Do you suffer from low blood pressure? Here's how to deal with hypotension

By Cristiano Antonino On May 25, 2023

Following a healthy lifestyle means not only eating right and exercising regularly, but also keeping a constant check on your vital parameters so that they are always in the normal range and do not cause problems

Blood pressure is one of these parameters, and it is always important to observe its trend as a drop or rise in it can be a direct symptom of the onset of more or less serious pathologies.

Measuring blood pressure means seeing the force with which blood is ‘pumped’ up the walls of the arteries by our most important muscle, the heart.

The sphygmomanometer, an instrument used to measure blood pressure, provides a minimum and a maximum value where minimum pressure means the diastolic pressure, i.e. the force with which the heart pumps blood when it is at rest, while the maximum value coincides with the systolic pressure (i.e. the values relating to when the heart is under stress and contracting).

In this article, we will talk about hypotension (low blood pressure), i.e. analysing the symptoms associated with blood pressure values that remain consistently low throughout the day or even weeks or months.

Hypotension is, by necessity, the opposite of hypertension

While in the former the blood pressure values measured at rest are below the average, which wants them at 120/80 mmHg (the first number indicates the maximum pressure, the second the minimum), in the latter they are far higher, above 140/90 mmHg.

While low blood pressure is not necessarily a symptom of something serious, it is essential to treat hypertension carefully as it can lead to very serious cardiovascular problems.

Hypotension generally affects individuals of all ages and both sexes, although there are some categories that are more susceptible

It has been ascertained that women suffer from it more than men (especially pregnant women, due to the direct action of the hormone progesterone), the elderly, young boys, athletes and those taking certain types of drugs (antidepressants, diuretics, beta-blockers, but also sedatives, painkillers and antihypertensives).

Those suffering from cardiovascular, nervous system or metabolic diseases may also suffer.

The blood pressure values that doctors consider optimal for a healthy individual are 120 mmHg for systolic and 80 mmHg for diastolic pressure, both measured at rest.

Blood pressure: Optimal values

Blood pressure is measured in millimetres of mercury, a unit referred to as mmHg.

Measuring blood pressure means using a special medical instrument, called a sphygmomanometer, to identify the blood pressure values at rest (a sphygmomanometer can be purchased by anyone, whether in a pharmacy or electronics shop).

In a healthy person, blood pressure values are usually between 90 – 129 mmHg for systolic or maximum (contracting heart) and between 60 – 84 mmHg for diastolic or minimum (resting heart).

In any case, it is important that they remain within the average range of 120/80 mmHg so as not to cause concern.

Blood pressure can be measured at rest, most commonly while sitting in a chair, or under stress, a situation that often occurs during sports medical examinations.

Low blood pressure: symptoms of hypotension

The diagnoses made count less common cases of hypotension than those of hypertension.

This is not to say that consistently low blood pressure is to be underestimated, nor that it is uncommon.

In fact, hypotension is often difficult to detect because it presents as asymptomatic, or it is easy to confuse it with simple tiredness and exhaustion.

Let’s see together what the main manifestations of hypotension are

tiredness and drowsiness
dizziness that can result in sudden fainting, often preceded by blurred vision
concentration problems, agitation and restlessness (the individual is often in a state of confusion and has difficulty paying attention)
nausea and vomiting, lack of appetite
palpitations and tachycardia
goose bumps, excessive and sudden sweating, especially around episodes of syncope

The causes of low blood pressure

Nowadays, it is not yet possible to identify absolute and unambiguous causes associated with both sporadic and recurrent drops in blood pressure.

