Home Diseases Low blood pressure: limits, symptoms, causes

Low blood pressure: limits, symptoms, causes

by Josephine Andrews
Published: Last Updated on 329 views

Low blood pressure (arterial hypotension) is common, especially in young, slim women. Low blood pressure is defined as blood pressure values ​​below 100/110 to 60 mmHg. Those affected usually suffer from dizziness, tiredness or tachycardia. Read more about the topic here: How does low blood pressure occur? What to do about it? Why is low blood pressure dangerous during pregnancy?

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

I95

quick overview

  • Symptoms: sometimes none, but often complaints such as palpitations, dizziness, headaches, tiredness, shortness of breath
  • Causes: Low blood pressure is partly hereditary. However, it can also be caused by environmental influences, diseases or medication as well as certain postures or (quick) changes in position.
  • Diagnostics: repeated blood pressure measurements, certain circulatory tests, if necessary further examinations (such as ultrasound and blood tests). Limits: 110 to 60 mmHg in men, 100 to 60 mmHg in women
  • Treatment: home remedies and general measures such as alternating showers, exercise, sufficiently salted food, drinking a lot; if all else fails: medication
  • Prognosis: usually not dangerous, only in certain cases close observation necessary.

Low Blood Pressure: Table of Limits

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 inside them is depends on the elasticity and resistance of the vessel walls. On the other hand, blood pressure is influenced by the heart’s beating power – ie by how much blood volume is transported into the circulatory system per heartbeat. Heart rate also plays a role.

Low blood pressure is actually just a symptom and not a disease, although it is often regarded as such in Germany. That is why low blood pressure in (English-speaking) countries is often mockingly referred to as “German disease”.

Blood pressure is measured in millimeters of mercury (mmHg). The upper (systolic) value describes the blood pressure at the moment when the heart muscle contracts and ejects blood. The bottom (diastolic) value refers to the relaxation (slackening) phase of the heart as it refills with blood.

Low blood pressure: values

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

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

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

Low blood pressure is rarely a threat. Low blood pressure can only become dangerous if the values ​​drop too much – there is a risk of fainting. Occasionally, arterial hypotension is indicative of potentially serious organ disease.

Low blood pressure: symptoms

Low blood pressure does not always cause symptoms. Symptoms such as dizziness, tachycardia and circulatory problems, headaches or tiredness can occur, especially if there is a rapid attack of blood pressure. Often affected are (inactive) pubescents, young slim women, pregnant women and gaunt older people. In principle, if low blood pressure causes symptoms such as the following and these occur frequently or very suddenly, you should have the cause clarified by your doctor:

Palpitations: When the blood pressure is low, it is often accompanied by a rapid heartbeat (pulse). This is because the body tries to counteract the reduced blood flow – and it does so by making the heart beat faster via activation of the sympathetic nervous system.

Dizziness: Low blood pressure also means a lack of blood supply to the brain. This causes visual disturbances such as the famous “seeing asterisks” or “blacking out”, ringing in the ears and dizziness. In the worst case, those affected will faint. These symptoms often become noticeable when those affected change position, for example stand up (quickly) or bend down. The blood pools 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 they occur while driving.

Headaches: Low blood pressure is often accompanied by a (stabbing, throbbing) headache. The reason: the blood flow in the head is reduced. Then it can help to drink something and thereby increase the circulating blood volume. A walk is also good because the fresh air improves the oxygen supply in the brain and stimulates the circulation.

Fatigue: Exhaustion, concentration problems, drowsiness, tiredness – low blood pressure makes you tired. Patients need longer to get going in the morning and generally feel listless. In addition, they are often shaky or sweat more due to the reduced blood flow.

Shortness of breath: Tightness in the chest or stitches in the area around the heart can also be signs of low blood pressure. Some sufferers have difficulty breathing, and their skin may feel cool and pale. This is because in arterial hypotension, the blood vessels are constricted to direct blood volume to vital organs such as the heart or brain.

Ringing in the ears , loss of appetite , irritability , weather sensitivity and depressive moods can also indicate low blood pressure.

