Low blood pressure causes serious problems

Low blood pressure (hypotension)

Low blood pressure - in short

From values ​​of about 100/60 mmHg and below, doctors speak of low blood pressure. Symptoms such as a high pulse, tiredness, dizziness, ringing in the ears, visual disturbances and even fainting can occur in connection with this. Usually home remedies and simple self-help measures are sufficient to get the symptoms under control. To be on the safe side, a doctor should first clarify whether the low blood pressure is due to an illness and which measures are suitable in the individual case.

Definition: Where Does Low Blood Pressure Start?

Low blood pressure (hypotension) is when blood pressure values ​​are below 100 to 60 mmHg. However, the boundary between normal and too low blood pressure is not as precisely defined as the upper limit in the direction of high blood pressure (hypertension).

Low blood pressure alone is not a disease. Only the appearance of complaints such as dizziness, star seeing or tiredness can turn it into a subjective problem. But while high blood pressure can lead to serious vascular and organ damage such as a stroke or heart attack, this is not the case with low blood pressure (hypotension). Only in Germany is hypotension a disease in its own right, which is why it is sometimes referred to as "German disease" internationally, the German disease.

Hypotension can also be an indication of an organ disease, such as a thyroid disorder or a weak heart muscle.

A relatively low filling volume of the arterial vessels is essential for the development of low blood pressure. This can be caused by a lack of fluids or blood loss, among other things. However, hypotension can also be caused by a reduced output of the heart (e.g. in the case of cardiac insufficiency) and a reduced return flow of blood to the heart (e.g. in the case of pulmonary artery embolism).

Symptoms

Symptoms that can occur with low blood pressure include:

  • Dizziness, especially in the morning and when getting up quickly
  • increased pulse
  • Faint
  • Fatigue, easy fatigue
  • tinnitus
  • cold hands and feet
  • Eye flicker
  • Difficulty concentrating
  • Loss of appetite
  • increased irritability
  • Weather sensitivity
  • Shortness of breath
  • depressive moods

Complications

During pregnancy, a slight drop in blood pressure is normal during the first six months; in the second trimester, the values ​​then slowly level off again. However, if the blood pressure drops too much in pregnant women, this can lead to an undersupply of the child, as the blood supply to the placenta is no longer sufficient. The maternity check-ups at the gynecologist or midwife always include a blood pressure measurement. In this context, pregnant women should also raise the issue if they experience symptoms of low blood pressure.

Older people with narrowing of the coronary arteries or arteries that lead to the brain are at risk of insufficient blood supply to vital organs such as the heart and brain if their blood pressure is too low.

In old age, standing and getting up are particularly problematic, and a sudden change in position of the body can cause symptoms. In healthy, younger people, standing for a long time or suddenly changing position is usually not a problem, the circulation reacts quickly enough. A slight dizziness or a clammy feeling in the legs can still be noticeable. However, if such a drop in blood pressure leads to fainting, it can lead to a fall, which, especially in older people, often leads to broken bones and other complications.

causes

Blood pressure can be divided into four different categories

1) Constitutional or constitutional hypotension

2) Hypotension in an acute shock situation

3) secondary hypotension, caused for example by illness or medication

4) orthostatic hypotension, i.e. difficulties in adjusting blood pressure regulation when changing body position, such as when moving from sitting or lying down to standing

1) Constitutional low blood pressure (constitutional hypotension)

A simple but well-functioning regulating system controls our blood pressure: In the vessel walls of most arteries, such as the carotid arteries and the abdominal aorta, there are so-called "strain sensors" or baroreceptors. The more the vascular wall is stretched, the more irritated you will be. A strong expansion of the vascular wall occurs due to high blood pressure, a slight expansion of the vascular wall due to low blood pressure.
The information from the baroreceptors reaches the brain stem (medulla oblongata) via nerve cords. From here commands from the "circulatory center" are issued to the heart and blood vessels in order to set the blood pressure back to the normal level (target value for blood pressure).

There is also another mechanism to adjust blood pressure. The hormone renin is produced in the kidneys. The body releases it when the blood pressure in the vessel that leads to the kidney falls. Renin, in turn, sets a control loop in motion which, among other things, leads to an increase in blood pressure because the vessels constrict and less water and table salt is excreted in the urine.

Normal blood pressure is therefore based on a regulation in which various mechanisms play a role. Here it may well be the case that the regulation is sometimes a little higher and sometimes a little lower due to the condition. This "setpoint adjustment" of the organism is then noticeable in a slightly higher or lower blood pressure due to the condition.

2) Hypotension in an acute shock situation

In the event of a circulatory collapse or shock, the amount of circulating blood decreases, for example due to severe blood loss. As a result, those blood vessels that have to supply less important organs and parts of the body automatically narrow. The blood flow to the skin, muscles, gastrointestinal tract and kidneys is reduced in order to maintain the blood supply to the cerebral and coronary arteries for as long as possible. This process is called "centralization". The heart rate increases. If these body's own regulatory mechanisms are insufficient, the blood pressure drops.

In addition to externally visible bleeding, the cause can also be internal bleeding - for example from a stomach ulcer. Excessive fluid loss, such as prolonged vomiting, severe diarrhea, or excessive urination due to poorly controlled diabetes, can also cause blood volume to drop and hypotension to occur.

3) Secondary hypotension

Low blood pressure can also occur as a result of illness or medication. Doctors then speak of secondary hypotension. Some possible causes:

If the heart muscle weakens, for example after a major heart attack, after heart muscle diseases or after longstanding high blood pressure, the heart is no longer able to pump the blood with the necessary force into the circulation. Even with a narrowing of the aortic valve (aortic stenosis), the blood pressure drops if the heart muscle is no longer able to drive sufficient blood through the too narrow valve into the circulation.

The aorta is the main artery. The two collarbone arteries that supply the arms branch off from it. In the aortic arch syndrome, the heart pushes the blood into the aorta with great force. Since the arteries are narrowed directly at a branch into the clavicular vessels, the blood pressure in the aorta and leg vessels is high, but blood pressure is too low, especially in the arms and the brain. This manifests itself in cold hands and dizziness. This type of low blood pressure can have extremely low blood pressure in the arms, for example 85/70 mmHg, while it is normal in the legs. Since blood pressure is usually measured on the arms, aortic arch syndrome can falsely simulate low blood pressure.

If the veins are weak, the vein walls may bulge, also known as varicose veins. The blood "sinks" into these too wide veins. This can lead to a drop in blood pressure, especially when standing. If there is not enough blood available to the entire circulatory system, it may also cause temporary circulatory problems in the brain and lead to collapse.

Thyroid and adrenal disorders can cause hormonal imbalances that also affect blood pressure. The hormones of the thyroid gland influence various processes in the body, including the heartbeat and blood pressure. The hormones of the adrenal glands regulate the salt balance and thus also have an influence on the fluid balance and blood pressure. An underactive thyroid or a disorder of the adrenal glands can always be responsible for low blood pressure.

  • Drug side effects

A sharp drop in blood pressure can also be due to the side effects of medication. This is often found with diuretics, as well as with various antihypertensive agents, especially at the beginning of treatment. Some psychotropic drugs also reduce blood pressure: This applies, for example, to tricyclic and tetracyclic antidepressants as well as to nerve suppressants (antipsychotics) from the phenothiazine series.

  • Neurological diseases

Nerve disorders, such as diabetic neuropathy, can lead to low blood pressure, as can some disorders of the spinal cord or brain.

4) Orthostatic hypotension