Hypotension should not cause anxiety when it is caused by

constitutional, genetic and physiological reasons. Some people suffer from hypotension by their own constitution, but this does not mean that they are ill. On the contrary, in this case one can go so far as to say that it is a benign situation.
Constant and intense physical activity. Athletes often suffer from low blood pressure, as constant and intense exercise lowers the heart rate considerably. It is mainly found in those who practice running and cycling, activities that put a strain on the respiratory and cardiovascular system.
In all pathological cases, medical consultation and advice is necessary, as low blood pressure can be a symptom or evolve into more serious illnesses.
Hypotension due to prolonged intake of drugs (especially anaesthetics, diuretics, beta-blockers, narcotics and antidepressants). Often the doctor decides to intervene directly, stopping their administration.
Pregnancy-induced hypotension. The lowering of pressure is due to the production and action of the hormone progesterone, which contributes to a general vasodilation.
Hypotension can be a symptom of certain diseases and traumatic states of the body such as: haemorrhage, dehydration due to vomiting or diarrhoea, dehydration due to burns, dehydration due to excessive sweating, Addison’s disease, diabetes, anaemia, vitamin deficiencies, anaphylactic shock, myocardial infarction, heart failure, arrhythmia, bradycardia, pulmonary embolism, sepsis, septic shock, severe trauma and injuries, thyroid problems.
Hypotension due to prolonged immobility in bed.
Hypotension due to the effect of narcotics.
It is also good to know that, at different times of the day, the body’s blood pressure is not the same.
Sleeping at night lowers the blood pressure values, which rise again when you wake up.
Throughout the morning, blood pressure usually rises to its peak, which usually corresponds to midday.

The pressure drops during digestion because blood is drawn towards the stomach and intestines and taken away from the other organs.

Relaxation lowers the pressure, stress raises it.

Warm environments lower pressure, as is generally the case during the summer months.

Types of hypotension

Doctors have subdivided cases of hypotension into 3 main types based on what triggers and how the drop in blood pressure values occurs.

Orthostatic or postural hypotension

It affects individuals of both sexes and all ages indiscriminately. Episodes of this type occur following sudden, abrupt movements such as getting up quickly after sitting or lying down for a long time.

Postprandial hypotension refers to drops in blood pressure during digestion after meals.

Postprandial hypotension sees cases recorded mostly among children, teenagers and young adults, following prolonged periods of standing. Put simply, what happens is that after long periods standing, the neurons experience a state of confusion, not recognising this as the correct position for the individual. As a result, the nervous system sends different impulses to the cardiovascular system, which changes the correct arterial function, leading to sudden drops in blood pressure and sometimes actual syncopes. This happens because the body is in an unusual position for too long.

Hypotension: the diagnosis and when to worry

It is not usually sporadic cases that are under special medical observation, but rather recurrent or chronic ones.

There are clinically different degrees of hypotension depending on the intensity of the manifestations and their severity:

mild hypotension (below 90/60 mmHg, but above 60/40 mmHg)
medium hypotension (less than 60/40 mmHg, but greater than 50/33 mmHg)
severe hypotension (less than 50/33 mmHg)

While the first case (mild degree), in the absence of symptoms, is benign and does not cause concern, being faced with medium or severe hypotension may imply the presence of more serious pathologies resulting in malfunctioning of the body.

For example, organs may not receive enough blood due to the heart’s weak thrust.

During the diagnosis, carried out by a general practitioner or at home with the right equipment, the blood pressure level is measured with a special instrument called a sphygmomanometer.

Measuring only the values, however, does not help. Even if you do this at home, on your own, it is a good idea to discuss it with your doctor in order to trace the triggering causes.

In the event of hypotension, doctors generally subject the patient to a series of tests such as blood tests, urine tests, ECGs and Holter blood pressure tests as well as radiological examinations (chest CT scan to detect problems with the lungs and cardiovascular system).

Hypotension: how to resolve it

As we have already seen, there are three different intensities with which hypotension can occur in affected individuals.

If the latter is mild, it is often asymptomatic and, even following clinical investigation, does not cause particular concern. Often, it is simply constitutional and physiological, or caused by the practice of constant physical activity.

It is beneficial and a symptom of a fit and trained body, and therefore does not require treatment.

If, on the other hand, the drop in blood pressure presents itself with rather obvious symptoms, it means that, in all likelihood, there is another pathology underway of which hypotension itself is but a manifestation.

It is in these cases that the doctor must intervene with a clinical investigation and tests to identify the triggering cause, and consequently prescribe the most appropriate drugs and therapies.

The most accredited pharmacological treatments for the treatment of hypotension are various.