Low blood pressure: causes and risk factors

The body itself has its own system that regulates blood pressure – small pressure gauges in the carotid arteries that can feel the blood pressure in the vessel. They transmit signals to the circulatory center in the brainstem. In the case of high blood pressure, this gives the command to dilate the blood vessels and in the case of low blood pressure, it gives the command to constrict the blood vessels. The kidneys also become active when the blood pressure in the supplying vessel falls too far: they then release the hormone renin . It triggers an increase in blood pressure via intermediate steps.

The mechanisms of blood pressure regulation may not function adequately or be disrupted for a variety of reasons. This results in low blood pressure. Doctors distinguish between 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. It occurs for no apparent reason. However, the tendency to do so may well be inherited. Because young, slim people (especially women) often have congenital low blood pressure, this is also referred to as constitutional hypotension (constitution = physique, general physical condition).

Secondary hypotension

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

  • Underactive thyroid (hypothyroidism)
  • Underactive adrenal cortex (Addison’s disease)
  • Hypofunction of the pituitary gland (anterior pituitary insufficiency)
  • Heart disease (heart failure, cardiac arrhythmias, pericarditis )
  • Salt deficiency (hyponatraemia)
  • Vein weakness (varicose veins)

Dehydration (when it is very hot, due to heavy sweating, severe diarrhea and vomiting, etc.) can also lower blood pressure: the large loss of fluid reduces the amount of circulating blood, causing the pressure in the vessels to decrease.

Blood pressure can also fall excessively as a side effect of some medications. Such drug-induced hypotension can be triggered by:

  • Psychotropic drugs (medicines for depression, anxiety, insomnia)
  • Antiarrhythmic drugs (medicines against cardiac arrhythmias)
  • Antihypertensives (medicines for high blood pressure)
  • Diuretics (water tablets)
  • Coronary drugs (for angina pectoris : nitro sprays)
  • vasodilators

Orthostatic hypotension

Orthostasis is the upright posture. Likewise, orthostatic low blood pressure occurs when you get up quickly from a lying position and the blood pools in your legs. This results in a volume shift to which the body cannot react sufficiently (quickly). Orthostatic hypotension is therefore also called orthostatic dysregulation .

Possible causes of orthostatic hypotension include:

  • secondary low blood pressure
  • Disorder of the autonomic nervous system (eg due to diabetes mellitus)
  • Damage to nerve cells in the brain (eg from Parkinson ‘s disease, alcohol abuse)
  • Varicose veins
  • Condition after deep vein thrombosis (postthrombotic syndrome)

Doctors distinguish two forms of orthostatic hypotension:

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

Low blood pressure in pregnancy

Low blood pressure is normal in the first six months of pregnancy. However, sometimes it remains too low even in late pregnancy. The reason for this can 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 child’s pressure on the large vena cava thus impairs the return flow of blood to the heart. As a result, the blood supply to the brain and other body regions is also reduced – resulting in low blood pressure.

Low blood pressure: investigations and diagnosis

In order to be able to diagnose “low blood pressure”, the doctor must measure the blood pressure repeatedly. It is usually important that the measurements are carried out on different days and at different times.

The tilt table study’s particularly performed on patients who have already failed as a result of circulatory problems. During the test, the patient is tied to a tilting table with two straps. Heart rate and blood pressure are monitored. After lying down for ten minutes, the tilting table is quickly raised to a tilting angle of 60 to 80 degrees. So getting up quickly from a lying position is simulated to see whether this causes a drop in blood pressure and heart rate and whether the patient faints. If this is the case, one speaks of so-called vasovagal syncope (fainting due to an excessive reaction of the vagus nerve, which is part of the autonomic nervous system).

On the other hand, low blood pressure as a result of poor orthostatic regulation (orthostatic hypotension) can be measured using the Shellong test . In this cardiovascular test, the patient must first lie down for ten minutes and then quickly get up and stand still for ten minutes. In orthostatic hypotension, the rapid change in position causes a drop in blood pressure and possibly other symptoms (such as dizziness).

