Is low blood pressure good or bad: The request could not be satisfied
Is Low Blood Pressure a Cause for Worry? – Cleveland Clinic
Most of us are aware that having high blood pressure places you at increased risks for serious health conditions such as having a heart attack, stroke or kidney damage. But just as too high of a blood pressure is a cause for concern, sometimes too low of a blood pressure can be as well.
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“Blood pressure is an essential part of your body’s normal physiology,” says heart rhythm specialist Jeffery Courson, MD. Blood pressure reflects your ability to send oxygen rich blood to your vital organs and especially your brain, he says.
Blood pressure is a simple measure of overall health that can be routinely performed at a doctors visit or at home. Home blood pressure monitors are widely available, inexpensive and relatively easy to use. If you have too high or too low blood pressure, you should monitor it routinely in accordance with our doctor, says
A normal blood pressure is 120/80mmHg. The top number is the systolic pressure and represents a measure of pressure in your arteries when your heart is contracting. The bottom number is the diastolic and represents pressure in your arteries when your heart is relaxing.
When blood pressure is too low
Whether blood pressure is too low has more to do with how you feel than the measured number. “A blood pressure of 90/60 mmHG may be normal for someone young and healthy, but may cause symptoms of lightheadedness or weakness in an older patient or someone with other health conditions,” Dr. Courson says.
What causes low blood pressure?
Medications are one of the most common causes for low blood pressure. Dr. Courson advises that if you do have low blood pressure measurements, you should review your medications with your doctor.
Though there are many factors that can affect blood pressure, three of the most important are:
- Stroke volume, which is the amount of blood pumped from your heart with each contraction.
- Blood vessel tone, which can be affected by stiffness or blockages in the blood vessels.
- Heart rate.
Disruption of any of these factors can result in low blood pressure. For example, a patient with heart failure and a low stroke volume may be prone to low blood pressures. This sometimes occurs if too much fluid is removed with diuretics (water pills).
Some conditions such as infection or paralysis can affect the tone in the blood vessels and result in low blood pressure. Arrhythmias that cause too slow (bradycardia) or too fast (tachycardia) heart rates can result in low blood pressure.
It’s normal for blood pressure values to fluctuate and to go up and down. You need a higher blood pressure when exercising and a lower blood pressure when at rest as your oxygen requirements differ under these conditions. Your autonomic nervous system regulates our blood pressure.
“I think of this as our ‘automatic’ nervous system as we do not control this by thought,” says Dr. Courson. So, if you get upset or exercise, your blood pressure will rise. But you can’t “think” your blood pressure up or down, says Dr. Courson.
Some people have disorders that affect their autonomic nervous system that can result in difficulty regulating their blood pressure. This can result in low blood pressures upon standing or very labile blood pressure that fluctuate between high and low.
When to call the doctor
Low blood pressure can cause symptoms of lightheadedness or dizziness, weakness or feeling faint. If you have any of these symptoms associated with a low blood pressure, you should contact your doctor.
If you have a lower than normal blood pressure but you feel fine without symptoms you are probably okay, says Dr. Courson.
What is low blood pressure?
You’ve probably heard of hypertension—when blood pressure is too high. But what happens when you have the opposite problem?
What is low blood pressure? | Symptoms | Causes | Diagnosis and types of hypotension | Signs of an emergency | How to raise low blood pressure
Most people know that when your blood pressure is too high—a condition called hypertension—it can contribute to heart attacks, heart disease, and other health concerns. But what about hypertension’s opposite, hypotension? What happens when your blood pressure is too low? If high blood pressure is bad, is lower blood pressure always good, or are there any health concerns people with hypotension should look out for?
“The main issue with low blood pressure is if patients are experiencing symptoms of dizziness, lightheadedness, or the sensation that they’re going to lose consciousness,” says Eugene Yang, MD, a professor of medicine at the University of Washington and chair of the American College of Cardiology’s Prevention Section and Leadership Council. “That’s what we worry about because, obviously, losing consciousness or passing out can be dangerous. If somebody’s driving a car or doing something that could put them in danger, they can cause significant trauma to themselves.”
Older adults, who are most at risk of suffering trauma in a fall, are more likely to experience symptoms of low blood pressure. They’re also more likely to develop low blood pressure as a result of medicines they may be taking to treat high blood pressure.
What is low blood pressure?
A blood pressure reading consists of two numbers, for example: 120 over 80. The first number is your systolic pressure, the force your heart exerts on the walls of your arteries each time it beats. The second number is diastolic pressure, the force your heart exerts on the walls of your arteries in between beats. Both systolic pressure and diastolic pressure are measured in millimeters of mercury (mmHg).
According to the American Heart Association, there is no particular number at which day-to-day blood pressure is considered too low, as long as you have no symptoms. The National Heart, Lung, and Blood Institute, on the other hand, describes hypotension as blood pressure that is lower than 90/60 mmHg. “In general, a systolic blood pressure that’s between 110 and 140 is the range that seems to be associated with optimal cardiovascular health,” says Dr. Yang.
“Blood pressure can vary quite a bit in an individual throughout the day, and there is quite a range of blood pressure in healthy populations,” adds Donna K. Arnett, Ph.D., dean of the University of Kentucky College of Public Health and professor of epidemiology.
If your systolic blood pressure is well below 110 at every reading, your healthcare provider may want to keep an eye on it, but if you have no symptoms, a low number is nothing to be alarmed about. However, if your blood pressure drops suddenly from, say, 120 to 90 or less, it could be the result of an underlying cause, and you should talk to a healthcare provider.
RELATED: Normal blood pressure levels
Low blood pressure symptoms
For most people, long-term low blood pressure is not an issue and often goes unnoticed. More serious cases of hypotension may produce the following symptoms:
- Dizziness or lightheadedness
- Fainting (also called syncope)
- Heart palpitations
- Blurred vision
- Lack of concentration
- Dehydration and thirst
- Cold, clammy, pale skin
- Rapid breathing
In rare cases of extreme hypotension, when the body’s vital organs fail to get the oxygen and nutrients they need, low blood pressure can lead to shock, a life-threatening condition that requires immediate medical attention. Other signs of shock include sweaty skin, rapid breathing, a blue skin tone, or a weak and rapid pulse.
What causes low blood pressure?
Low blood pressure isn’t always linked to a medical condition. Prolonged bed rest and pregnancy (hypotension is common in the first 24 weeks) are possible causes of low blood pressure, and even standing too long can bring on a condition called neurally mediated hypotension, which can lead to dizziness, nausea, and fainting.
Low blood pressure often coexists with depression, but doctors aren’t sure about the relationship between the two. “This remains unclear,” says Arnett. “There is some evidence that an association exists between low blood pressure and depression that appears late in life (late-life depression, or LLD), but whether low blood pressure causes depression or depression causes low blood pressure is unknown at this time.”
Underlying medical conditions that can cause hypotension include:
- Blood loss from an accident
- Severe infection (septic shock or septicemia)
- Allergic reaction (anaphylaxis or anaphylactic shock)
- Heart problems, such as a low heart rate (bradycardia) or heart failure
- Endocrine problems like hypothyroidism, parathyroid disease, adrenal insufficiency (Addison’s disease), low blood sugar, and, in some cases, diabetes
- Anemia (this is often due to nutritional deficiencies like a lack of vitamin B-12 or folic acid)
- Autonomic nervous system conditions such as Parkinson’s disease
Medications that can cause low blood pressure as a side effect include:
Diagnosis and types of hypotension
Once a healthcare provider has determined through a blood pressure reading that you have hypotension, diagnosis will focus on figuring out what is causing your blood pressure to be too low. Your healthcare provider will examine your medical history to look for underlying causes and may order a blood test to see if you have low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), or a low red blood cell count (anemia).
To see if your heart is functioning the way it’s supposed to, the healthcare provider may order an electrocardiogram (ECG), which records your heart’s electrical signals and can detect irregularities in your heart rhythm, structural problems in your heart, and issues with the supply of blood and oxygen to the heart muscle.
If you are experiencing dizziness or neurally mediated hypotension, a tilt-table test may be performed. In this test, a person lies on a table that is tilted to raise or lower their upper body in order to evaluate how their body reacts to changes in position.
There are five main types of hypotension.
Orthostatic hypotension, or postural hypotension
This is a sudden drop in blood pressure when you get up from a seated or lying position. Orthostatic hypotension can cause chest, neck, or shoulder pain in addition to the other symptoms of low blood pressure. This condition is more common first thing in the morning and in older adults.
Neurally mediated hypotension
Brought on by standing for a long period of time, this condition occurs because of a miscommunication between the brain and the heart. Neurally mediated hypotension is more common in children and young people.
This is a drop in blood pressure that typically occurs one to two hours after eating a meal. Postprandial hypotension can cause people to feel lightheaded or dizzy and is most common in adults, people with high blood pressure, and people with autonomic nervous system disorders.
Severe hypotension linked to shock
The Cleveland Clinic calls shock the most extreme form of hypotension. When someone goes into shock, their blood pressure drops to dangerously low levels, and their organs and brain can’t get enough blood and oxygen to function correctly.