As with any pharmacological therapy, they must be prescribed exclusively by the doctor on the basis of the patient’s medical history.

Erythropoietin: increases red blood cells, consequently also raising blood pressure
Corticosteroids
Fludrocortisone: treats Addison’s disease, which is one of the main causes of permanent hypotension (and consequently also resolves this)
Vasopressors act on vasoconstriction by increasing pressure values in blood vessels
Norepinephrine and norepinephrine act by increasing pressure values, as does phenylephrine
Ethylephrine-based therapies, usually administered orally, are mainly used to treat orthostatic hypotension

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Low blood pressure: prevention and effects on everyday life

The prevention of hypotension and the pathologies to which it can be linked passes first of all through maintaining a healthy lifestyle, with a correct diet and regular exercise, to be associated with other simple rules of good physical conduct.

The Mediterranean diet is certainly the main ally against hypotension, as it is rich in foods that allow a varied intake of all the necessary vitamins and minerals.

For those ‘sick’ of hypotension, nutritionists recommend

increase salt intake in dishes, both cold and during cooking, as it directly contributes to raising blood pressure values
chew natural liquorice roots, which have the ability to act on blood pressure
drink properly without excessive diuretics, which, as we know, contribute to lowering blood pressure;
do not overdo coffee intake. If small amounts have a beneficial effect on blood pressure, raising its values and increasing energy, an excessive amount has the opposite effect
always eat plenty of fruit and vegetables and, especially in hot, summery weather, combine this with magnesium and potassium supplements so that you always have the correct amount of minerals
eat numerous small meals throughout the day. Avoid large meals because, as we have seen, poor digestion increases postprandial hypotension.

If you are prone to episodes of hypotension, specialists also advise against

overtraining, especially in summer. At the end of each training session, it is a good idea to replenish lost fluids immediately with a proper supply of mineral salts
frequent excessively hot environments. Heat acts as a vasodilator and excessive sweating causes a huge loss of fluid, increasing the drop in blood pressure values
standing for too long a period of time
after sitting or lying down for a long time, getting up abruptly
exaggerating with certain types of medication (antidepressants, diuretics, beta-blockers, sedatives, painkillers and antihypertensives), taking them only when prescribed by a doctor.

If you suffer from hypotension or suspect it, always tell your doctor, who will be able to identify the causes and provide the right explanations and treatment.

How to measure blood pressure at rest and under stress

You can measure your blood pressure directly from home, so that you can keep it under control regularly.

It is the specialists themselves who recommend that you gradually write down your values in a notebook, so that you can provide your doctor with a complete medical history during the routine examination.

Measuring one’s blood pressure regularly is important not only to prevent, but also to detect at an early stage, the onset of more serious diseases.

How do you measure blood pressure?

First of all, you need a sphygmomanometer.

Today, you can find digital, state-of-the-art models in almost all pharmacies.

It is good to measure blood pressure at least once or twice a week, preferably at the same time, in the morning or in the evening (these are the times of day when the person is most at rest).

Before measurement, it is a good idea to eliminate anything that could affect the correct collection of data.

It is advisable not to drink coffee or smoke shortly before the measurement.

During the measurement, the subject should be calm, seated and in total relaxation.

If you have been exercising a few hours before, it is a good idea to postpone the measurement, as exercise alters the values.

The arm on which the blood pressure will be measured should be kept free, without wearing shirts with too tight sleeves, which act as vasoconstrictors.

It can happen that, between the two arms, the measurements do not coincide.

The important thing is that the difference is not too great (between 10 – 20 mmHg deviation is fine) and it is recommended that the measurement taken on the arm with the higher values is always taken into account.

It is recommended to take several measurements, taking the right amount of time between each one. The values obtained will be averaged.

It is essential to take several attempts as the first measurement often gives false values due to a general state of anxiety in the subject.

Stress pressure, on the other hand, is measured by a doctor, often a sportsman, during a specialist examination.

Special electrodes are applied to the patient’s chest and a blood pressure monitor is used to collect arterial values while the individual performs physical activity (usually running on a treadmill or exercise bike).

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