac output can frequently manifest with acute hypotensive symptoms.
Causes of decreased cardiac output include.
Vasodilation describes the sudden widening of blood vessels due to chemical, neurologic, or immunologic stimuli. With vasodilation, blood pressure will drop in tandem with increases in blood vessel circumference.
Common causes of vasodilation include:
- Vasodilating drugs: Such as calcium channel blockers, angiotensin II receptor blockers, nitroglycerin, nitrous oxide, Rogaine (minoxidil), and Viagra (sildenafil)
- Dysautonomia: A condition in which which the autonomic nervous system malfunctions, affecting the heart, bladder, intestines, blood vessels, and other organs
- Sepsis: Can lead to septic shock
- Anaphylaxis: A severe, whole-body allergy that can lead to anaphylactic shock
- Acidosis: Elevated blood acids
- Brain or spinal cord injury: Can lead to neurogenic shock
Hypotensive syndromes are interconnected events that bring about a sudden drop in blood pressure. Some of these occur on their own with no underlying disease or long-term consequences. Others occur in response to disease or other external factors.
Hypotensive syndromes tend to come on suddenly with overt and sometimes dramatic symptoms, including extreme dizziness and unconsciousness.
Some common hypotensive syndromes include:
- Neurogenic orthostatic hypotension (NOH) is when a change in body position, such as rising from a chair or bed, causes a dramatic drop in blood pressure. NOH is caused by an underlying neurologic disorder that affects the autonomic nervous system. It is common with neurogenerative disorders like Parkinson’s disease and Lewy body dementia as well as diabetic nerve damage.
- Orthostatic hypotension (OH) has the same symptoms as NOH but brought on by non-neurologic causes such as decreased cardiac output, extreme vasodilation, and the chronic use of diuretics, tricyclic antidepressants, and anti-hypertensive drugs. OH and NOH can also be collectively referred to as postural hypotension.
- Supine hypotensive syndrome occurs in later pregnancy when the weight of the baby presses down on two of the largest blood vessels in the body—the aorta and the inferior vena cava—decreasing the flow of blood to the heart.
- Postprandial hypotension occurs after eating when blood is diverted to the intestines to aid in digestion, temporarily robbing the brain of blood and oxygen. It is most common in the elderly and generally occurs within 30 to 75 minutes of eating.
- Vasovagal syncope is an overreaction to certain triggers, such as the sight of blood or extreme emotional distress, leading to a steep drop in blood pressure and fainting (syncope). It is caused by the overactivation of the vagus nerve, which relays nerve signals from the heart, liver, heart, lungs, and gut to the brain.
- Situational reflex syncope affects the vagus nerve but is caused when physical stress is placed directly on the nerve. Examples include straining during a bowel movement, lifting a heavy weight, or standing for too long in one place. Urinating after taking a vasodilating drug like Cialis (tadalafil) can also induce reflex syncope.
- Carotid artery syncope is similar to supine hypotension in that it involves the compression of another major artery, the internal carotid artery of the neck. Wearing a tight collar, shaving, or turning the head can cause a sudden drop in blood pressure, especially in older people or those with carotid arterial stenosis.
Hypotension can be readily diagnosed with a blood pressure cuff called a sphygmomanometer. What a sphygmomanometer cannot tell you is the cause of a sudden drop in blood pressure.
For this, the doctor will need to review your medical history, family history, current symptoms, and medication use to draw up a list of possible causes. Among the exams and tests the doctor may order:
- Valsalva maneuver: An in-office test used to diagnose orthostatic hypotension in which you blow hard through pursed lips to see how it affects your blood pressure and heart rate
- Blood tests: Used to check for conditions associated with acute hypotension, including diabetes, anemia, hypoglycemia, thyroid problems, kidney impairment, and hormonal imbalances
- Urinalysis: Used if kidney failure is suspected
- Electrocardiogram (ECG): Measures electrical activity in the heart to detect rhythm disorders, heart failure, and other cardiovascular disorders
- Echocardiograms: Uses sound waves to create video images of the heart to detect structural defects like heart valve leakage
- Imaging tests: X-ray, computed tomography (CT), or magnetic resonance imaging (MRI) used to detect internal bleeding, structural heart problems, kidney problems, or a brain or spinal cord injury
- Tilt table testing: Measures heart function and blood pressure as the body is tilted into different angles on an adjustable table. It is primarily used to diagnose postural hypotension.
- Stress testing: Measures a person’s heart function and blood pressure while running on a treadmill or pedaling a stationary bike. It is primarily used to diagnose coronary artery disease.
The treatment of acute hypotension varies based on the underlying cause. If the condition is not a medical emergency, you should either sit or lie down immediately and raise your feet above heart level. If you are dehydrated, you should replenish lost fluids and seek immediate medical attention if the symptoms are severe.
If hypovolemic or hemorrhagic shock is involved, you may be given an intravenous (IV) saline solution or a blood transfusion. Septic shock may require IV antibiotics, while anaphylactic shock almost invariably requires epinephrine (adrenaline).