Multiple system atrophy with orthostatic hypotension
This is a rare disorder, also known as Shy-Drager syndrome; it is similar to Parkinson’s disease. Multiple system atrophy causes progressive damage to the autonomic nervous system, which controls involuntary bodily functions like blood pressure, heart rate, breathing, and digestion.
When is low blood pressure an emergency?
In most cases, low blood pressure is nothing to worry about unless you start to show symptoms of hypotension. If you notice mild symptoms, such as temporary dizziness or occasional blurred vision, make an appointment with a healthcare provider to have the condition checked out.
“If you’re having minor symptoms, like some lightheadedness or fatigue, and you have low blood pressure, that’s when you should contact your doctor and get evaluated to find out what’s causing it,” says Yang.
In rare cases, a sudden drop in blood pressure can lead to more serious complications like shock, heart attack, and even death. These situations require immediate medical attention. If you can, have someone get you to a hospital emergency room immediately. If you’re alone, call 911, and don’t try to drive yourself to a hospital.
“If someone has low blood pressure, call 911 if their heart rate increases, their breathing is shallow, they’re confused, or the person is cold and clammy,” says Arnett. “This is most likely shock and not just low blood pressure.”
What to do if blood pressure is too low
Most cases of low blood pressure that don’t cause symptoms—or only cause mild symptoms—don’t require treatment. When treatment is necessary, it generally depends on the underlying condition causing your blood pressure to be too low. Hypotension caused by medications is usually treated by stopping use of the medication or changing the dosage. Low blood pressure due to dehydration can be treated by making sure to drink more fluids. Hypotension resulting from blood loss is treated by stopping the bleeding and administering intravenous fluids or a blood transfusion.
To help prevent orthostatic hypotension at home, be aware of how you stand up, get up in the morning, or change positions. Other home-care remedies that can help treat low blood pressure include:
“Sodium intake has a large influence on blood pressure in some individuals, and an increase in salt intake may help,” says Arnett. “But before increasing salt intake, it is very important to know the cause of the low blood pressure. If the cause is cardiac in nature, you should consult with your physician about sodium intake.”
RELATED: Is salt bad for you?
Eating smaller, healthier meals and limiting carbohydrates can help keep your blood pressure stable—so can limiting or avoiding alcohol.
RELATED: How to stick to a heart-healthy diet
Fluids will help increase blood volume and prevent dehydration, which can help prevent low blood pressure.
Doing exercises that raise your heart rate for 30-60 minutes a day helps increase your overall heart health.
5. Compression stockings
Tight elastic stockings can help decrease the pooling of blood in your legs and can help if you have to stand for long periods of time.
“If behavioral things like wearing compression stockings, increasing fluid intake, and minimizing alcohol don’t work, then there are what we call volume expanders, or medications that increase your intravascular blood volume,” says Yang.
Medications that healthcare providers may prescribe for hypotension—particularly orthostatic hypotension—include:
Work with your healthcare provider to find the combination of strategies that works for you.
Normal Blood Pressure Numbers By Age – Forbes Health
High blood pressure, also known as hypertension, is defined by systolic readings of at least 130 mmHg and diastolic readings of at least 80 mmHg, according to the Centers for Disease Control and Prevention (CDC). As of 2021, 116 million U. S. adults have high blood pressure.
What Causes High Blood Pressure?
The cause of high blood pressure, or hypertension, is often unknown. It develops over time and often happens as a result of unhealthy lifestyle choices, according to the Centers for Disease Control and Prevention (CDC).
“Occasionally, some people have hypertension caused by an underlying condition, such as kidney disease, adrenal gland tumors or thyroid disorders,” says Dr. Wong. Other conditions like pregnancy, diabetes and obesity can also increase your risk.
“Some people are susceptible to high blood pressure from certain medications, such as birth control pills, some decongestants and even some over-the-counter pain relievers,” says Wong. “Illicit drugs, such as cocaine and amphetamines may also raise blood pressure.”
High blood pressure is extremely common. A 2017 to 2018 survey conducted by the National Center for Health Statistics found 45.5% of U.S. adults have hypertension.
High Blood Pressure Symptoms
High blood pressure is known as “the silent killer” because it typically has no symptoms. In fact, most people don’t even realize they have hypertension until their blood pressure is monitored.
“Symptoms don’t develop until the numbers get very high and organs get damaged, often irreversibly,” says Dr. Desai.
If you have severe hypertension, you might notice the below symptoms, some of which were reported by patients in a study in the British Journal of General Practice:
- Shortness of breath
- Chest pains
- Visual changes
- Blood in urine
- Mood changes
High Blood Pressure Treatment
“A healthy lifestyle can help prevent some of the damage that can occur with hypertension, as well as help lower blood pressure to some extent,” says Dr. Wong. He recommends:
- Limiting your salt intake to 2. 3 grams a day.
- Completing 150 minutes a week of moderate-intensity aerobic exercise.
- Limiting your alcohol intake.
- Following the Dietary Approaches to Stop Hypertension (DASH) diet, which can help reduce blood pressure, says Dr. Wong. It’s a diet high in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish and nuts. It’s low in sweets, sugar-sweetened beverages and red meats.
- Managing your stress with practices like meditation.
- Reducing your total body fat percentage.
- Appropriately managing associated medical conditions like diabetes.
Side Effects of High Blood Pressure
“Dangers of untreated high blood pressure include stroke, heart attack, heart failure, vision loss, kidney failure, vascular dementia and sexual dysfunction,” says Dr. Desai. It’s one of the top risk factors for developing atrial fibrillation, which is the most common heart rhythm disorder worldwide and can lead to stroke, heart failure and reduced quality of life.
What Your Blood Pressure Says About You
Doctors have been measuring patients’ blood pressure, the force that blood exerts on the inside walls of your vessels — since the first sphygmomanometers (yes, that’s what blood pressure cuffs are called) were invented at the beginning of the 20th century.
Doctors are still finding new ways to glean information about your health from these numbers. British researchers recently found differences in blood pressure between the right and left arms might be a sign of vascular disease. Likewise, a difference in blood pressure when you’re lying down vs. standing up may indicate heart problems or blood vessel disease. Doctors can tell that from a painless test that takes only a few minutes.
The Basics: What Does Blood Pressure Mean
The most important thing to know about your blood pressure is whether or not it’s high. A blood pressure reading consists of two numbers, with acceptable ranges for each one. The first, or top, number is called the systolic number. That’s the pressure inside your arteries when your heart beats. The bottom, or diastolic, number is the pressure between beats. You want those numbers to be below 120 and 80, respectively.
“What high blood pressure means is too much resistance inside your arteries,” says Ivan V. Pacold, MD, a cardiology professor at Loyola University’s Stritch School of Medicine and director of cardiology at Gottlieb Memorial Hospital in Chicago. “Simply speaking, that causes arterial damage and increases your risk for stroke, heart attack, heart failure, and kidney failure.”
The Lowdown on Low Blood Pressure
“In a healthy person, low blood pressure is a sign of good health as long as the systolic pressure is above 80,” explains Dr. Pacold. “Very low blood pressure in a person with heart disease could be a sign of heart failure.”
One type of low blood pressure that could predict future heart problems is called orthostatic hypotension. In this type of low blood pressure, “there is a drop of 10 to 20 points of blood pressure when a person moves from a sitting or supine (flat) position to a standing position,” Pacold says. “It causes a sudden sense of lightheadedness and can be due to a heart that is starting to have trouble compensating.”
A recent study on orthostatic hypotension published in the journal Hypertension followed more than 12,000 adults for about 17 years. None of them had heart failure at the start. People who had episodes of orthostatic hypotension during the study period, especially between the ages of 45 to 55, were more likely to develop heart failure by the end.
Blood Pressure Differences Between Arms
Has your doctor ever measured your blood pressure in both arms? “Not a bad idea,” says Pacold. “Finding blood pressure differences between one side of the body and the other can be a warning sign for atherosclerosis in the main blood vessel leaving the heart or elsewhere in the body. It is a signal that you need to look further.”
Research published in the British medical journal The Lancet found that a blood pressure difference of 10 to 15 points between arms increases the risk for dying from a stroke or from heart disease. Having a difference of 15 points or more was found to double the risk for peripheral artery disease (PAD), a condition that affects more than 12 million Americans. Researchers concluded this after reviewing 20 studies that recorded blood pressure differences between arms.
Getting Blood Pressure Help
You should get your blood pressure checked during your routine doctor visits, or at least once every two years, according to the American Heart Association. “Blood pressure is called the silent killer because there may be no symptoms until damage is already being done,” Pacold says. “You can prevent that damage by getting early diagnosis and treatment.” Here are some takeaway tips:
- Blood pressure readings from 120 to 139 (systolic) or from 80 to 89 (diastolic) are considered to be pre-hypertension. You may need to have your blood pressure checked more frequently.
- If your blood pressure readings stay at or above 140 and 90 over time, your doctor may start you on a treatment program.
- Any time you have a blood pressure reading of over 180 systolic or over 110 diastolic, check it again. If it is still that high, you need to get emergency blood pressure help right away.
