Low blood pressure

Quick Overview

• limits: 110 to 60 mmHg in men, 100 to 60 mmHg in women
• symptoms: sometimes no, but often symptoms such as palpitations, dizziness, headache, tiredness, shortness of breath
• Causes: Low blood pressure is partly hereditary. It can also be caused by environmental influences, illness or medication as well as certain postures or (fast) changes in position.
• Diagnosis: repeated blood pressure measurement, specific circulatory tests, if necessary further examinations (such as ultrasound and blood test)
• Treatment: Home remedies and general measures such as changing showers, exercise, enough salted food, a lot of drinking; at their inefficiency medication
• Forecast: usually not dangerous, only in certain cases, accurate observation necessary.

Low Blood Pressure: Limit Table

The term blood pressure refers to the pressure in the large arteries. These are the vessels that lead away from the heart. How high or low the pressure in their interior depends, on the one hand, on the elasticity and the resistance of the vessel walls. On the other hand, the blood pressure is influenced by the impact of the heart – that is, how much blood volume per heartbeat is transported into the circulation. The heart rate also plays a role.

A low blood pressure is actually only a symptom and not a disease, although it is often considered as such in Germany. That is why low blood pressure in foreign countries is often mockingly referred to as “German disease”.

Blood pressure is expressed in millimeters of mercury (mmHg). Of the upper (systolic) value describes the blood pressure the moment the heart muscle contracts and expels blood. Of the lower (diastolic) value refers to the relaxation phase of the heart (slack) when it refills with blood.

Low blood pressure: values

According to the World Health Organization (WHO), blood pressure should optimally be below 120 to 80 mmHg. If the systolic value is below 110 (men) or 100 (women) and the diastolic value is below 60, physicians speak of low blood pressure (arterial hypotension). How deviations from the optimum value are assessed upwards can be found in the table:

	Systolic (mmHg)	Diastolic (mmHg)
Low blood pressure (hypotension)	< 110/100*	< 60
Optimal blood pressure	< 120	< 80
Normal blood pressure	120 – 129	80 – 84
High normal blood pressure	130 – 139	85 – 89
High blood pressure (hypertension)	≥ 140	≥ 90

* In men, values ​​below 110/60 are considered low blood pressure, in women values ​​below 100/60.

Low blood pressure is rarely threatening. Only if the values ​​fall too low, a low blood pressure can be dangerous – it faints a fainting. Occasionally, arterial hypotension is an indication of a potentially serious organ disease.

Low blood pressure: symptoms

Low blood pressure does not always cause symptoms. Especially with a rapid attack of blood pressure symptoms such as dizziness, palpitations and circulatory problems, headaches or tiredness may occur. Frequently affected are (inactive) adolescents, young slender women, pregnant women, and haggard older people. In principle: If low blood pressure causes symptoms such as the following and these occur frequently or very suddenly, the cause should be clarified by the doctor:

Palpitations: If the blood pressure is low, often accompanying a rapid heartbeat (pulse) occurs. That’s because the body wants to counteract the decreased blood flow – and it does so by making the heart beat faster by activating the sympathetic nervous system.

Dizziness: Low blood pressure also means lack of blood supply to the brain. This causes blurred vision such as the famous “seeing star” or “black in front of the eyes”, tearing and dizziness. In the worst case victims will faint. Often, these symptoms also become noticeable when the affected person changes position, for example, (quickly) getting up or bending over. The blood collapses in the legs, and the body needs a moment to regulate the blood pressure again.

Such “dropouts” become dangerous when there is a risk of falling or when driving.

A headache: Often, low blood pressure is accompanied by a (stinging, pulsating) headache. The reason: The blood circulation in the head is throttled. Then it can help to drink something and thereby increase the circulating blood volume. Even a walk is good, as the fresh air improves the oxygen supply in the brain and stimulates the circulation.