If hypotension is related to extreme vasodilation or decreased cardiac output, medications such as vasodilators (like midodrine) or cardiostimulatory drugs (like digitalis) may be prescribed to improve heart function and output.
People with severe postural hypotension may benefit from the use of the anti-inflammatory steroid fludrocortisone.
Compression socks are often prescribed for people with orthostatic hypotension to prevent the pooling of blood in the legs. Wearing them keeps more blood in the upper body.
Acute hypotension can usually be treated successfully. The underlying cause, on the other and, may require extensive treatment and the care of a specialist cardiologist, neurologist, or endocrinologist.
A Word From Verywell
It is important not to ignore the signs of hypotension, no matter how subtle they may be. Hypotension may be something you are simply born with or something you can control by hydrating properly. At other times, it may be a sign of something more serious.
This is especially true if the drop is sudden and severe. By seeing a doctor and pinpointing the cause of acute hypotension, you can be treated appropriately and avoid any long-term harm to your health.
Your blood pressure is borderline high. What should you do about it?
Perhaps this has happened to you: You go to the doctor, for a checkup or a sprained ankle, and find that your blood pressure is high.
Not really high, not hypertension high, but borderline high. Say 130 over 85. Normal blood pressure is 120/80 or below, and hypertension is defined as 140/90 or higher.
Should you be worried? Is there something you can do now to ward off a later diagnosis of hypertension?
Hypertension increases your risk for heart attack and stroke, as well as for kidney disease and vision loss. And hypertension is very common: The Centers for Disease Control and Prevention estimates that one of every three American adults has the condition.
But the cardiovascular risks don’t suddenly begin at the magic number of 140/90. “It’s important to realize that there’s a continuum of risk,” says Elliott Antman, president of the American Heart Association and a cardiologist at Brigham and Women’s Hospital in Boston. “The higher the blood pressure, the higher the risk.”
The label “prehypertension” became official when clinical practice guidelines were updated in 2003. Since then, researchers have continued to find significant risks associated with borderline high blood pressure. A 2013 review of studies encompassing more than a million people found that those with prehypertension had a 28 percent increased risk of dying from cardiovascular disease and a 41 percent increased risk of dying from stroke compared with people who had normal blood pressure.
For someone going in for a checkup, it’s important to remember that blood pressure readings are not static; they change with activity level, time of day and stress level. So a single higher-than-normal reading should not guide treatment decisions.
Doctors are well aware of a phenomenon called “white coat hypertension” — when blood pressure readings are high in the doctor’s office because a patient is nervous. (There’s an opposite case known as “masked hypertension” — when blood pressure readings are low in the doctor’s office because a patient feels particularly safe and relaxed.)
By givingnear-hypertension the label of prehypertension, doctors hope patients will take this in-between condition more seriously. It’s a warning sign and offers a chance to prevent a progression to full-blown hypertension, which requires more-aggressive treatments such as a lifetime prescription for antihypertensive drugs, which can mean a lifetime of side effects.
Domenic Sica, president of the American Society of Hypertension and an internist at the Virginia Commonwealth University Medical Center in Richmond, says he hopes that “with a diagnosis of prehypertension, people are more likely to change their health behaviors than if their doctor tells them, ‘Do this because it’s good for you.’ ”
Still, not all doctors are happy with the term “prehypertension.” “Those words, to a patient, say, ‘I don’t have to worry yet,’ ” Antman says.
What can you do about prehypertension? Healthful eating and exercise are the two biggies. Antman also recommends reducing salt in your diet.
The AHA exercise recommendation for lowering blood pressure is to get an average of 40 minutes of aerobic activity three or four times a week.
Diet recommendations include eating plenty of fruits and vegetables and choosing whole grains. The AHA also emphasizes watching your salt intake.
The average American consumes about 3,400 milligrams of salt daily, according to a 2013 Institute of Medicine report. For reducing blood pressure, the AHA sets a fairly strict goal of 1,500 milligrams per day. The American Society of Hypertension is a bit more lenient, recommending 2,300 milligrams for most people and 1,500 for those at high risk, such as people who already have hypertension and African Americans, who, studies have shown, are sensitive to the high blood pressure effects of salt consumption.
Both the AHA and the ASH recommend the DASH diet (Dietary Approaches to Stop Hypertension). “The DASH diet will help lower blood pressure, even without lowering salt,” Marla Heller, a registered dietitian who has written four bestselling books about the diet, said in an e-mail. “The first DASH study showed blood pressure reduction equal to the first-line medications at a daily sodium intake of 3300 mg of sodium.”
Experts say that people with prehypertension should monitor their blood pressure. You can do this at some physicians’ offices and drugstore kiosks; you can even buy a blood pressure cuff to use at home. (Cuffs can vary significantly in price and quality, so it’s worth doing some research.) If you’re exercising and eating better, it can be very motivating to see the positive effects in lower blood pressure numbers. In turn, that positive feedback can inspire people to stick with newly adopted healthful behaviors.