Your blood pressure readings can tell you and your doctor a lot about your current health and may even predict future problems. If you are concerned about PAD or if you have episodes of feeling dizzy when you stand up, talk to your doctor. Checking your blood pressure, both sitting and standing and in both arms, is a great way to learn more about what’s going on inside your arteries.
For the latest news and information on living a heart-healthy lifestyle, follow @HeartDiseases on Twitter from the editors of @EverydayHealth.
Blood Pressure UK
There are two main types of physical activity – aerobic (or dynamic) and isometric (or static) exercise, and our bodies react differently to them. Ideally, we should do some of each type, but if you have high blood pressure, some types of exercises won’t be suitable.
Aerobic (dynamic) exercise
Aerobic exercises get the heart and lungs working. They use the large muscle groups in your body, often in repeated and rhythmic movements. They’re sometimes called dynamic exercises because you move through a whole range of movement. They include swimming, cycling, brisk walking, tennis, dancing and heavy gardening.
Aerobic exercise is very good for your heart and blood vessels as it gives them a good workout, helping them to become more flexible and keeping them in good shape.
During aerobic exercise, your heart pumps your blood with more force which does raise your blood pressure a little, but because the blood flows into a large number of muscles around the body, the blood has plenty of space to flow through and your blood pressure won’t rise very much. In fact, regular aerobic activities will help to lower your blood pressure over time. Just avoid pushing yourself too hard.
Isometric (or static) exercises are exercises which build muscle and strength, for example weight lifting and using resistance bands. They’re sometimes called static exercises because you will stay in one place, for example with bench press where you lay flat and push against a bar.
Some types of isometric exercise, including lifting heavy weights, can raise your blood pressure very high very quickly while you’re doing the exercise. This puts extra strain on the heart and blood vessels, so they might not be suitable for you if you have high blood pressure. Light weights wont be a problem.
Isometric exercises involve the sustained contraction of just one set of muscles, rather than the whole body. The heart beats with more force, but only a small number of muscles are being used meaning there is less space in the for the blood to flow in, causing the rise in blood pressure.
Speak to your doctor or a qualified fitness professional before taking on a new exercise to make sure it’s safe for you. Read more about physical activity and your blood pressure.
Low Blood Pressure: Range, Symptoms, Causes & Treatment
When people are otherwise healthy and low blood pressure doesn’t cause symptoms, no treatment is necessary. Even if symptoms occur occasionally or are mild, doctors may not recommend treatment. This is because low blood pressure is generally a healthy thing for your heart. (Normal blood pressure is less than 120/80 mmHg.)
When people have concerning symptoms, treatment will depend on the cause. If medications are causing the problem, your doctor may adjust the dose or switch to another drug. For other underlying causes, treating them may help resolve your symptoms.
Treatments to raise your low blood pressure
Sometimes, there is no clearly identifiable cause of low blood pressure. Or there may not be an effective treatment for the underlying cause. In these cases, the goal is to help prevent symptoms of low blood pressure. Your doctor may recommend the following strategies:
- Drink more water: Water keeps your blood volume high and prevents dehydration. Sports drinks and rehydration drinks also add electrolytes.
- Eat some salt: Salt can help raise your blood pressure. Many people need to limit salt because it makes their blood pressure too high. For people with low blood pressure, salt can actually be helpful. However, too much salt can be bad for your heart and kidneys. Check with your doctor to find the right amount of salt intake for you.
- Wear compression stockings: These stockings stop blood from pooling in your lower legs and promote better circulation.
If you have orthostatic hypotension, your doctor may prescribe a medication, such as midodrine (Orvaten).
Home remedies for raising low blood pressure
Lifestyle changes may help some people with low blood pressure including:
- Avoiding standing for long periods of time or spending long periods in hot, humid conditions
- Changing positions slowly and deliberately
- Drinking caffeine in the morning, if it is safe for you, but avoid it for the rest of the day
- Eating several small meals throughout the day, which can help even out blood pressure and blood sugar
- Exercising on a regular basis, including both strength and cardio activities
- Limiting alcohol, which is a vasodilator—it relaxes blood vessels—and can contribute to dehydration
Alternative treatments for low blood pressure
Certain herbal supplements can increase blood pressure including:
- Natural licorice (not licorice flavoring)
Be sure to check with your doctor before starting any herbal supplement. Make sure all your healthcare providers, including your pharmacist, are aware of the supplement you are taking.
Health Threats From High Blood Pressure
High blood pressure threatens your health and quality of life
In most cases, the damage done by high blood pressure (HBP, or hypertension) takes place over time. Left undetected (or uncontrolled), high blood pressure can lead to:
- Heart attack — High blood pressure damages arteries that can become blocked and prevent blood flow to the heart muscle.
- Stroke — High blood pressure can cause blood vessels in the brain to clog more easily or even burst.
- Heart failure — The increased workload from high blood pressure can cause the heart to enlarge and fail to supply blood to the body.
- Kidney disease or failure — High blood pressure can damage the arteries around the kidneys and interfere with their ability to filter blood effectively.
- Vision loss — High blood pressure can strain or damage blood vessels in the eyes.
- Sexual dysfunction — High blood pressure can lead to erectile dysfunction in men or lower libido in women.
- Angina — Over time, high blood pressure can lead to heart disease or microvascular disease (MVD). Angina, or chest pain, is a common symptom.
- Peripheral artery disease (PAD) — Atherosclerosis caused by high blood pressure can cause a narrowing of arteries in the legs, arms, stomach and head, causing pain or fatigue.
Download the consequences of HBP infographic: English (PDF) | Spanish (PDF) | Traditional Chinese (PDF)
Can hypertension cause other problems?
When your blood pressure is too high for too long, it damages your blood vessels – and LDL (bad) cholesterol begins to accumulate along tears in your artery walls. This increases the workload of your circulatory system while decreasing its efficiency.
As a result, high blood pressure puts you at greater risk for developing life-changing and potentially life-threating conditions.
Your best protection is knowledge, management and prevention
High blood pressure and hypertensive crisis
If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and then test your blood pressure again. If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis.
High blood pressure and metabolic syndrome (insulin resistance syndrome)
Metabolic syndrome refers to a cluster of risk factors, including high blood pressure, that raises the risk of heart disease, diabetes, stroke and other health problems. It is diagnosed when any three of these risk factors are present:
- High blood glucose (sugar)
- Low levels of HDL (good) cholesterol in the blood
- High levels of triglycerides in the blood
- Large waist circumference or “apple-shaped” body
- High blood pressure
Download the metabolic syndrome fact sheet (PDF).
90,000 whether it is necessary to increase it and what to do in case of fainting
Blood pressure is one of the most important indicators of health, depending mainly on the tone of blood vessels and on the volume of circulating blood. Everyone knows about the dangers of high blood pressure. And what do doctors say about low?
The normal level of pressure at any age is less than 140/90 mm Hg. Art. Increase in blood pressure above 140/90 mm Hg. Art. called arterial hypertension, or hypertension. This condition is dangerous by the development of strokes, heart attacks and other cardiovascular complications, requires treatment and medical supervision even if you do not feel it.What about reduced pressure?
Natalia Polenova – Ph.D., family doctor, cardiologist, pediatric cardiologist, nutritionist at GMS Clinic.
Hypotension (a drop in blood pressure of less than 90/60) is usually not a health hazard. Constantly low blood pressure numbers are often found in young girls of fragile physique, but this, as a rule, does not affect the quality of life.
Persistent hypotension with good health does not require treatment.But, if the pressure dropped sharply and this led to fainting or caused a light-headed state, medical attention and additional examination may be required.
Special attention should be paid to the reduction of blood pressure in the following situations:
Orthostatic hypotension – loss of consciousness with a sharp change in body position from horizontal to vertical, for example, when suddenly getting out of bed. Because of this, the volume of circulating blood is redistributed and the blood supply to the brain is temporarily reduced.Often this condition occurs in pregnant women due to changes in the circulatory system and a shift in the center of gravity. Therefore, it is important during pregnancy to avoid sudden movements and to be careful when getting out of the car or getting out of the chair.
Taking medications to lower blood pressure. The goal of antihypertensive therapy is to achieve a sustained reduction in blood pressure below 140/90 mm Hg. Art, but without episodes of a sharp decline. Inappropriate dosage of the drug can cause hypotension – this leads to weakness, fatigue during exercise and dizziness.In this case, you need to conduct daily monitoring of blood pressure and adjust therapy.
Fainting is a short-term loss of consciousness due to an impaired blood supply to the brain. For a complete loss of consciousness, a sudden cessation of cerebral blood flow for 6-8 seconds is sufficient.
Types of fainting:
- reflex, due to fear, pain, heat or stuffiness;
- orthostatic, with a sharp transition to the vertical position;
- cardiogenic, in diseases of the heart or blood vessels, as well as due to cardiac arrhythmias.
After a sudden loss of consciousness, especially if it is a repeated case, you need to seek medical attention. You may need to consult a therapist, cardiologist, neurologist. In addition, it is important to undergo examinations: Holter monitoring, record an ECG and conduct an MRI of the brain. And also examine the level of sugar, iron and thyroid hormones.
