http://www.mayoclinic.

org/diseases-conditions/low-blood-pressure/basics/definition/con20032298

Low blood pressure (hypotension)

Definition
Low blood pressure (hypotension) would seem to be something to strive for.
However, for many people, low blood pressure can cause symptoms of
dizziness and fainting. In severe cases, low blood pressure can be lifethreatening.
Although blood pressure varies from person to person, a blood pressure
reading of 90 millimeters of mercury (mm Hg) or less systolic blood pressure
(the top number in a blood pressure reading) or 60 mm Hg or less diastolic
blood pressure (the bottom number) is generally considered low blood
pressure.
The causes of low blood pressure can range from dehydration to serious
medical or surgical disorders. Low blood pressure is treatable, but its
important to find out whats causing your condition so that it can be properly
treated.

Symptoms
For some people, low blood pressure can signal an underlying problem,
especially when it drops suddenly or is accompanied by signs and symptoms
such as:

Dizziness or lightheadedness

Fainting (syncope)

Lack of concentration

Blurred vision

Nausea

Cold, clammy, pale skin

Rapid, shallow breathing

Fatigue

Depression

Thirst

When to see a doctor

In many instances, low blood pressure isnt serious. If you have consistently
low readings but feel fine, your doctor is likely to monitor you during routine
exams.
Even occasional dizziness or lightheadedness may be a relatively minor
problem the result of mild dehydration from too much time in the sun or a
hot tub, for example. In these situations, its not a matter so much of how far,
but of how quickly, your blood pressure drops.
Still, its important to see your doctor if you experience any signs or symptoms
of hypotension because they sometimes can point to more-serious problems.
It can be helpful to keep a record of your symptoms, when they occur and
what you were doing at the time.

Causes
Blood pressure is a measurement of the pressure in your arteries during the
active and resting phases of each heartbeat. Heres what the numbers mean:

Systolic pressure. The first (top) number in a blood pressure reading,

this is the amount of pressure your heart generates when pumping blood
through your arteries to the rest of your body.

Diastolic pressure. The second (bottom) number in a blood pressure

reading, this refers to the amount of pressure in your arteries when your
heart is at rest between beats.

Current guidelines identify normal blood pressure as lower than 120/80 mm

Hg.
Although you can get an accurate blood pressure reading at any given time,
blood pressure isnt always the same. It can vary considerably in a short
amount of time sometimes from one heartbeat to the next, depending on
body position, breathing rhythm, stress level, physical condition, medications
you take, what you eat and drink, and even time of day. Blood pressure is
usually lowest at night and rises sharply on waking.

Blood pressure: How low can you go?

Whats considered low blood pressure for you may be normal for someone
else. Most doctors consider chronically low blood pressure too low only if it
causes noticeable symptoms.
Some experts define low blood pressure as readings lower than 90 mm Hg
systolic or 60 mm Hg diastolic you need to have only one number in the low
range for your blood pressure to be considered lower than normal. In other
words, if your systolic pressure is a perfect 115, but your diastolic pressure is
50, youre considered to have lower than normal pressure.

A sudden fall in blood pressure also can be dangerous. A change of just 20

mm Hg a drop from 110 systolic to 90 mm Hg systolic, for example can
cause dizziness and fainting when the brain fails to receive an adequate
supply of blood.
And big plunges, especially those caused by uncontrolled bleeding, severe
infections or allergic reactions, can be life-threatening.
Athletes and people who exercise regularly tend to have lower blood pressure
and a slower heart rate than do people who arent as fit. So, in general, do
nonsmokers and people who eat a healthy diet and maintain a normal weight.
But in some rare instances, low blood pressure can be a sign of serious, even
life-threatening disorders.

Conditions that can cause low blood pressure

Some medical conditions can cause low blood pressure. These include:

Pregnancy. Because a womans circulatory system expands rapidly

during pregnancy, blood pressure is likely to drop. This is normal, and
blood pressure usually returns to your pre-pregnancy level after youve
given birth.

Heart problems. Some heart conditions that can lead to low blood
pressure include extremely low heart rate (bradycardia), heart valve
problems, heart attack and heart failure.
These conditions may cause low blood pressure because they prevent
your body from being able to circulate enough blood.

Endocrine problems. Thyroid conditions such as parathyroid

disease adrenal insufficiency (Addisons disease), low blood sugar
(hypoglycemia) and, in some cases, diabetes can trigger low blood
pressure.

Dehydration. When you become dehydrated, your body loses more

water than it takes in. Even mild dehydration can cause weakness,
dizziness and fatigue. Fever, vomiting, severe diarrhea, overuse of
diuretics and strenuous exercise can all lead to dehydration.
Far more serious is hypovolemic shock, a life-threatening complication of
dehydration. It occurs when low blood volume causes a sudden drop in
blood pressure and a reduction in the amount of oxygen reaching your
tissues. If untreated, severe hypovolemic shock can cause death within a
few minutes or hours.

Blood loss. Losing a lot of blood from a major injury or internal bleeding
reduces the amount of blood in your body, leading to a severe drop in
blood pressure.

Severe infection (septicemia). Septicemia can happen when an

infection in the body enters the bloodstream. This condition can lead to a
life-threatening drop in blood pressure called septic shock.

Severe allergic reaction (anaphylaxis). Anaphylaxis is a severe and

potentially life-threatening allergic reaction. Common triggers of
anaphylaxis include foods, certain medications, insect venoms and latex.
Anaphylaxis can cause breathing problems, hives, itching, a swollen throat
and a drop in blood pressure.