Five things to know about sudden fall in blood pressure and aging
By Daniel Romila
This is a summary of a letter to the Journal of the American Geriatrics Society published by ICORD researchers from the Department of Medicine at the University of British Columbia. The intention is to make physicians aware of sudden changing in blood pressure in elderly patients.
Original letter to the editor: Mills P, Gray D, Krassioukov A. (2014) Five things to know about orthostatic hypotension and aging. Journal of the American Geriatrics Society. 62(9), 1822-3. Find the original article here.
Orthostatic hypotension is the sudden drop in blood pressure when suddenly standing or changing position. It is defined as a fall in systolic (maximum) blood pressure of at least 20 mm Hg or diastolic (minimum) blood pressure of at least 10 mm Hg when a person assumes a standing position. Typical symptoms are dizziness, light-headedness, blurred vision, shoulder pain. Atypical symptoms include backache and discomfort in the lower parts of the body. It is not uncommon, and can happen to anyone, but is more prevalent in older people and those with low blood pressure (hypotension).
Five things to know about sudden fall in blood pressure and aging:
1. Orthostatic hypotension is itself a risk factor in elderly adults, and can cause accidents.
Doctors should identify elderly adults who are at risk of this condition. It can lead to falls, fractures and head injuries. Recent studies suggest the condition can affect the normal functioning of the brain.
2. Orthostatic hypotension can manifest in different ways.
The fall in blood pressure usually happens during or shortly after standing, but can happen even after three minutes following a change in body position. This delayed fall in blood pressure may escape detection during a visit to the doctor. It is important for doctors to know how the fall in blood pressure manifests; if it is sudden or delayed, especially when screening high-risk patients.
3. Orthostatic hypotension occurs more often with aging. The risk is higher for those taking medication and those with conditions affecting the nervous system.
Some medication may cause sudden fall in blood pressure. Medication used for high blood pressure, drugs that promotes the production of urine and drugs that allows urine to flow out of the bladder more easily and drugs for treating depression are considered high-risk medications. Diabetes and Parkinson’s are examples of conditions that increase the risk in elderly adults.
4. Orthostatic hypotension often goes unnoticed.
A large study found the condition is present in 18.2% of individuals aged 65 and older. While 43% of those experiencing sudden blood pressure drop had typical symptoms, like dizziness, visual problems and pain centered in the neck and shoulders, 33% had no symptoms at all. 24% had non-specific symptoms, including backache and lower extremity discomfort.
5. A cautious approach is necessary, starting with methods not involving medication.
Reversible causes (such as anemia) should be identified and treated. Whenever possible, high-risk medication should be removed or reduced. The treatment should be oriented more towards avoiding accidents and improving the individual’s quality of life, than obtaining a specific blood pressure level.
How does this relate to individuals with SCI?
The above 5 points should be considered by individuals with SCI, as some can be troubled with orthostatic hypotension when changing their position.
According to one of the authors, Dr. Krassioukov, in an ICORD information postcard that can be found here, people with SCI may be prone to falls in blood pressure due to changes in blood vessels, which cannot push blood back to the heart.
Orthostatic hypotension can affect the ability to participate in activities likely to provoke falls in blood pressure, including rehabilitation programs.
More information about how orthostatic hypotension specifically affects individuals living with SCI can be found in the article, “Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology”.
90,000 Human pressure: age indicators, how to measure it correctly and the reasons for deviations from the norm
Arterial blood pressure is a purely individual indicator and depends on many factors. And, nevertheless, there is a certain average medical norm. That is why deviations from the accepted indicators allow the doctor to suspect malfunctions in the body’s systems.
However, it must be remembered that indicators can change. It depends, for example, on the time of day, as well as the age of the person.So, the pressure of a person is the norm by age, what is it, what does it depend on and why can it deviate? Portal davlenie.org tells.
What is blood pressure?
Behind this concept lies the force that the blood flow exerts on the walls of the vessels. Blood pressure indicators depend on the speed and strength of a person’s heart, as well as the total volume of blood that it is able to pass through itself within a minute.
And the recognized norm of pressure by age is one of the medical indicators of the correct functioning of the heart, the autonomic nervous system, and also the endocrine system.
Foto: PantherMedia / Scanpix
Normal pressure in an adult should be determined only at rest, since any stress (both physical and emotional) has a huge impact on his performance. The human body independently controls blood pressure, and with a moderate load, its indicators rise by about 20 mm Hg. This is due to the fact that the muscles and organs involved in the work require a better blood supply.
If we talk about what blood pressure is considered normal, then at the moment the medicine recognized indicators in the range 91 … 139/61 … 89 mm Hg. In this case, the absolute norm is considered to be blood pressure 120/80 mm Hg, slightly increased – 130/85 mm Hg, increased normal – 139/89 mm Hg. An increase in numbers higher than 140/90 mm Hg already indicates the presence of pathology.
With age, irreversible processes occur in the human body, which provoke an increase in pressure throughout life.The older a person is, the higher his blood pressure readings.