Fatigue: Fatigue, concentration problems, drowsiness, tiredness – low blood pressure makes you feel weak. Patients take longer in the morning to get going, and feel altogether impotent. In addition, they are often shaky or sweating due to the reduced blood flow.

Shortness of breath: A chest tightness or pricks in the heart area may also be signs of low blood pressure. Some sufferers get bad breath, the skin may feel cool and is pale. This is because in arterial hypotension, the blood vessels are narrowed to direct the blood volume to the vital organs such as the heart or brain.

Also tinnitus, anorexia, irritability, meteorosensitivity and depressive moods may indicate low blood pressure.

Low blood pressure: causes and risk factors

In itself, the body has its own system that regulates blood pressure: small pressure gauges in the carotid arteriesthat can feel the blood pressure in the vessel. They relay signals to the circulatory center in the brain stem. This is the command for vasodilatation in high blood pressure and the command for vasoconstriction at low blood pressure. Also the kidney becomes active when the blood pressure in the feeding vessel falls too low: it then releases the hormone renin. It triggers an increase in blood pressure via intermediate steps.

The mechanisms of blood pressure regulation for various reasons may not work properly or be disturbed. Then results in a low blood pressure. Physicians distinguish different forms of hypotension: primary (essential) hypotension, secondary hypotension and orthostatic hypotension.

Primary hypotension

Primary or essential low blood pressure is the most common form of hypotension. He appears without apparent cause. The inclination to it can probably be inherited. Because especially often young, slim people (especially women) have a congenital low blood pressure, one speaks here of constitutional hypotension (constitution = physique, general physical condition).

Secondary hypotension

Secondary low blood pressure is a consequence or symptom of an underlying disease. These include, for example:

• Hypothyroidism (hypothyroidism)
• Subfunction of adrenal cortex (Addison’s disease)
• Hypofunction of the pituitary gland (pituitary anterior lobe insufficiency)
• Heart disease (heart failure, cardiac arrhythmia, pericarditis)
• Salt deficiency (hyponatremia)
• Venous insufficiency (varicose veins)

dehydration (high heat, heavy sweating, severe diarrhea and vomiting, etc.) can also lower blood pressure: The large loss of fluid reduces the amount of circulating blood, which reduces the pressure in the blood vessels decreases.

Also, as a side effect of some medications, blood pressure may drop excessively. Such drug hypotension can be triggered by:

• Psychotropic drugs (remedies for depression, anxiety, insomnia)
• Antiarrythmics (anti-arrhythmic agents)
• Antihypertensive agents (antihypertensive agents)
• Diuretics (diuretic drugs)
• Coronary means (for angina pectoris: nitro-sprays)
• Vasodilators (vasodilators)

Orthostatic hypotension

Orthostasis is the upright posture. Accordingly, orthostatic low blood pressure occurs when you get up quickly from lying down and get the blood in your legs. So there is a volume shift that the body can not respond to (quickly). Orthostatic hypotension therefore also becomes orthostatic dysregulation called.

Possible reasons for orthostatic hypotension are:

• secondary low blood pressure
• Disruption of the autonomic nervous system (for example due to diabetes mellitus)
• Nerve cell damage in the brain (for example due to Parkinson’s disease, alcohol abuse)
• Varicose veins
• Condition after deep vein thrombosis (postthrombotic syndrome)

Physicians distinguish two forms of orthostatic hypotension:

1. Sympatheticotone orthostatic hypotension: After getting up, the systolic blood pressure drops while the heart rate increases.
2. Asympathicotonic orthostatic hypotension: Systolic and diastolic blood pressure drop when standing, while the pulse rate remains unchanged or also falls.

Low blood pressure in pregnancy

In the first six months of pregnancy, low blood pressure is normal. Sometimes it stays too low in late pregnancy. The reason for this may be the vena cava syndrome: the unborn child presses on the large vena cava (vena cava) of the mother. This large blood vessel carries blood from the body back to the heart. The pressure of the child on the large vena cava thus affects the blood backflow to the heart. As a result, the blood supply to the brain and other parts of the body is also reduced – low blood pressure results.

