Low Blood Pressure (cont.)
How is low blood pressure treated?
Low blood pressure in healthy subjects without symptoms
or organ damage needs no treatment. However, all patients with symptoms possibly due to
low blood pressure should be evaluated by a doctor. (Patients who have had a
major drop in blood pressure from their usual levels even without the
development of symptoms also should be evaluated.) The doctor needs to identify
the cause of the low blood pressure because treatment will depend on the cause.
For example, if a medication is
causing the low blood pressure, the dose of medication may have to be reduced or
the medication stopped, though only after consulting the doctor. Self-adjustment
of medication should not be done.
- Dehydration is treated
with fluids and minerals (electrolytes). Mild dehydration without nausea and
vomiting can be treated with oral fluids and electrolytes. Moderate to severe
dehydration usually is treated in the hospital
or emergency room with intravenous fluids and electrolytes.
- Blood loss can be treated with intravenous fluids and
blood transfusions. Continuous and severe bleeding needs to be treated immediately.
- Septic shock is an emergency and is treated with intravenous fluids and antibiotics.
- Blood pressure medications or diuretics are adjusted, changed, or stopped by
the doctor if they are causing low blood pressure symptoms.
- Bradycardia may be due to
a medication. The doctor may reduce, change or stop
the medication. Bradycardia due to sick sinus syndrome or heart block is treated
with an implantable pacemaker.
- Tachycardia is treated
depending on the nature of the tachycardia. Atrial
fibrillation can be treated with oral medications, electrical
cardioversion, or
a catheterization procedure called
pulmonary vein
isolation. Ventricular tachycardia can be controlled with medications or with
an implantable defibrillator.
- Pulmonary embolism and deep vein thrombosis
is treated with blood thinners, intravenous initially with
heparin, and oral warfarin (Coumadin) later.
- Pericardial fluid can be removed by a procedure called pericardiocentesis.
- Postural hypotension can be treated by increasing water and salt intake*,
increasing intake of caffeinated beverages because
caffeine
constricts blood vessels, using compression stockings to compress the leg veins and reduce the pooling of blood in the leg veins, and in some patients, the use of a medication called
midodrine (ProAmatine). The problem with
ProAmatine is that while it increases blood pressure in the upright position, the supine blood pressure may become too high, thus increasing the risk of strokes. Mayo
Clinic researchers found that a medication used to treat muscle weakness in Myasthenia gravis called
pyridostigmine (Mestinon) increases upright blood pressure but not supine blood pressure. Mestinon, an anticholinesterase medication, works on the autonomic nervous system, especially when a person is standing up. Side effects include minor abdominal cramping or increased frequency of bowel movements.
*Note: Increasing salt intake can lead to heart failure in patients with existing heart disease and should not be undertaken without consulting a doctor.
- Postprandial hypotension refers to low blood pressure occurring after meals.
Ibuprofen
(Motrin) or
indomethacin (Indocin) may be beneficial.
- Low blood pressure, also called hypotension, is blood
pressure that is low enough that the flow of blood to the organs of the body
is inadequate and symptoms and/or signs of low blood flow develop.
- Low pressure alone, without symptoms or signs,
usually is not unhealthy.
- The symptoms of low blood pressure include lightheadedness, dizziness, and fainting. These symptoms are most prominent
when individuals go from the lying or sitting position to the standing
position (orthostatic hypotension).
- Low blood pressure that causes an inadequate flow of
blood to the body's organs can cause strokes, heart attacks, and kidney
failure. It's most severe form is shock.
- Common causes of low blood pressure include a reduced
volume of blood, heart disease, and medications.
- The cause of low blood pressure can be determined
with blood tests, radiologic studies, and cardiac testing to look for
arrhythmias.
- Treatment of low blood pressure is determined by the cause of the low
pressure.
References: Medlineplus, "Vital Signs." WebMD, "Alpha Blocker Medications for Prostatitis." Hilz MJ, Marthol H, Neundorfer B. "Syncope - a systematic overview of classification, pathogenesis, diagnosis and management," Fortschr Neurol Psychiatr. 2002 Feb;70(2):95-107. Park Nicollet Methodist Hospital, "Postural Hypotension." American Family Physician, "Off-Label Applications for SSRIs."
Last Editorial Review: 8/7/2008
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From the Doctors at MedicineNet.com  |
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- Complete Blood Count - A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures the concentration of white blood cells, red blood cells, and platelets in the blood. Source:MedicineNet
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- Electrolytes - Electrolytes in the body need to be maintained for bodily fluid function. Electrolytes are lost through bodily secretions such as sweat, diarrhea, vomiting. Source:MedicineNet
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