Blood pressure: norm by age
What is normal human blood pressure? The question is somewhat abstract, since the norm for each person, most often, is individual. Educational medical literature suggests taking the figure of 120/80 mm Hg as the norm. It is these indicators that are recorded in people aged 20 … .40 years.
Normal blood pressure for a person aged 16 … 20 may be slightly lowered.This applies to both systolic and diastolic values. In general, the pressure at rest is 100/70 mm Hg. is a physiological norm.
Pressure standards by age (the table is presented a little below) are determined by the following indicators:
Foto: Publicitātes attēli
As the table of human pressure shows, age-related changes relate to both upper and lower blood pressure. But you need to remember that these are just average clinical indicators.
But not only an increase, but also a decrease in blood pressure indicators is a sure sign of a deterioration in the activity of body systems. That is why the ability to use a tonometer can be attributed to a good prevention of almost all diseases. And in order to track the dynamics of pressure changes, you need to keep a special diary.
How to measure pressure correctly?
There is a special device for measuring blood pressure – a tonometer. At home, it is most convenient to use automatic or semi-automatic devices, since measuring with a manual tonometer requires a certain skill.
To obtain correct results, the following recommendations must be observed:
- before measuring pressure, physical activity must be completely eliminated;
- smoking is prohibited;
- measuring blood pressure immediately after eating will also give incorrect results;
- measure blood pressure while sitting in a comfortable chair;
- the back must be supported;
- The hand on which the measurement is carried out should be located at the level of the heart, i.e. pressure is measured while sitting at the table;
- when measuring pressure, you must remain motionless and not talk;
- readings are taken from both hands (measurement interval is 10 minutes).
Significant deviations from the norm require the obligatory consultation of a specialist doctor. Only a doctor, after passing all the diagnostic procedures, will be able to choose an adequate treatment for the existing problem.
Abnormality: probable causes
There are many reasons that can provoke changes in blood pressure. But the most common are the following:
- Inability of the heart to work in the same mode and with the required strength.
- Change in blood quality. With age, it becomes thicker. And the thicker the blood, the more difficult it is for it to flow through the vessels. The cause of thickening can be, for example, such complex diseases as diabetes mellitus or autoimmune pathologies.
- Decreased vascular elasticity. This leads to an incorrect nutritional system, increased loads, and certain medications.
- Formation of atherosclerotic plaques, which form when the level of “bad” cholesterol in the blood is increased.
- A sharp change in the lumen of the vessel caused by hormones.
- Incorrect work of the endocrine glands.
Most of the causes of pressure surges can be eliminated by yourself, which will allow you to maintain health as long as possible. Correctly selected diet, leading an active lifestyle, a calm attitude to life, which allows you to avoid stressful situations. Compliance with these simple rules allows you to normalize blood pressure.
Pulse, as an indicator of health
The next indicator of health, along with the numbers of blood pressure, is the pulse.A pulse in the range of 60… 80 beats / min is considered normal. The more intensive the metabolism takes place, the higher the number of beats per minute.
As well as for blood pressure indicators, there are averaged norms for different age categories.
Foto: Publicitātes attēli
By measuring your heart rate, you can learn to recognize an impending problem. For example, if the number of heart beats increases 2-3 hours after a meal, then poisoning can be suspected.
A magnetic storm in people who are acutely reacting to a sharp change in weather causes a decrease in blood pressure. The body reacts to this by increasing the heart rate in order to maintain the optimal blood pressure level.
An intense pulse, the beats of which a person feels very clearly, indicates a sharp increase in blood pressure.
90,000 MGNOT Recommendations for COVID-19 and Postcoid Syndrome 2021
8.1 Disease Image
The clinical manifestations and laboratory characteristics of postcoid syndrome vary widely.This disease does not have pathognomonic symptoms – signs that allow an unambiguous diagnosis to be made. PCR even in the acute period of the disease has assumptions both in the frequency of positive tests (not all positive tests are the basis for the diagnosis) and in negative tests – only a part of patients with COVID-19 infection, perhaps 30-40%, have positive results PCR. Ig is more specific, however, the frequency of detecting their increased values is different in different periods of the illness: from 30% in the first weeks of the illness to 90% by 3-4 weeks, followed by a rapid decrease in the frequency of detecting increased values ( reference to Cochrane ).However, the study of a large number of cases, the comparison of recurring symptoms allows you to form a picture of the signs of the disease – the image of the disease. For this, it is possible and necessary to use formalized systems for automatic registration of complaints and anamnesis of patients. MGNOT has developed 2 questionnaires based on the MeDiCase platform to obtain data on the symptoms of the disease both in the acute period of the disease and at the stage of postcoid syndrome: a total of more than 20 thousand people have been surveyed since May-June 2020.Taking into account the inextricable link between acute COVID-19 and postcoid syndrome, we present the results of the formation of the image of the disease for both stages of the process.