Prevention of a sharp decrease in blood pressure
Avoid situations that provoke a drop in pressure (do not get out of bed suddenly, try to avoid stuffy and hot rooms, as well as stress).
Drinking cold water quickly can also prevent orthostatic hypotension (fainting when there is a sudden change in body position).
Simple exercises such as crossing your legs and clenching your hand into a fist can help raise blood pressure quickly and effectively and prevent fainting.
Tilt training – regular exercise that simulates standing up from a prone position in young people with recurrent fainting can significantly reduce the incidence of hypotensive conditions.
First aid for fainting
With a sharp drop in blood pressure, you need to lie down, raise your legs higher and open a window to increase the access of oxygen and, if possible, drink water.
To maintain normal blood pressure levels at any age are important: constant physical activity, adequate fluid intake and a balanced diet. It is important to remember that normal pressure numbers are less than 140/90 mm Hg.Art.
Low blood pressure: should it be increased and what to do in case of fainting :: Health :: RBK Style
May 24, 2021
Blood pressure is one of the most important indicators of health, depending mainly on the tone of blood vessels and on the volume of circulating blood. Everyone knows about the dangers of high blood pressure. And what do doctors say about low?
The normal level of pressure at any age is less than 140/90 mm Hg. Art. Increase in blood pressure above 140/90 mm Hg.Art. called arterial hypertension, or hypertension. This condition is dangerous by the development of strokes, heart attacks and other cardiovascular complications, requires treatment and medical supervision even if you do not feel it. What about reduced pressure?
Natalya Polenova – Ph.D., family doctor, cardiologist, pediatric cardiologist, nutritionist GMS Clinic
Hypotension (lowering blood pressure less than 90/60) is usually not hazardous to health. Constantly low blood pressure numbers are often found in young girls of fragile physique, but this, as a rule, does not affect the quality of life.
Persistent hypotension with good health does not require treatment. But, if the pressure drops sharply and this led to fainting or caused a light-headed state, medical attention and additional examination may be required.
Special attention should be paid to the reduction of blood pressure in the following situations:
Orthostatic hypotension – loss of consciousness with a sharp change in body position from horizontal to vertical, for example, when suddenly getting out of bed.Because of this, the volume of circulating blood is redistributed and the blood supply to the brain is temporarily reduced. Often this condition occurs in pregnant women due to changes in the circulatory system and a shift in the center of gravity. Therefore, it is important during pregnancy to avoid sudden movements and to be careful when getting out of the car or getting out of the chair.
Taking medications to reduce blood pressure . The goal of antihypertensive therapy is to achieve a sustained reduction in blood pressure below 140/90 mm Hg.Art, but without episodes of a sharp decline. Inappropriate dosage of the drug can cause hypotension – this leads to weakness, fatigue during exercise and dizziness. In this case, you need to conduct daily monitoring of blood pressure and adjust therapy.
Fainting is a short-term loss of consciousness due to impaired blood supply to the brain. For a complete loss of consciousness, a sudden cessation of cerebral blood flow for 6-8 seconds is sufficient.
Types of fainting:
- reflex, due to fear, pain, heat or stuffiness;
- orthostatic, with a sharp transition to the vertical position;
- cardiogenic, in diseases of the heart or blood vessels, as well as due to cardiac arrhythmias.
After a sudden loss of consciousness, especially if it is a repeated case, seek medical attention.You may need to consult a therapist, cardiologist, neurologist. In addition, it is important to undergo examinations: Holter monitoring, record an ECG and conduct an MRI of the brain. And also examine the level of sugar, iron and thyroid hormones.
Prevention of a sharp decrease in blood pressure
Avoid situations that provoke a drop in pressure (do not get out of bed suddenly, try to avoid stuffy and hot rooms, as well as stress).
Taking cold water quickly can also prevent orthostatic hypotension (fainting when there is a sudden change in body position).
Simple exercises such as crossing the legs and clenching the hand into a fist can help raise blood pressure quickly and effectively and prevent fainting.
Tilt training – Regular training that simulates standing up from a prone position in young people with recurrent fainting can significantly reduce the incidence of hypotensive conditions.
First aid for fainting
In case of a sharp drop in blood pressure, you need to lie down, raise your legs higher and open a window in order to increase the access of oxygen and, if possible, drink water.
To maintain normal blood pressure levels at any age, it is important: constant physical activity, adequate fluid intake and a balanced diet. It is important to remember that normal pressure numbers are less than 140/90 mm Hg. Art.
90,000 I woke up and was already tired. Experts on How to Raise Pressure | HEALTH
Heat and stuffiness – the worst time for hypotonic patients.People with low blood pressure are generally acutely aware of any changes in the weather. How to improve your well-being and keep your blood pressure normal even in the intense summer heat? Is the point of view correct that hypotension will not lead to a heart attack? And is this state really as harmless as it seems at first glance. This is what AiF-Yug had talked about with cardiologist Inna Belan.
Tatiana Zakharova, AiF-Yug: What is hypotension in general? What blood pressure is considered to be pathologically low?
Inna Belan: We talk about hypotension when blood pressure is below 100/60 mm.Hg in young people and below 105/65 mm Hg. in people aged. This condition, as a rule, is accompanied by such vegetative manifestations as sweating of the palms and feet, pallor of the skin, palpitations, dizziness, weakness. Young girls and adolescents suffer from the disease more often, but the disease also occurs in other categories of people, including the elderly.
– What worries hypotensive patients?
– Most often they complain of dizziness, headache, weakness, sleep disturbances, fatigue, irritability.The skin is pale, the fingertips may turn blue, there may be various disturbances in the work of the heart rhythm, shortness of breath, darkening in the eyes with sudden movements, gastrointestinal disorders. In an acute condition, symptoms develop rapidly, up to and including loss of consciousness. The so-called orthostatic hypotension is often found – the pressure drops sharply when the body position changes from horizontal to vertical. This is observed in adolescents and elderly patients with diabetes mellitus and hypertension.
During physical exertion, hypotensive patients may experience tachycardia, shortness of breath and discomfort in the chest area.Often, the state of health worsens after suffering acute respiratory infections, as well as in the spring and summer seasons.
Not only inherited
– Low blood pressure – a hereditary disease?
– Hypotension is physiological and pathological. Physiological – hereditary, manifests itself during excessive physical exertion, as well as as a result of adaptation of the body to the environment, as, for example, among residents of highlands or subtropics.Pathological hypotension is divided into primary and secondary.
The primary cause in most cases is vegetative-vascular dystonia, which develops against the background of stress, depression, chronic fatigue, and lack of sleep. Secondary hypotension develops against the background of various endocrine disorders, brain injuries, osteochondrosis of the spine, gastric ulcer, anemia and some other diseases. They are the ones that cause low blood pressure.
– Hypotension is not hypertension.Will not lead to a heart attack. This point of view is shared by many. Is it really so?
– With age, hypotension disappears, since changes appear in the vessels, blood pressure increases, the likelihood of hypertension cannot be ruled out. To think that hypotensive patients will never become hypertensive is wrong.
Against the weather
– Are the hypotonics weather dependent?
– Yes, it is. People with arterial hypotension are sensitive to weather changes.As a rule, they do not tolerate heat, low atmospheric pressure. The best weather for hypotonic people is sunny frosty days. They do not tolerate climate change extremely well, so they are recommended to spend their holidays in their familiar climatic zone. It is difficult for hypotonic patients to endure stuffiness and immobility, many of them prefer to walk, instead of standing at a bus stop waiting for transport, and even more so to go in a stuffy cabin. In many, hypotension manifests itself only in the form of increased fatigue and meteosensitivity.In addition, in hypotonic patients, the tone of the sympathetic nervous system is reduced. That is why they are often apathetic, inhibited, and quickly get tired. Due to a lack of oxygen, dizziness, darkening in the eyes up to fainting, headaches in the frontal or temporo-parietal regions often occur. Migraines with hypotension can also occur in violation of the outflow of blood from the veins of the skull, since their tone is reduced. For this reason, the headache is localized in the back of the head and often occurs in the morning after sleep. At the same time, patients wake up already tired, and become active only in the evening hours.
Important to know: arterial hypotension syndrome can be important in the diagnosis of critical conditions. For example, during the acute phase of myocardial infarction, the clinical parameters of an extremely high risk of coronary events are arterial hypotension, heart failure up to cardiogenic shock. Hypotension can be one of the first manifestations of internal bleeding, cancer, etc.
– Is it possible to cure hypotension?
– If the pressure of the hypotensive is reduced by only 20% compared to the norm and the state of health does not deteriorate, then therapy is not carried out.With primary hypotension with a deterioration in well-being, it is necessary to consult a cardiologist. True, it is difficult to treat it. There are few drugs. They usually contain caffeine, which is considered a stimulant of the central nervous system. They relieve spasms of the cerebral vessels, thereby reducing the headache, but caffeine is addictive, so you cannot take such drugs for a long time. Also used for treatment are nootropics that support the body and improve metabolic processes in the brain, complexes of vitamins and minerals (B1, B2, B3, B5, E, C) and metabolism.Physiotherapy, massage of the cervical-collar zone, acupuncture, osteopathy, swimming, aromatherapy give a good effect.
