When the BP is less than 90/60 mmHg it is referred to as low BP.
What causes the blood pressure to drop?
Dr. Sudhir Kumar talks about the medications used for treating high BP, Parkinson’s disease, tricyclic antidepressants; the effect of heart diseases, such as heart attack, heart failure, low heart rate, problems with heart valves; endocrine diseases, such as Addison’s disease, hypothyroidism.
The doctor also highlights the effect of dehydration, blood loss, internal bleeding, infection, allergic reaction and nutritional deficiencies like Vitamin B12, folate and iron deficiency can cause anaemia.
Heart deconditioning and postural hypotension
Dr. Sudhir Kumar stresses on heart deconditioning, one of the reasons behind low BP in certain individuals. This refers to the decline in cardiovascular fitness and efficiency due to reduced physical activity or prolonged bed rest. During inactivity, the heart muscle weakens, and its pumping capacity diminishes. This leads to a decrease in cardiac output and can result in symptoms like shortness of breath, fatigue, and reduced exercise tolerance. Heart deconditioning is often observed in individuals with sedentary lifestyles, prolonged hospital stays, or those recovering from illness or surgery.
When the body is at rest or when an individual is lying down, the heart is at the same level as the brain. The same individual might experience dizziness immediately after waking up. This is known as postural hypotension or orthostatic hypotension. This is a condition where blood pressure significantly drops upon standing up from a sitting or lying position. The sudden change in posture causes a temporary decrease in blood flow to the brain, leading to dizziness or fainting. Common causes include dehydration, certain medications, or underlying medical conditions affecting the autonomic nervous system. Symptoms may include lightheadedness, blurred vision, and weakness.
Highlighting the importance of recognizing the signs of low blood pressure, Dr. Sudhir Kumar shares the health risks associated with low BP:
1. Systolic BP <120 mmHg (as compared to those with systolic BP 120-139 mmHg) is associated with 25% higher risk of death after stroke. The risk of death was higher among people with low BP and comorbidity (such as smoking, heart disease, cancer or dementia).
2. Higher risk of mini-stroke: Low BP increases the risk of mini-strokes, also known as low-flow transient ischemic attacks. In these cases, the paralysis recovers in <24 hours, however, people with TIAs have a higher risk of getting a stroke in the future.
3. People with orthostatic hypotension have a higher risk of dementia and stroke. Orthostatic hypotension is defined as a drop in systolic blood pressure (BP) of at least 20 mm Hg or a drop in diastolic BP of at least 10 mm Hg on standing.Those detected to have orthostatic hypotension are more likely to suffer from dementia and stroke.
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4. U-shaped association between blood pressure and stroke: A study suggested a U-shaped association between BP and the risk of stroke. Aggressive BP control (<110/65 mm Hg) and high BP (≥160/100 mm Hg) were both associated with an increased risk of stroke among patients with type 2 diabetes.
5. Higher risk of falls: Low BP can result in falls at any age; however, falls are more common among elderly.
6. Acute kidney injury: Sudden severe drop in blood pressure (due to dehydration, burns, severe infections, trauma, etc) can result in acute kidney injury.
7. Hepatic ischemia: Refers to lack of blood flow to the liver, which can happen due to low blood pressure. Hepatic ischemia can lead to injury to liver cells.
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