Image of the disease of acute COVID-19: at the first stage, on the basis of literature data and the knowledge of doctors, questions for diagnosis (symptoms) were highlighted, which were entered into the system. The survey of respondents was carried out in the public domain on the Internet, anyone interested could become a participant in the survey. ( www.medicase.pro/covid19 ) At the time of the analysis of the survey results (August 2020.), the system was used by 4,900 people. From the total population, 2,695 sessions were selected for analysis, in which all the necessary fields were fully filled in and it was noted that the respondents answered the questions correctly. The system produced more than 1 diagnostic hypothesis in humans.
Symptoms of the disease were detected in 1,268 people (47.05%), respectively, their system suspected COVID-19 of mild and moderate severity. Potential infection (in other words, there was contact with the sick person, but there were not enough symptoms to diagnose the disease – “low-symptom course”) was identified in 1,323 people (49.09%).72.2% of respondents had contacts with patients. Positive laboratory tests for COVID-19 (PCR) and Ig tests were obtained in 411 people (15.25%).
3 groups were formed: 1 (n = 1870) – a diagnostic hypothesis of the disease or possible infection (“low-symptom course”) was established, 2 (n = 120) – there is a laboratory-confirmed diagnosis of COVID-19 (PCR or antibodies) and 3 (n = 291) – respondents with negative laboratory test results A detailed analysis is presented in (Effectiveness of the artificial intelligence system MeDiCase in the diagnosis of COVID-19 infection in an outpatient setting Problems of standardization in health care, 2020.11-12 DOI: https://doi.org/10.26347/1607-2502202011-12027-036 27-36 Vorobiev A.P., Vorobiev P.A., Mukanin D.A., Krasnova L. WITH.).
According to the survey results, weakness was found in group 2 in 90.79% of cases, and in group 3 in 76.76% of cases, headache in group 2 in 60.53% and in 64.47% in group 3. Fever was in 64.47% in group 2 and in 47.03% in group 3, while long-term fever was noted by 73.48% of respondents in group 2 and 55.18% in group 3. The sensitivity of fever to paracetamol was quite close in group 2 – 63.27% febrile and in group 3 – 66.66%.”Sore throat” was noted in 60.53% of the respondents in the 2nd group and in 48.65% in the 3rd. Cough was noted in 44.74% in group 2 and 35.14% in group 3, of which more than 2/3 of the respondents had dry, and hacking – in 70.59% of respondents in group 2 and 24.62% in group 3. A feeling of compression in the chest was in 65.79% and 48.11%, respectively, in groups 2 and 3. Dyspnea was noted by 48.68% in group 2 and 35.68% in group 3, myalgia 64.47% patients from group 2 and 49.19% – from group 3. Depressive state was in 55.26% and 45.95%, the presence of suicidal thoughts – in 42.11% and 30.27% in groups 2 and 3, respectively.Anosmia with ageusia was in 50% in group 2 and in 21.62% in group 3, runny nose – in 36.84% and 29.73%, respectively. Unusually vivid dreams were observed in group 2 in 42.11% and in 20% in group 3. Abdominal pain and diarrhea occurred in 56.58% in group 2 and 30.27% in group 3. Thus, in group 2, patients from which had an unconditioned (laboratory-confirmed) infection with COVID-19, symptoms such as weakness, prolonged fever, dry and hacking cough, chest tightness, anosmia and augesia, vivid dreams, abdominal pain and diarrhea were significantly more common.
The work noted that the sensitivity of the method for detecting COVID19 infection using the MeDiCase system is 89.5%: the system detected COVID-19 in 89.5% of individuals who had a positive laboratory response to the pathogen.
Image of the disease of the postcoid syndrome:
To identify symptoms in patients, questions were formulated on the available symptoms for an automated tree-like questionnaire. The wording of the questions, traditionally for the MeDiCase system , were constructed in such a way that the answers to them could only be “yes” or “no.” Additionally, the system was supplemented with questions to identify depressive conditions (many patients complained about this) and decision rules for identifying some acute conditions (for example, causes of cardialgia or dizziness) from previous versions of the MeDiCase program that have already been validated earlier.Some questions had a scale for assessing by choosing from the proposed menu (for example, in the presence of weakness, the question was asked about its severity – very strong, moderate and insignificant).
Based on the results of the analysis of literature data and an expert survey of patients, decisive rules were created for assessing the fact of the disease, the approximate degree of severity and probability. The experts were MGNOT members with experience in working with this pathology and other respiratory infections – 2 professors, doctors of medical sciences, 2 candidates of medical sciences.
The questionnaire was sent to members of the “Atypical Coronavirus” groups on Facebook addressed to the mailing addresses available to the group administrators in October-November 2020. The analysis included the responses of 1400 respondents.
51.4% of respondents had previously laboratory confirmed COVID-19 (PCR or the presence of antibodies), 24.6% had a negative laboratory test result, another 24% did not pass laboratory tests to confirm infection.
The most common symptom was weakness – in 80% of the respondents, while 58.6% were unable to perform their usual physical activity.
Periodic increase in body temperature was observed in 50.8%, 47.1% had chills or chills, 44.9% had night sweats or sweats during the day.
50.8% had insomnia, drowsiness, disturbed change of day and night, 18.4% noted the appearance of unusual and vivid dreams, at the same time 45.2% had signs of depression, 43.6% noted headaches.