Although hypotension is an unpleasant ailment, you can find some advantages in it: it slows down the onset of atherosclerosis and increases life expectancy up to 10 years.
How to live with hypotension?
- – Lead a healthy lifestyle.
- – Avoid being in stuffy rooms, vehicles and outdoors in hot weather.
- – Stop drugs that may cause hypotension.
- – Correctly organize the mode of work and rest. At night it is desirable to sleep until 10 o’clock.
– Eat fractionally often, do not skip breakfast. Spices (cinnamon, allspice, ginger) may be present in the diet, they help to increase blood pressure, as well as spicy, salty foods.
- – Get out of bed without sudden movements, first on the side, then gradually sit down. Fainting may occur if you move quickly from horizontal to vertical.
- – A contrast shower is useful in the morning.Alternate hot and cool water for 5 minutes. This helps to tone the blood vessels and normalize blood pressure.
- – Do not neglect regular exercise.
- – Observe a positive psycho-emotional environment.
- – Refuse nicotine and alcohol, because they lower the vascular tone.
- – Avoid sudden movements: fast running and lifting weights are contraindicated in hypotension. On the other hand, breathing exercises, Pilates, yoga and walking stabilize the physical and psycho-emotional state well.
- – Keep feet and hands warm, wear a hat. If you feel unwell due to extreme cold, you must definitely take a hot shower, hot foot baths, drink sweet hot tea or coffee. In cold weather and with a reduced atmospheric pressure, hypotonia needs a daytime sleep.
- – In the morning in bed, do breathing exercises: take a deep breath and exhale, while sticking out your stomach with repetitions of at least 7 times, lying on your back. Also, while lying in bed, do the “bicycle” exercise.
90,000 Consequences of low blood pressure in patients with treated hypertension and cognitive impairment: results of a prospective observational study
AH – hypertension
AGT – antihypertensive therapy
HELL – blood pressure
AMAD – ambulatory blood pressure monitoring
DBP – diastolic blood pressure
CR – cognitive disorders
SBP – systolic blood pressure
UKR – moderate cognitive impairment
Background to the study
Both arterial hypertension (AH) and various forms of cognitive disorders (CD) are characterized by a high prevalence and are often combined in the elderly. According to the available data, AH is present in 54% of men and 57% of elderly women . Dementia occurs in 6–8% of people 60 years of age and older, and its frequency increases to 25% in people 85 years of age and older . Moderate cognitive impairment (MCI), a less severe form of cognitive decline that may be a harbinger of clinically overt dementia, occurs in a large number of people 65 years of age or older, and is estimated to have a prevalence of about 25% . Previously, there was evidence that dementia is becoming one of the main causes of disability in the elderly , and Alzheimer’s disease is the sixth most common cause of death in the United States of the Caucasian race .
The relationship between high blood pressure (BP) and the development of dementia is not so clear-cut. The results of cross-sectional studies, in the course of which a connection was established between the level of blood pressure and cognitive functions, are rather contradictory . Several prospective studies [6-8] with long follow-up periods have reported a higher risk of dementia, including Alzheimer’s disease, in patients with elevated blood pressure. At the same time, results from other prospective studies [9-11], especially those involving participants aged 75 years or older, indicated that higher blood pressure was associated with a lower incidence of dementia.
Data on the prognostic value of elevated blood pressure in patients with CR are even more limited and contradictory, especially for patients with clinically evident dementia . A recent study  that included individuals with MCI showed an association between elevated BP and faster rates of cognitive decline. These findings are consistent with observational studies [14, 15], which have noted a protective effect of antihypertensive drugs on cognitive function in older persons with dementia or MCI.At the same time, the development of dementia is usually accompanied by a spontaneous decrease in blood pressure , which leads to the possibility of excessive antihypertensive therapy (AHT), if this therapy is not changed accordingly. Moreover, there have been no well-organized experimental studies that included only patients with CR, and the results of large RCTs of AHT in elderly patients could not eliminate the contradictory data on the relationship between cognitive functions and blood pressure . It was assumed that, due to cerebral hypoperfusion, hypertension can negatively affect cognitive functions in patients with dementia , despite the lack of experimental confirmation of the presence of cerebral autoregulation disorders in Alzheimer’s disease .
There is a lack of reliable evidence to support a recommendation for the treatment of hypertension in the elderly with dementia or MCI. In accordance with the latest version of the recommendations of the European Society for the Treatment of Hypertension and the European Society of Cardiology , the decision to use AHT in debilitated elderly patients is made at the discretion of the attending physician. Moreover, these recommendations do not indicate target blood pressure levels in the treatment of patients with CR. In the American recommendations of the eighth report of the US Joint National Committee on the Prevention, Detection, Evaluation and Treatment of Hypertension (JNC8), which was published in 2014.,  there are also no recommendations for the management of patients over 85 years of age, weak and elderly with CR.
Ambulatory blood pressure monitoring (ABPM) results can provide prognostic information in addition to the results of routine blood pressure measurements in a hospital to clarify the risk of death  and the development of severe complications of cardiovascular diseases . Moreover, in persons suffering from CR, who are in special medical institutions, the results of measuring blood pressure by medical personnel do not fully correspond to the results of monitoring blood pressure, which is largely due to the high prevalence of AH in the “white coat” .According to the data available to the authors of the study, never before have prospective studies been conducted in elderly persons with CR, in the course of which AMAD was used to predict changes in cognitive functions.
Purpose of the study
To assess the value of blood pressure measured at a research center, blood pressure according to 24-hour AMAD, as well as the use of antihypertensive drugs to predict cognitive decline and progression of disability in elderly patients with dementia or MCI. In addition, it was proposed to assess the effect of blood pressure measured at the research center and blood pressure according to AMAD data on the incidence of such outcomes as death, severe complications of cardiovascular diseases, hospitalizations, syncope, falls and bone fractures.
Prospective observational study carried out at 2 research centers; median follow-up is 9 months.
Material and research methods
Each study participant signed an informed consent prior to enrollment. Each patient was examined immediately after inclusion in the study and then after 6-8 months of observation. In the period from June 1, 2009 to May 31, 2011 and from September 1 to December 31, 2012, the study included patients referred to two clinics located in Italy and specializing in the treatment of patients with memory impairments.
Patients 65 years of age or older who were diagnosed with dementia were included in the study (according to the criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Illness or MCM (according to the criteria of the International MCM Working Group [ 24]), whose score on the MMSE (Mini-Mental State Examination) scale  ranged from 10 to 27 points (the scale range is from 0 to 30 points; with 0 points corresponding to the maximum degree of CR).Exclusion criteria: a permanent form of atrial fibrillation (due to the limited accuracy of automatic blood pressure measurement), the patient’s refusal to wear an AMAD device or from the proposed examination during the study. In patients with moderate and severe CR, special attention was paid to explaining the goals and procedures of the study with the involvement of family members caring for the sick, if necessary. The details of the initial characteristics of patients whose blood pressure levels belonged to different tercils of systolic blood pressure (SBP) according to AMP in the daytime are presented in the table.
Table. Baseline characteristics of patients whose blood pressure levels belonged to different tertiles of SBP according to AMAD data in the daytime
At the initial examination, the clinically most significant concomitant vascular diseases were identified, including hypertension, diabetes mellitus, chronic heart failure, coronary heart disease, arrhythmias (except for atrial fibrillation, which was the criterion for exclusion from the study), cerebrovascular disease, and chronic kidney disease.Each of these diseases was diagnosed on the basis of history data, records in medical records and physical examination and expressed in points; moreover, the presence of a certain concomitant vascular disease corresponded to 1 point, and the absence – 0. The index of concomitant vascular diseases was calculated by summing the points; the range of assessment on the scale was from 0 to 7 points. In addition, the use of any antihypertensive drug, including angiotensin-converting enzyme inhibitors, calcium antagonists, β-blockers, diuretics, angiotensin II receptor blockers and α-blockers, was taken into account, and SBP and diastolic blood pressure (DBP) were recorded. A mercury sphygmomanometer was used to measure blood pressure in accordance with the recommendations . Cognitive functions were assessed using the MMSE scale. In addition, the limitations of daily activity were assessed using the BADL scale (Basic activities of daily living) and the IADL scale (Instrumental activities of daily living) [26, 27]. The range of assessments on the BADL scale corresponds to from 0 to 6 points, and on the IADL scale – from 0 to 8 points; with higher scores corresponding to a more pronounced limitation of daily activity.At enrollment in the study, all patients underwent AMAD using the oscillometric method (device model
; Spacelabs Healthcare). AMAD was offered to all patients regardless of the presence or absence of diagnosed hypertension. During blood pressure monitoring, the cuff was placed on the non-dominant arm. Cuffs of the appropriate size were used, and they provided the opportunity to choose one of three cuffs of different sizes, while the cuff had to cover at least 80% of the arm circumference. The BP monitor was configured to automatically record BP every 15 min (using a warning signal about the start of the measurement) during the daytime (from 7 to 22 h) and every 20 min (in the absence of a warning signal) in the night period (from 22 to 7 h). If it was impossible to register blood pressure during the first measurement within 2 minutes, blood pressure was automatically re-measured. Depending on the state of cognitive functions, the participants were orally explained about the operation of the device and were recommended to keep their hand in a motionless and relaxed state during the measurement of blood pressure.In order to confirm the operation of the device for measuring AMP and the patient’s consent to its use, the first measurement of blood pressure was performed at the research center. During the analysis of the AMBP data, three indicators were calculated: 1) the average SBP and DBP in the daytime (from 9 to 21 hours) and at night (from 1 to 6 hours), which were calculated using the method of constant narrow intervals, excluding measurements from the analysis, performed during the period of awakening and going to bed (in accordance with the European recommendations for monitoring blood pressure ; 2) variability of blood pressure, which was assessed by calculating the standard deviations of SBP; 3) the degree of decrease in blood pressure at night, which was assessed by the difference between the average level of SBP in the daytime and at night and was expressed as a percentage of the level of SBP in the daytime. At the second examination at the research center (6-18 months after the first examination), BP was measured, as well as cognitive functions were assessed using the MMSE scale and limitations in everyday life using the BADL and IADL scales. Based on reports from doctors and medical personnel, as well as records in medical records, deaths, the development of severe complications of cardiovascular diseases, hospitalization, the development of fainting, falls and bone fractures in general in the study population were taken into account.To reduce the number of patients who were followed up to the end of the study for developing adverse events, study participants were contacted by phone.
