Low blood pressure? Here's when to worry
The question
What, on the other hand, are the relevant clinical aspects of arterial hypotension?
Answer: First of all, it must be premised that there is no definite value for establishing that a person has hypotension, in the sense that some individuals are characterised by blood pressure values that are 'constitutionally' lower than others, without this causing any disturbance or problem. On the contrary, arterial hypotension takes on clinical significance when it causes certain disorders, which naturally vary depending on the extent of the drop in values and the situations that cause this drop in blood pressure.
The most common symptoms related to hypotension (also unspecific because they could also be due to other causes), include fatigue, muscle weakness, sometimes headache or a feeling of nausea, a weak and rapid pulse, palpitations, and a sense of confusion.
These symptoms can occur most frequently when the subject is exposed to an abrupt increase in external temperature. This leads to profuse sweating with excessive fluid loss and dilation of blood vessels. This phenomenon is further amplified if the subject does not drink enough water, a typical situation in the elderly subject who 'physiologically' loses the sense of thirst.
Another clinical situation that leads to clinically relevant hypotension is copious fluid loss due to certain gastrointestinal conditions, such as prolonged vomiting or persistent diarrhoea. If hypotension is caused, on the other hand, by a rapid transition from a sitting to a standing position (so-called 'orthostatic hypotension'), symptoms such as dizziness, blurred vision, pale and cold skin, and even, in the worst condition, a loss of consciousness, known as syncope, may appear more frequently. This situation represents a defence mechanism of the body, and falling to the ground makes it easier for the blood to resume proper supply to the brain and heart.
Similarly, if a person suffers a collapse (sensation of fainting, without loss of consciousness), it is important that, while waiting for medical help, the person is kept lying down with his or her legs elevated, to encourage circulation. In the event of an episode of syncope or collapse, you should inform your doctor, who will investigate the clinical picture and, if necessary, identify the cause.
If hypotension affects a patient with high blood pressure who is being treated with specific antihypertensive drugs, hypotension with symptoms may be the consequence of overtreatment. In that case, the advice of the doctor should be sought, who will decide whether and which drugs to discontinue, at least temporarily.
Pregnancy is another situation in which hypotension with symptoms frequently occurs, and of course in this case too, the gynaecologist attending the pregnant person must be notified immediately.
What advice should be given to counteract the symptoms of hypotension? In the simplest and most common cases, there are no specific drugs, only the invitation to follow certain correct behaviours. Among them, especially in hot weather, are:
- increase the amount of water you drink, avoiding alcoholic substances that increase vasodilation and worsen hypotension.
- take care with your diet, avoiding meals that are too large and rich in carbohydrates;
- stand up slowly from the table at the end of the meal;
- use appropriate clothing (light clothes that allow the skin to breathe);
- avoid exposure to the sun during the hottest hours.