47.1% of the respondents had a feeling of chest congestion and lack of air, 43% had non-angina pain in the heart, 41.5% had tachycardia attacks, 30.4% had an increase in blood pressure, and 14 , 9% – lowering blood pressure.
Slightly more than a third (35.1%) complained of hair loss, 32.9% complained of goose bumps, burning of the skin, 19.6% had skin rashes, 18.2% had nodes on the veins, sore veins.
28.1% had visual impairment, 13.6% – hearing impairment, 17.9% – gait impairment.
25.4% of the respondents had diarrhea.
Other symptoms were less common: panic attacks, seizures, polyneuropathy, a feeling of vibration in the head and chest (some figuratively called it the sensation of a transformer), difficulty concentrating, distraction, forgetfulness, the appearance of a “fog in the head”, gynecomastia, menstrual irregularities , libido and other sexual functions, dizziness, noise and ringing in the ears, bruising, nosebleeds, emotional lability, pathophagia and pathoosmia (no or haunted by odors, aversion to meat, chocolate, alcohol), toothache, dental problems (cystic changes in the jaw bones)), allergic reactions, edema, lymphostasis, lymphadenopathy.
Taking into account the results of the preliminary survey and the results of the management of patients with postcoid syndrome on the basis of MeDiCase, a new, refined questionnaire was formed. Group members were asked to go through it to further validate the questionnaire. According to the analysis of IP addresses, it was found that the persons who participated in the survey at the first stage did not take part in the repeated survey. In total, 327 respondents took part in the repeated survey in February-March 2021, 194 questionnaires were statistically processed.Culling was associated with a negative answer to the question “did you answer truthfully?” General characteristics of the respondents: men 21.1%, women 78.9%; under the age of 18 3.6%, 18-55 years old – 82%, over 55 years old – 14.4%. The duration of the disease was 1-3 months in 44.3%, 3-5 in 29.4%, more than 5 months in 26.3% of the respondents. Acute covid was confirmed by a doctor in 62.9% of cases. 82% were tested for covid, of which the diagnosis was immunologically confirmed in 87.4%.
In terms of frequency, the symptoms were as follows:
- Weakness fatigue 84.5%
- Pain in muscles, bones and joints 63.9%
- Inability to perform normal activities 60.3%
- Insomnia, daytime sleepiness 77.3%
Poor sleep 71.3%
Superficial sleep 70%
Wakes up often 78%
There is sleepiness during the day 72%
Wakes up sleepy, broken 80%
- Congestion in the chest, breathing problems 36.6%
- Chills 51.5%
- Headaches appeared 43.8%
· Constant 24.7%
· Paroxysmal 71.8%
- Violation of blood pressure regulation 55.2%
Increase in blood pressure 76.6%
Decrease in blood pressure 37.4%
- Visual impairment 40.7%
Impaired focus 84.8%
Decreased visual acuity 83.5 %
Flickering before the eyes 44.3%
- 9004 6 Loose stools 22.7%
- Skin rashes 25.3%
- Of these, 28.6% of them had similar rashes before venous pattern 22.7%
Venous mesh on the legs 75%
Soreness, burning along the veins 50%
Knots or swelling in the veins (aneurysms) 50%
- Gait disorder 24.2%
- Tinnitus, hearing impairment 40.7%
- Pain in the region of the heart 43.3%
Pain behind the sternum in the middle of the chest 69%
Unbearable pain 10.3%
Pierces from the front back 25.9% 900 09 to the left of the sternum 8.3%
Pain increases with pressure on the painful place 14.3%
Pains appear when moving or turning 42.9%
Spilled pain 22.6%
Constant pain -10.5%
Accompanied by weakness, interruptions, sweating 21.1%
Pass after taking validol, Corvalol 15.8%
- Skin hurts 22.4%
- Sweating at night or during the day 46.9%
- Hair loss 41.2%
- Burning, tightening of the skin 35.1%
- Violation of potency, libido 7.2 %
- Weight loss 40.7%
Up to 5 kg 58.2%
5-10 kg 34.2%
More than 10 kg 7.6%
- Dizziness 52, 6%
sudden dizziness 67.6%
gait disorders 58.8%
- Appetite disorders 28.4%
- Frequent urination 24.2%
- Swollen and sore lymph nodes 18.6%
Lymph nodes in the submandibular region on the neck 77.8
In the axillary region 30.6%
In the groin 19, 4%
- Heartbeats, rhythm disturbances 63.4%
Shaking hands 42.3%
- Drinking a lot of coffee or tea 13%
- Feeling of uneven heart rhythm 62.6%
Acceptance of diuretics 7.3%
Diagnosed with thyroid disease 23.6%
Paroxysmal nature 73.2%
- Mild depression 68.6%
- Anxiety 68.6%
- Feeling guilty towards others 50.5%
- Reflection on past mistakes 51.5%
- Suicidal thoughts 35.5%
- Goosebumps 37.1%
- Dysregulation of body temperature 47.9%
· increase 55.9%
· decrease 47.3%
- · Menstrual irregularities 27.7% (from women)
The most common characteristic symptoms of viral infections are always skin rash (exanthema).The formation of exanthema is presumably associated with an inflammatory tissue response. The main mechanisms of development of inflammation: expansion of capillaries; blood stasis; increased vascular permeability with the development of hemorrhages and edema; necrosis of the epidermis and dermis; dystrophic changes in cells; formation of inflammation ( Yushchuk N.D. Infectious diseases: syndromic diagnosis / edited by N. D. Yushchuk, E. A. Klimova – Moscow: GEOTAR-Media, 2017 .– 176 p. – ISBN 978-5-9704- 4045-2. – Text: electronic // URL: https: // www.rosmedlib.ru/book/ISBN9785970440452.html ).