The results of measuring blood pressure in the research center and AMAD were divided into tertiles. In the course of the analysis, the method of substitution for missing data was not applied. K.R. and disability were assessed by differences in the MMSE, BADL, and IADL scores during the study, and then such differences were compared in subgroups of patients whose SBP corresponded to certain tertiles. A similar analysis was repeated after stratification for antihypertensive drug use. Multiple comparisons were made taking into account age, baseline MMSE, Vascular Combined Disease Scale, AHT use, and the interaction between BP and AHT use. The same analysis was performed both in general in all patients included in the study and in subgroups of patients with dementia and MCI.
Analysis of variance (with Bonferroni corrections for secondary analysis) or the Kruskal-Wallace test for non-normal data was used to compare continuous data between groups.Qualitative characteristics were compared between groups using Pearson’s χ test 2 . Comparison of the data obtained at the beginning and at the end of the study was performed using the paired t test for continuous data and using the Wilcoxon test for data whose distribution was different from normal.
Multivariate analysis was performed using analysis of covariance, introducing qualitative features as constant factors and continuous data as covariates. The boundaries of the means (and 95% CI) were calculated using the models.All types of statistical analysis were performed using the SPSS version 20 software package (IBM). Differences were considered statistically significant at p <0.05.
In the period between June 1, 2009 and December 31, 2012, a total of 193 patients were included in the study, of whom 172 (89.1%) were re-examined during the study; their data were included in the analysis. The average age of such patients reached 79 ± 5 years (63.4% women). Data on nighttime AMAD results were available in only 159 patients, as 13 participants removed the device before completing BP registration.In 177 patients, data on adverse events were obtained. When included in the study, dementia and MCI were diagnosed in 68 and 32% of patients, respectively. The average score on the MMSE scale reached 22.1 ± 4.4 points. In general, when included in the study, hypertension was noted in 73.5% of patients, and antihypertensive drugs were taken in 69. 8% of patients. The dividing points for tercils of the SBP level in the daytime were 128 mm Hg. or less, from 129 to 144 mm Hg. and 145 mm Hg. or more. For tertile SBP measured at the research center, such separation points were 125 mm Hg.Art. and less, from 126 to 149 mm Hg. and 150 mm Hg. and more.
During the observation, the median duration of which reached 9 months, in general, there was a decrease in the MMSE score on average from 22.1 ± 4.4 to 20.7 ± 5.8 points (p <0.001). The degree of disability increased on the BADL scale from 1.0 ± 1.3 to 1.6 ± 1.8 points, and on the IADL scale - from an average of 3.0 ± 2.4 to 3.8 ± 2.6 points (p <0.001 for both indicators). A.D. level according to the measurement data at the research center has not changed. At inclusion in the study and at the end of the observation period, SBP was 138 ± 21 and 138 ± 18 mm Hg.Art. (p = 0.90), and the mean DBP was 76 ± 10 and 77 ± 8 mm Hg. (p = 0.50).
After the participants were divided into groups depending on the daytime SBP tercils (according to AMAD data), in the group of patients whose SBP corresponded to the lower tertile, a more pronounced decrease in cognitive functions was revealed according to the MMSE score (on average, −2. 8 ± 3.8 points) compared with the group of patients whose SBP level corresponded to the middle tertile (−0.7 ± 2.5 points; p = 0.002) and the upper tertile (−0.7 ± 3.7 points; p = 0.003 ).In contrast, there was no statistically significant association between SBP as measured at the research center and cognitive progression. There was also no association between changes in cognitive functions and the level of DBP as measured at the research center or other indicators of ABP, including the level of SBP at night, as well as between the variability of blood pressure, the sufficiency of blood pressure reduction and the use of antihypertensive therapy. Moreover, no association was found between blood pressure variability and changes in BADL and IADL scores.After stratification, taking into account the use of AHT, a statistically significant relationship between low SBP in the daytime and a more pronounced decline in cognitive functions persisted only in patients who used AHT. According to this analysis, in the subgroup of patients who took antihypertensive drugs, the average change in the MMSE score in the group of patients whose SBP corresponded to the lower, middle and upper tertiaries reached −3.9 ± 3.5, −0.6 ± 2 , 2 and −0.4 ± 3.7 points, respectively (p <0.001 for comparing each of the groups of the middle and upper tertile with the group of the lower tertile).A similar trend was also found for the SBP level. In the group of patients whose SBP corresponded to the lower tertile, a more pronounced decrease in cognitive functions was revealed in the case of the use of antihypertensive drugs: the average decrease in the MMSE score in this group reached -2.7 ± 3.7 points; in the group of patients whose SBP level corresponded to the upper tertile, the decrease in the MMSE score was only −0.9 ± 3.6 points (p = 0.06). Moreover, the results of assessing cognitive functions turned out to be better in patients who did not take antihypertensive drugs: in the group of patients whose SBP corresponded to the lower and upper tertile, the change in the MMSE score was 1.3 ± 2.8 and −1.8 ± 3.1 points, respectively; p = 0.01.
Similar results were obtained for the SBP level at night (according to AMAD data). In the group of patients whose nighttime SBP belonged to the lower tertile (mean nighttime BP 119 mm Hg and less), there was a tendency for a more pronounced deterioration of cognitive functions in the case of antihypertensive drugs compared with the group of patients who used such drugs, but for which the SBP level at night belonged to the upper tertile (more than 135 mm Hg): in the group of the lower and upper tertile, the decrease in the MMSE score in such cases was −2.2 ± 3.7, respectively, and −1.0 ± 4.0 points (p = 0.45).However, it should be noted that there are no statistically significant differences between groups for these indicators.
Multivariate analysis, including age, baseline MMSE and Vascular Comorbidity Scale, tercile SBP, and use of AHT, suggested that the interaction between low SBP and AHT use was independently associated with a more pronounced decrease in cognitive functions for daytime SBP indicators (Fisher’s test – F = 6.139; p = 0.003) and SBP indicators as measured at the research center (F = 7.393; p = 0.001).The average change in the standardized MMSE score, depending on the SBP level during the daytime in patients who took antihypertensive drugs, reached −3.9 points (with a 95% CI from −4.9 to −2.8 points) for the lower tercil and was −0.7 (at 95% CI −1.7 to 0.4) for the middle tertile and −0.4 points (−1.4 to 0.6 points) for the upper tertile. Such indicators in patients who did not take antihypertensive drugs were −0.4 points (with 95% CI from −2.1 to 1.3 points) for the lower tercil, −0.8 points (with 95% CI −2, 3 to 0.7 points) for the middle tertile and −1.4 points (with a 95% CI from −3.1 to 0.3 points) for the upper tertile.The mean change in the standardized MMSE score depending on the SBP level measured at the research center in patients who took antihypertensive drugs reached -2.7 points (95% CI from -3.8 to -1.7 points) for the lower tertile, −1.2 points (at 95% CI -2.3 to −0.1 points) for the middle tertile and −0.9 points (at 95% CI from −2.0 to 0.2 points) for the upper terzil. Such indicators in patients who did not take antihypertensive drugs were 1.4 points (with 95% CI from −0.4 to 3.3 points) for the lower tercil, −1.3 points (with 95% CI from −3, 1 to 0.6 points) for the middle tertile and −1.8 points (with a 95% CI from −3.2 to −0.4) for the upper tertile.