Low blood pressure: examinations and diagnosis

To make the “low blood pressure” diagnosis, the doctor must repeatedly measure the blood pressure. It is important that the measurements are carried out on different days and at different times.

With the help of Schellong tests the doctor can find out if a low blood pressure is due to the lack of orthostatic regulation (orthostatic hypotension): In this cycle test, the patient must first lie ten minutes and then get up quickly.

A somewhat more elaborate measuring method is the so-called Tilt table test: Here the patient is tied to a tilting table with two straps. The blood pressure is initially measured for ten minutes while lying, then measured at 60 degrees upright tilt.

Does the doctor suspect that a low blood pressure is caused by a certain underlying disease (secondary hypotension), further investigations can bring clarity. For example, the thyroid levels in the blood are measured and the thyroid gland is examined by ultrasound to clarify hypothyroidism. Evidence of heart disease (such as arrhythmias) may be the result of electrocardiography (ECG).

Low blood pressure: treatment

The good news: as annoying as the symptoms of low blood pressure can be, home remedies and a few simple measures can noticeably relieve the symptoms. Drug therapy is only necessary if low blood pressure causes serious discomfort or a health hazard.

Low blood pressure: home remedies

So what can you do concretely with low blood pressure? First of all, move. Because physical activity gets the circulation going and reduces symptoms like dizziness and fatigue. Especially endurance sports such as jogging, swimming or cycling are suitable. By the way, movement already starts before getting up. It often helps to stretch and bend your feet in bed to stimulate blood flow or to ride your feet in the air – and then slowly rise. If necessary with a Break on the edge of the bed.

Other home remedies for low blood pressure are Compression / support stockings, They can stimulate the blood circulation in the legs. Meaningful are synonymous cold showers: The rapid change between warm and cold water causes the blood vessels to expand and contract alternately. This trains the vessel walls and stimulates the circulation.

Who spares a full body sprinkling with cold water, at least the lower half of the body – from the feet up to the buttocks – cold shower. A circulation-enhancing brush or a massage sponge increase the stimulating effect.

Speaking of exciting effect: Den has synonymous Cup of coffee in the morning. Green or black tea also have a stimulating effect on the circulation. Generally you should drink a lot if the blood pressure is too low (water, herbal or fruit tea etc.). This increases the blood volume and thus the blood pressure.

Saline also increases blood volume and blood pressure by binding fluid in the body. People with low blood pressure should eat their food salt enough (maximum five grams per day). Advisable are as well several small meals a day instead of less big.

A positive effect with low blood pressure should also saponins to have. These plant substances are found, for example, in licorice, oats and legumes. They can increase cortisol production in the body and increase blood pressure.

Low blood pressure: medications

If home remedies and general measures (exercise, etc.) do not adequately relieve low blood pressure symptoms, you should talk to your doctor about medication. If necessary, he can prescribe medications that increase blood pressure. These include something called sympathomimetic: They narrow the blood vessels and increase the heart rate. Another example is dihydroergotamine: This ingredient increases the wall tension of the veins and thus counteracts a collapse of the blood in the legs. It is suitable for the treatment of sympathicotonic orthostatic hypotension.

Drug therapy for low blood pressure is recommended only when absolutely necessary. The drugs can have side effects. In the case of sympathomimetics, for example, these may be cardiac arrhythmias. Dihydroergotamine may induce reduced blood flow to limbs and organs.

Low blood pressure: history and prognosis

Usually, low blood pressure is safe and does not cause permanent damage. In severe cases, however, it can lead to severe dizziness and fainting.

Even a low blood pressure during pregnancy can be dangerous: It can happen that the uterus is not sufficiently supplied with blood. Then the care of the unborn child is no longer guaranteed. Such a permanent shortage of the child can lead to developmental disorders and increase the risk of complications in childbirth. That’s why low blood pressure be carefully monitored and monitored by a doctor during pregnancy.