Cutaneous manifestations of COVID-19 can be divided into 2 groups depending on the pathophysiological mechanism ( Lesort C, Kanitakis J, Villani A et al. COVID-19 and outbreak of chilblains: are they related? J Eur Acad Dermatol Venereol 2020; 34: e757 – e758 DOI: 10.1111 / jdv.16779 ):
– in the form of a skin rash due to an immune response to viral nucleotides.
– secondary to the systemic consequences caused by the virus (vasculitis and thrombotic vasculopathy).
The lesions of the skin and its appendages in COVID-19 are diverse ( Skin rashes in case of coronavirus infection COVID-19 caused by SARS-CoV-2. Guidelines No. 9. GBUZ MNPTSDK DZM, Moscow 2021 ). They can appear several days before the development of the infection, the duration of changes in the skin varies from 1 to 14 days. ( Cutaneous manifestations associated with anosmia, ageusia and enteritis in SARS-CoV-2 infection – a possible pattern? Observational study and review of the literature. Birlutiu V, Feiereisz AI, Oprinca G, Dobritoiu S, Rotaru M, Birlutiu RM, Iancu GM.Int J Infect Dis. 2021 Apr 19: S1201-9712 (21) 00370-2. doi: 10.1016 / j.ijid.2021.04.058., Cutaneous Manifestations in Confirmed COVID-19 Patients: A Systematic Review. Conforti C, Dianzani C, Agozzino M, Giuffrida R, Marangi GF, Meo ND, Morariu SH, Persichetti P, Segreto F, Zalaudek I, Neagu N. Biology (Basel). 2020 Dec 5; 9 (12): 449. doi: 10.3390 / biology9120449.) Similar rashes are observed in postcoid syndrome and long-term covid.In some patients, cutaneous manifestations of coronavirus infection may be the only manifestation of viral infection. ( Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Genovese G, Moltrasio C, Berti E, Marzano AV Dermatology.2021; 237 (1): 1-12.doi: 10.1159 / 000512932. )
6 main clinical images (patterns / groups) of actual skin manifestations and 2 – lesions of skin appendages ( SARS-CoV-2, COVID-19, skin and immunology – What do we know so far? Novak N, Peng W, Naegeli MC, Galvan C, Kolm-Djamei I, Brüggen C, Cabanillas B, Schmid-Grendelmeier P, Catala A.Allergy. 2021 Mar; 76 (3): 698-713. doi: 10.1111 / all.14498.).
Group 1. Urticaria . In some cases, it may even be a harbinger of the onset of COVID-19. Its classical development is also possible due to drug intolerance. It manifests itself in the form of pink spots with uneven edges, localized mainly on the limbs, chest, abdomen, and back. May be accompanied by Quincke’s edema. Spots up to 15 mm are called roseola, more than 20 mm – erythema. Usually this is not 1 element, but a merger of several.Patients may feel severe itching or burning of the palms and soles, painful sensations when touched, etc. 90,000 Low pressure: causes, methods of correction, prevention
Hypotension and its causes Low blood pressure (doctors also call it arterial hypotension) is a condition in which blood pressure drops below 100/60 mm Hg. in men and below 95/60 mm Hg. among women. For the elderly, the pressure is below 105/65 mm Hg. already considered downgraded.Low blood pressure is not necessarily a sign of impaired health. There is also the so-called physiological hypotonia. At the same time, against the background of low blood pressure, a person feels great, he has normal performance, there are no complaints.
Pathological low blood pressure brings many problems to people. Often, a predisposition to low blood pressure is inherited from parents who suffered from this ailment. In most cases, this problem worries women.The tendency to low blood pressure, as a rule, is observed from childhood. Such children are lethargic, inactive, quickly get tired playing with their peers. For hypotonic adults, the so-called asthenic constitution is characteristic – high growth and low weight. Most of them are thin people with pale skin.
Who is suffering from hypotonic disease? In the overwhelming majority, these are people who have been exposed to strong and prolonged psycho-emotional stress. Another possible reason may be prolonged mental stress, as a result of which the body falls into a state of decompensation.A previous traumatic brain injury can also leave a mark in the form of low blood pressure. Industrial hazards, such as high noise levels, vibration, overheating, can, in turn, lead to disruption in the work of vasomotor centers. Many hypotensive patients in childhood have suffered severe infections or their nutrition has been disturbed. Pathologically low blood pressure is often recorded in people who have been exposed to ionizing radiation. The most common cause of hypotension is autonomic vascular dysfunction.The next most frequent cause is the pathology of the endocrine glands.