If the doctor suspects that low blood pressure is caused by a specific underlying disease ( secondary hypotension ), further examinations can bring clarity. For example, to clarify hypothyroidism, the thyroid levels in the blood are measured and the thyroid is examined using ultrasound.An electrocardiography (ECG ) can provide indications of a heart disease (such as arrhythmias) .

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 usually relieve the symptoms noticeably. Drug therapy is only necessary if low blood pressure causes serious symptoms or a health hazard.

Low blood pressure: home remedies

So what can you do specifically if you have low blood pressure? First of all move. Physical activity gets the circulation going and reduces symptoms such as dizziness and fatigue. Especially endurance sports such as jogging , swimming suitable for this.

By the way, exercise starts even before you get up: It often helps to alternately stretch and bend your feet while lying in bed to stimulate blood flow, or to cycle with your feet in the air. Only then slowly get up – if necessary with a break to sit on the edge of the bed .

Fluctuations in blood pressure when you get up in the morning can often be prevented by sleeping with your upper body elevated at night (tilt the head section to about 20 degrees).

Another home remedy for low blood pressure is compression/support stockings . They can stimulate blood circulation in the legs.

Shower instead of full bathis also a good tip for people with low blood pressure. If you don’t want to do without a full bath, you should make sure that the bath water is not too warm and that you only get out of the tub very slowly at the end. The heat causes the vessels to dilate, which is why the blood can easily sink into the legs when you stand up.

Contrast showers are very useful if you have low blood pressure: The rapid change between warm and cold water causes the blood vessels to alternately widen and contract again. This trains the vessel walls and stimulates the circulation.

If you don’t want to have your whole body sprinkled with cold water, you can at least take a cold shower on the lower half of your body – from your feet up to your buttocks. A circulation-enhancing brush or a massage sponge increase the stimulating effect.

Speaking of the stimulating effect: a cup of coffee in the morning also has that effect. Green or black tea also has a stimulating effect on the circulation. In general, you should drink a lot if your blood pressure is too low (water, herbal or fruit tea, etc.). This increases blood volume and thus blood pressure.

Table salt also increases blood volume and blood pressure by binding fluid in the body. People with low blood pressure should therefore add enough salt to their food (maximum five grams per day). Several small meals a day are also advisable instead of fewer large ones.

If you have low blood pressure, you should also limit your alcohol consumption . Alcohol expands the blood vessels and thus lowers blood pressure, at least in the short term.

Saponins are also said to have a positive effect on low blood pressure . These plant compounds are found in liquorice, oats and legumes, for example. They can increase cortisol production in the body, thereby raising blood pressure.

Some medicinal plants can also stimulate the circulatory system. These include, for example, ginseng, hawthorn and rosemary . A tea can be prepared from some medicinal plants, while others are available as herbal preparations. Ask your doctor or pharmacist for advice on this.

Home remedies and medicinal plants have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

Low blood pressure: medication

If home remedies and general measures (exercise, etc.) do not sufficiently alleviate the symptoms of low blood pressure, you should speak to your doctor about medication. However, he will only prescribe such medication for you if it is absolutely necessary. Because all active ingredients used can also have side effects.

The following active substances are available for the treatment of low blood pressure:

  • Sympathomimetics : These drugs (e.g. etilefrine, caffeine) constrict blood vessels and increase heart rate, which increases blood pressure. Possible side effects: cardiac arrhythmias.
  • Fludrocortisone : This drug increases blood pressure by increasing the amount of fluid in the blood vessels. Possible side effects: Fluid retention in the tissue (edema), weight gain and potassium deficiency .

In the past, so-called dihydroergotamines were also given for low blood pressure. However, since 2014 they may no longer be prescribed for orthostatic hypotension due to pronounced side effects.

Low blood pressure: course and prognosis

Generally, low blood pressure is harmless and will not cause permanent damage. In severe cases, however, it can lead to severe dizziness and fainting.

Low blood pressure during pregnancy can also be dangerous: it can happen that the uterus does not receive enough blood. Then the care of the unborn child is no longer guaranteed. Such a permanent undersupply of the child can lead to developmental disorders and increase the risk of complications at birth . Therefore, low blood pressure during pregnancy should be carefully monitored and monitored by a doctor.

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