A similar analysis was performed separately in subgroups of patients with dementia and MCI. In patients with dementia, whose SBP level in the daytime belonged to the lower tertile, there was a more pronounced decrease in the MMSE score (on average, −3.5 ± 4.1 points) compared with patients in whom this SBP level corresponded to the average tertile (on average, −0.6 ± 2.8 points; p = 0.004), and in patients in whom it corresponded to the upper tertile (on average, −1.2 ± 4.1 points; p = 0.003). Similar data were obtained in the subgroup of patients with MCI.In patients whose SBP corresponded to the lower tertile during the day, there was a more pronounced decrease in cognitive functions (on average by −1.4 ± 2.7 points) compared with patients in whom this SBP level corresponded to the upper tertile (on average 0, 8 ± 1.9 points; p = 0.02). There was no association between changes in the MMSE scale and SBP as measured at the research center in both the subgroup of patients with dementia and the subgroup of patients with MCI. And in this case, the relationship between low SBP in the daytime and a more pronounced decline in cognitive functions was observed only in patients who took antihypertensive drugs in both the subgroup of patients with dementia and the subgroup of patients with MCI.
Results of multivariate analysis, performed in subgroups of patients with different characteristics, confirmed an independent association between more pronounced decline in cognitive functions and the interaction between SBP level during the daytime and the use of antihypertensive drugs in patients with dementia (F = 3.592; p = 0.03) and patients with MCI (F = 4.907; p = 0.01). In the subgroup of patients with dementia, the mean change in the standardized MMSE score depending on the daytime SBP level when taking antihypertensive drugs reached −4.4 points (with a 95% CI from −5.8 to −3.1 points) for the lower tercil , −1.0 points (with 95% CI from −2.4 to 0.5 points) for the middle tertile and −0.6 points (with 95% CI from −2.0 to 0.7 points) for the upper tertile …The same indices for untreated patients were −0.7 points (with 95% CI from −3.3 to 1.8 points) for the lower tercil, −0.3 points (with 95% CI from −2.4 to 1, 8 points) for the middle tertile and -2.0 points (with 95% CI from -4.3 to 0.2 points) for the upper tertile. In the subgroup of patients with MCI, the mean change in the standardized MMSE score depending on the SBP level in the daytime when taking antihypertensive drugs reached -2.9 points (with a 95% CI from -4.1 to -1.7 points) for the lower tertile , 0.4 points (with 95% CI from −1.7 to 0.8 points) for the middle tertile and 0.4 points (with 95% CI from −0.8 to 1.6 points) for the upper tertile.The same indicators for untreated patients were 0.4 points (with 95% CI from −1.2 to 2.1 points) for the lower tertile, −1.3 points (with 95% CI from −3.1 to 0.6 points) for the middle tertile and 0.7 points (at 95% CI from −1.5 to 2.8 points) for the upper tertile. Results from a similar analysis performed for the SBP measured at the research center confirmed an independent association in the subgroup of patients with dementia, but the absence of such an association in the subgroup of patients with MCI.
Of the 177 patients included in the study, 1.7% died, and severe complications of heart disease, bone fractures, reports of at least one fall, an episode of fainting and hospitalization during the study were noted in 9.6, 6.8, 26.6, 6.8 and 23.7% of patients, respectively.There were no statistically significant differences between groups in the incidence of such adverse outcomes for daytime SBP and study center SBP, despite a trend towards increased syncope and hospitalization rates with a decrease in SBP during the day. In patients whose SBP level in the daytime corresponded to the lower, middle and upper tertiaries, the incidence of syncope reached 10.5, 6.8, and 3.4%, respectively (p = 0.33), and the frequency of hospitalizations was 33.3. 21.7 and 17.2%, respectively (p = 0.11)
Low daytime SBP is independently associated with more pronounced cognitive decline in elderly patients with dementia and MCI among those receiving AHP.An excessive decrease in SBP can harm older patients with K.R. AMAD may be helpful in preventing excessive AHT in this population.
The results of the study indicate a relationship between a low SBP level in the daytime according to AMAD data and a more pronounced deterioration of cognitive functions in adult patients with CR with a median follow-up period of 9 months. However, the presence of such a relationship was noted only in patients with treated hypertension; moreover, this relationship did not depend on age, assessment on the scale of associated vascular diseases, or the baseline level of cognitive functions.This relationship remained statistically significant when the data on patients with dementia and MCI were analyzed separately. A similar trend was noted for the association between lower SBP measured at the research center and more pronounced cognitive impairment. However, the results of all analyzes indicated that such an association was weaker than the association with daytime SBP as measured by AMAD and did not reach the level of statistical significance. Lower BP levels were not accompanied by a positive effect on prognosis.
The effect of blood pressure on the progression of dementia remains poorly defined . One study  reported that there was no association between BP and cognitive function, while the results of another  indicated a negative predictive effect of elevated BP on cognitive function only in younger age groups. Finally, according to a third study , a similar relationship between BP and cognitive function was observed only in individuals aged 85 and over.In contrast, the results of the Leiden 85-plus Study , which included persons aged 85 years or older (CR was observed in 65% of participants), the decline in cognitive functions after 3 years of follow-up was less pronounced with higher SBP levels, especially in the subgroup of patients with more severe impairment of such functions when included in the study.
The data obtained in the course of the Leiden 85-plus Study  are consistent with the results of the present study, which indicate an association between lower SBP and decreased cognitive function in elderly patients with dementia and MCI with relatively short follow-up.Since in the elderly there is a link between low blood pressure and cerebral atrophy , low SBP may be a marker of more severe degenerative processes in the central nervous system. It should be noted that the authors of the presented study did not reveal any correlations between cognitive functions and blood pressure levels according to the data of the first survey, and with long-term follow-up, the relationship remained statistically significant according to the analysis performed taking into account the initial assessment on the MMSE scale.Despite the small sample size, the association remained statistically significant in the subgroup of patients with MCI, in whom mild or no degenerative changes in the nervous system can be assumed.
Two studies specifically assessed the prognostic role of risk factors for vascular disease, including hypertension, in individuals with MCI and noted an association between elevated blood pressure and a higher risk of dementia  and cognitive decline .However, the follow-up period in such studies was longer (5 years  and 3 years ) than in the presented study. Moreover, in this study, the relationship between low SBP and decreased cognitive functions, in accordance with the results of a previous study , was observed only in patients who used antihypertensive drugs, while in patients untreated with such drugs, the opposite trend was revealed, which confirms the hypothesis about the negative effect on cognitive functions of a more pronounced decrease in blood pressure.Despite the fact that the use of antihypertensive drugs can be a marker of the presence of concomitant heart diseases, for example, heart failure, which is also associated with a decrease in cognitive diseases.
The peculiarities of this study include the implementation of AMAD. This may suggest that daytime SBP should be considered more accurate than standard clinical BP measurement to establish a link between low SBP and greater cognitive decline.It should be noted that the SBP level according to the AMAD data (and not the SBP level measured in the research center) was associated with changes in cognitive functions in general in all patients included in the study, both taking antihypertensive drugs, and those who did not use them, as well as in the final model including patients with MCI. According to the authors of the study, measuring blood pressure in a medical institution should be the first stage of the examination, given its simplicity. However, then, when deciding whether to start AHT or to increase it in debilitated patients with increased SBP, AMAD can be recommended as a standard examination tactic.In contrast, there was no statistically significant relationship between SBP and DBP at night, as well as the degree of BP reduction at night or BP variability with changes in cognitive functions. According to the data available to the authors of the study, the prognostic value of indicators of daily variability in blood pressure in persons with CR has not been previously studied. The results of cross-sectional studies evaluating ABPM and cognitive function performed in the general elderly population have been mixed. In particular, several studies have shown an association between cognitive decline and factors such as insufficient nighttime BP reduction [34–36], increased DBP levels as measured by 24-hour BP monitoring , and decreased SBP levels. in the daytime and at night , higher variability in blood pressure  or no variability in blood pressure according to AMAD .
The main disadvantages of this study, according to its authors, are the small sample size and observational nature of the study, which does not allow us to draw a definite conclusion about the negative effect of taking antihypertensive drugs on cognitive function. Other limitations of this study include a short follow-up period, which does not allow establishing the possible protective effect of such therapy, as well as performing the study on the basis of outpatient clinics specializing in memory problems, which does not directly extend the findings to the actual practice of providing care in primary care. links of health care or departments in which assistance is provided to patients with acutely developed diseases.Moreover, due to the limited availability of personnel and equipment for performing AMAD, not all patients with appropriate characteristics were included in this study, although the absence of any specific exclusion criteria from the study makes it unlikely that there is a bias associated with patient selection. …
However, despite these shortcomings, the authors of the study believe that additional information obtained during the study may be useful in determining the tactics of treating hypertension in elderly patients with CR.It should be noted that the RCT HYVET (Hypertension in the Very Elderly Trial) , the main results of which indicated the effectiveness of the use of AHT for the prevention of severe complications of heart disease and reducing mortality in patients with hypertension aged 80 years and older, included the elderly. with GARDEN 160 mm Hg or more in the absence of severe concomitant diseases (including dementia). Thus, there are currently no special recommendations for the treatment of hypertension in elderly patients with CR or dementia [19, 20].The results of a previous study , which included elderly people in nursing homes (ie, people who often have dementia), indicated that there was no predictive effect of blood pressure levels, as well as a weak correlation between the results of blood pressure measurements by medical personnel and data obtained with AMAD. Such facts allow the authors to doubt the validity of the results of measuring blood pressure in a medical institution in elderly patients with CR.