Main symptoms. Most of the unpleasant symptoms with low blood pressure are associated with impaired blood circulation in the vessels of the brain. In this case, there is a throbbing pain in the temples, less often in the back of the head. But pain of other localization (in the forehead, heaviness in the temples) may also bother you. Often there are migraine-like pains localized in one half of the head. They may be accompanied by nausea, vomiting. The pain is dull, persistent.Many people note the appearance of complaints when the weather changes, during the period of magnetic storms. Often worried about dizziness, darkening in the eyes, especially when suddenly getting out of bed. Some hypotonic people have fainting, but they are rare. Another symptom that is often found in hypotensive patients is weakness, fatigue. By the end of the working day, these people feel a decrease in their working capacity. Disturbed by absent-mindedness, memory loss. As a result of the slowing down of blood flow, the vital activity of the body decreases.Often, hypotonic people are irritable, emotionally unstable, subject to sudden mood swings, and prone to depression.
Decreased vascular tone creates certain disturbances in the work of the heart, which can be manifested by pain in the chest and in the heart region. These unpleasant sensations are permanent, may be accompanied by palpitations and sensations of interruptions in the work of the heart, not associated with physical or nervous stress. It is as if the hypotonic people do not have enough air, they constantly yawn.More often, sensations of lack of air occur during physical exertion. People with low blood pressure often have a cold snap and numbness of the hands and feet, increased sensitivity to heat and cold.
Emergency care for acute drop in pressure. What to do if the person next to you feels worse, his head is spinning, his eyes darken, he turns pale? Unfortunately, this sometimes happens with hypotonic patients, especially in a stuffy room, in the sun. In this case, you need not to get confused and take the following measures:
1.The person needs to be laid down as quickly as possible, since in this position the blood supply to the brain is facilitated.
2. The head should be positioned as low as possible, do not put a pillow, as in this position blood flow to the brain is impeded.
3. If it is not possible to lay the person down, sit him down with his head as low as possible between the knees. It is imperative to give a drink of water or tea.
4. Vapors of essential oils have a beneficial effect in such a situation.A bottle with a mixture of rosemary and camphor oils or peppermint oil is enough to bring to the person’s nose. A few breaths are usually enough to restore your well-being. You can put a few drops on a handkerchief and periodically bring it to your nose.
The normalization of blood pressure includes various health procedures: regular physical exercises, massage, water and air procedures. They have a positive, tonic effect on the body, normalize the work of the nervous system, and therefore the work of internal organs.Herbs and herbal preparations have proven themselves well under reduced pressure. However, when starting treatment, it is necessary to consult a doctor.
1. Cinnamon rose hips – 40 g; herb of medicinal lungwort – 30 g; stinging nettle leaves – 30 g; black currant fruits – 20 g; fruits of common barberry – 20 g.
2. Common chicory root – 30 g; lanceolate plantain leaves – 30 g; black currant leaves – 30 g; stinging nettle leaves – 30 g; dandelion root – 20 g.
3. Fruits of red mountain ash – 40 g; creeping wheatgrass rhizomes – 30 g; wild strawberry leaves – 25 g; herb centaury small – 10 g.
The herbal preparations described in recipes 1-3 are prepared according to the same scheme: mix the prepared ingredients. Take 2 tbsp. tablespoons of the herbal mixture and pour 400 ml of boiling water over them. Leave to infuse for 4 hours. Strain. Take 100 ml 3 times a day before meals.
4. Black currant leaves – 30 g; crushed cinnamon rose hips – 30 g; stinging nettle leaves – 30 g; drooping birch leaves – 30 g; wild strawberry leaves – 20 g.
1 st. pour a spoonful of herbal collection with 250 ml of boiling water. Boil over low heat for 2 minutes. Then leave to infuse for 1 hour. Strain. Take ½ cup 3-4 times daily before meals.
Simple rules for hypotonic
1. For a hypotensive, the best medicine is movement, not lying on the couch. Exercise improves the supply of oxygen to the brain and other organs. By loading your body, you will sleep better, and, therefore, you will feel more invigorated in the morning.
2. Eat lightly. Overeating leads to stress in digestive processes and energy expenditure. Eat as much as you need, but not until you feel sleepy.
3. Do not skip meals, especially breakfast. Low sugar is bad for the brain. If you are not hungry, you can eat some fruit. This will maintain the desired sugar level and saturate the body with vitamins and minerals.
4. Be careful with coffee. Do not overuse this invigorating drink, otherwise you risk turning into a coffee lover.A cup of coffee in the morning for you may be necessary. But she should follow a light breakfast, never on an empty stomach. Try to drink no more than 2 cups of coffee a day, and after lunch it is better not to drink it at all.
5. For many hypotonic people, naps are good medicine.