Thus, the results of this study provide additional information about outpatients with MCI or dementia, which suggests a negative effect of a more pronounced decrease in SBP on cognitive function, and that the most acceptable therapeutic range for SBP during the daytime could be from 130 to 145 mmHgArt. For a more accurate assessment of the prognostic role of blood pressure in elderly patients with CR, it is necessary to conduct long-term prospective studies with AMAD and the inclusion of a larger number of patients. At the same time, the implementation of RCTs would make it possible to assess the risks and benefits of antihypertensive therapy in achieving different target blood pressure levels in such patients.
90,000 hypertension and hypotension have become younger and are found even in schoolchildren – Rossiyskaya Gazeta
Doctors sound the alarm: hypertension and hypotension, which have always been diseases of pensioners, have become younger and are already found even in schoolchildren.
Studies have shown that at least 40 million people suffer from hypertension in our country. And at the same time, many do not even suspect about the true causes of their ailment, although it often leads to such sad consequences as a stroke and heart attack. And they don’t pay attention to hypotension (low blood pressure). But she, too, is capable of causing serious damage to our health.
What do you need to know about pressure for hypotonic patients (they are especially meteosensitive) in order to avoid the dangers of winter, when the most contrasting weather jump occurs – from above zero to below zero?
- Modern standards for the classification of high and low blood pressure are defined by the World League of Hypertension.The optimum (also called the cosmonaut) is 120 by 80 millimeters of mercury. Normal blood pressure is less than or equal to 130/85 mm Hg. Art. The maximum permissible high pressure is 140/90. However, the exact boundaries for hypotension have not been established.
- Hypotension is manifested by unmotivated weakness, dizziness (especially when the head bends down), headaches, sweating, irritability, palpitations during physical exertion. It happens that with a sharp rise, legs go numb, darkens in the eyes, this condition can lead to fainting.All this is especially pronounced when the weather changes – the hypotension is meteorological.
- Low blood pressure may accompany some diseases (pulmonary tuberculosis, peptic ulcer, liver disease, endocrine system diseases, for example, diabetes or, conversely, low blood sugar), be a manifestation of vascular dystonia.
- Suddenly developing hypotension is a symptom of acute vascular insufficiency. If the pressure drops sharply and remains low, it can pose a threat due to a violation of the blood supply.There is an urgent need for medical attention.
- Stress, heatstroke, infections, eating disorders, various diets or, conversely, irregular eating, pregnancy, disorders of the central nervous system, overdose of drugs for high blood pressure, weather changes, a sharp change in climatic conditions, alcohol abuse can lead to a sharp decrease in pressure, allergic reaction.
What hypotensive patients need to know:
- Coffee pressure raises very well, strong sweet tea (both black and green).
- Fatty and salty foods, which are by no means recommended for high blood pressure, help hypotonic patients. But you should limit the use of honey, butter, milk, sour cream, potatoes.
- You need foods that contain a lot of iron: dried apricots, almonds, raisins, carrots, beets.
American nutritionists offer such a tonic drink for hypotonic patients: a bunch of parsley, two celery stalks, one peeled garlic clove, four carrots.Pass everything through a juicer, and the healing drink is ready!
Don’t push me: the whole truth about meteorological dependence
The overwhelming majority of work in biometeorology is assessing statistics of doctor visits or surveys of people whose opinions may be subjective. There are so many factors in life that can make you feel worse, and it’s not a fact that the weather is one of them. To prove otherwise, clinical trials with a control group are needed, but they are not easy to organize. Is it easy to put hundreds of people with arthritis or hypotension in a pressure chamber for several days, and another hundred in a placebo pressure chamber, in which the pressure is like outside? Take one group to the mountains, and leave the control group at the foot, but do not open the windows? By the way, scientists tried the option with artificially adjustable conditions in a small experiment on 75 healthy volunteers.As a result, it was possible to show that under reduced pressure and high humidity … the ability to smell is reduced. However, the authors of the article did not find any threats to health.
Today we learn about the weather from forecasts, and it is much easier to spoil the “blind” experiment and convince yourself that your subjective feelings have changed. But if you still think that you are meteosensitive (and got high scores in the METEO-Q test), then in the coming days, be more attentive to your chronic problems.The risk group will be those suffering from hypotension or hypertension, those who are characterized by surges in pressure, and other people with diseases of the heart and blood vessels, because the contraction of the heart and the expansion and narrowing of blood vessels directly affect the pressure. The same applies to people with respiratory diseases. Therefore, many doctors advised such people not to go outside. However, the house is not a spacesuit with forced air, where the necessary pressure is maintained, even when there is a cosmic vacuum around. The whims of the earthly atmosphere also work inside buildings, so just staying indoors will not make much of a difference.But if your pressure gives you constant problems, it is better to heed the advice of these doctors – you may save yourself from fainting on the subway or train.
A magic pill for weather dependence, alas, does not exist: clinical trials that would unequivocally confirm that right now a person had joint pain or a head or pressure jumped precisely because of the weather, and then because of the medicine it would go away, just not … Therefore, only general advice related to blood pressure can be given.Drinking coffee, alcoholic beverages, smoking and overeating on such days is not worth it. Drinking more water may be beneficial, as a drop in atmospheric pressure can alter the viscosity of blood and synovial fluid, which softens joint friction. Avoid strenuous physical exertion, stuffiness and nervous strain, try to get enough sleep. And don’t worry too much – otherwise trigger the nocebo effect (it’s like a placebo, but vice versa), and the excitement itself will cause pressure surges or pains that you wanted to avoid.As for the upcoming magnetic storms, at the turn of winter and spring 2019, forecasters predict disturbances in the atmosphere of the G1 category (the lowest of the five). Chances are good that you simply would not have noticed such a storm if you had not watched the news.
Perhaps some of the readers will be disappointed: these advice sounds like common truth. “Yeah, lead a healthy lifestyle, and it will be better for me, why am I reading this then,” you will be indignant. But if it’s that simple, why not follow these rules for a change? A healthy body that is cared for is definitely less sensitive to weather conditions, and this approach will help people with chronic diseases feel better.
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Venous pressure is the secret of our blood circulation
Decrease in venous pressure
Venous pressure decreases from peripheral vessels to the heart. At the level of the ankles of a standing person, it is usually equal to 90 – 110 mm Hg.Art. and depends on the force of gravity and the distance from the feet to the heart. Accordingly, a person’s height is critical to the level of venous pressure while standing. With the onset of movements, the pressure drops to about 20 mm Hg. Art., and is kept at this level until a good venous outflow is provided. Several factors are important for venous return to the heart.
Effect of the heart on peripheral circulation (reversible action)
First of all, the heart is a delivery pump, and secondly, it is a suction pump.In an adult with a healthy heart, with each heartbeat, on average, about 70 milliliters of blood is thrown from the left ventricle into the aorta. This volume exerts additional (to the already existing) pressure on the blood column in the aorta and arteries that drain it. This pressure “pushes” blood through the vascular system through the arterial part of the capillary into the venules and from there through the veins towards the right heart.
The larger the diameter of the veins towards the heart, the lower the blood pressure.In a healthy person in the supine position, the pressure in the venous capillaries is about 20 mm Hg. At the groin level, it decreases to 8–12 mm Hg. Art., and in the abdominal cavity (intra-abdominal) – yes 3-5 (mm / Hg. Art.). In the right atrium, the blood pressure is already only 2 mm Hg.
This pressure allows blood to return to the heart. The suction action of the heart takes effect only in the last venous segment, that is, shortly before the superior vena cava flows into the right atrium. This suction action occurs during the ejection phase and is formed by valve movements in the heart.
Suction effect caused by breathing
The pressure in the chest cavity is negative (partial vacuum). On inhalation, this negative pressure increases, and at the same time, intra-abdominal pressure increases as the diaphragm moves downward. This causes the venous valves in the femoral vein to close.
This phenomenon, called the Valsalva principle, is used in vein diagnostic testing as the first functional test of venous valves.Venous pressure decreases from the abdomen to the chest, causing a suction action in the thoracic veins.
When we exhale, the valves open again in response to a decrease in intra-abdominal pressure. As a result, the pelvic veins and inferior vena cava are refilled with blood, which then moves further towards the heart. This so-called abdominal-thoracic biphasic pump is stimulated by the heart.
Blood in the veins exerts pressure on the venous wall.This creates tension in the venous wall, which ensures that the venous pressure no longer increases. Venous pressure and venous blood volume are closely related.
Deep veins are located between the muscles. Because of this, each muscle contraction compresses the veins and pushes the blood column towards the heart. When the muscles relax, the venous valves prevent blood from flowing back towards the capillaries.
With each muscle contraction, only a certain amount of blood is transported towards the heart. In this regard, the gastrocnemius muscles play an important role. also efficient venous valves are essential for effective “drainage” of blood.
In general, it should be remembered that the movement of blood through the veins is passive and depends on the interaction of several factors. If at least one of them is impaired, for example, “emptying” of the veins during the contraction and relaxation of the leg muscles, disorders of venous circulation may develop.This can, in turn, cause thrombosis or even thromboembolism.