Lack of nutrients in your diet. A lack of the vitamins B-12 and folate
can cause a condition in which your body doesnt produce enough red
blood cells (anemia), causing low blood pressure.

Medications that can cause low blood pressure

Some medications you may take can also cause low blood pressure,
including:

Diuretics (water pills), such as furosemide (Lasix) and

hydrochlorothiazide (Microzide, Oretic)

Alpha blockers, such as prazosin (Minipress) and labetalol

Beta blockers, such as atenolol (Tenormin), propranolol (Inderal,

Innopran XL, others) and timolol

Drugs for Parkinsons disease, such as pramipexole (Mirapex) or those

containing levodopa

Certain types of antidepressants (tricyclic antidepressants), including

doxepin (Silenor), imipramine (Tofranil), protriptyline (Vivactil) and
trimipramine (Surmontil)

Sildenafil (Viagra) or tadalafil (Cialis), particularly in combination with

the heart medication nitroglycerin

Types of low blood pressure

Doctors often break down low blood pressure (hypotension) into different
categories, depending on the causes and other factors. Some types of low
blood pressure include:

Low blood pressure on standing up (orthostatic, or postural,

hypotension). This is a sudden drop in blood pressure when you stand up
from a sitting position or if you stand up after lying down.
Ordinarily, gravity causes blood to pool in your legs whenever you stand.
Your body compensates for this by increasing your heart rate and
constricting blood vessels, thereby ensuring that enough blood returns to
your brain.
But in people with orthostatic hypotension, this compensating mechanism
fails and blood pressure falls, leading to symptoms of dizziness,
lightheadedness, blurred vision and even fainting.
Orthostatic hypotension can occur for a variety of reasons, including
dehydration, prolonged bed rest, pregnancy, diabetes, heart problems,

burns, excessive heat, large varicose veins and certain neurological

disorders.
A number of medications also can cause orthostatic hypotension,
particularly drugs used to treat high blood pressure diuretics, beta
blockers, calcium channel blockers and angiotensin-converting enzyme
(ACE) inhibitors as well as antidepressants and drugs used to treat
Parkinsons disease and erectile dysfunction.
Orthostatic hypotension is especially common in older adults, with as many
as 20 percent of those older than age 65 experiencing orthostatic
hypotension.
But orthostatic hypotension can also affect young, otherwise healthy
people who stand up suddenly after sitting with their legs crossed for long
periods or after working for a time in a squatting position.

Low blood pressure after eating (postprandial

hypotension). Postprandial hypotension is a sudden drop in blood
pressure after eating. It affects mostly older adults.
Just as gravity pulls blood to your feet when you stand, a large amount of
blood flows to your digestive tract after you eat.
Ordinarily, your body counteracts this by increasing your heart rate and
constricting certain blood vessels to help maintain normal blood pressure.
But in some people these mechanisms fail, leading to dizziness, faintness
and falls.
Postprandial hypotension is more likely to affect people with high blood
pressure or autonomic nervous system disorders such as Parkinsons
disease.
Lowering the dose of blood pressure drugs and eating small, lowcarbohydrate meals may help reduce symptoms.

Low blood pressure from faulty brain signals (+ludrocor mediated

hypotension). This disorder causes blood pressure to drop after standing
for long periods, leading to signs and symptoms such as dizziness, nausea
and fainting.
Neurally mediated hypotension mostly affects young people, and it seems
to occur because of a miscommunication between the heart and the brain.
When you stand for extended periods, your blood pressure falls as blood
pools in your legs. Normally, your body then makes adjustments to
normalize your blood pressure.
But in people with Eludrocor mediated hypotension, nerves in the hearts
left ventricle actually signal the brain that blood pressure is too high, rather
than too low.
As a result, the brain lessens the heart rate, decreasing blood pressure
even further. This causes more blood to pool in the legs and less blood to
reach the brain, leading to lightheadedness and fainting.

Low blood pressure due to nervous system damage (multiple

system atrophy with orthostatic hypotension).Also called Shy-Drager
syndrome, this rare disorder causes progressive damage to the autonomic
nervous system, which controls involuntary functions such as blood
pressure, heart rate, breathing and digestion.
Although this condition can be associated with muscle tremors, slowed
movement, problems with coordination and speech, and incontinence, its
main characteristic is severe orthostatic hypotension in combination with
very high blood pressure when lying down.

Risk factors
Low blood pressure (hypotension) can occur in anyone, though certain types
of low blood pressure are more common depending on your age or other
factors:

Age. Drops in blood pressure on standing or after eating occur primarily

in adults older than 65. Orthostatic, or postural, hypotension happens after
standing up, while postprandial hypotension happens after eating a meal.
Neurally mediated hypotension happens as a result of a miscommunication
between the brain and heart. It primarily affects children and younger
adults.

Medications. People who take certain medications, such as high blood

pressure medications like alpha blockers, have a greater risk of low blood
pressure.

Certain diseases. Parkinsons disease, diabetes and some heart

conditions put you at a greater risk of developing low blood pressure.

Complications
Even moderate forms of low blood pressure can cause not only dizziness and
weakness but also fainting and a risk of injury from falls.
And severely low blood pressure from any cause can deprive your body of
enough oxygen to carry out its normal functions, leading to damage to your
heart and brain.

Preparing for your appointment

No special preparations are necessary to have your blood pressure checked.
You might want to wear a short-sleeved shirt to your appointment so that the
blood pressure cuff can fit around your arm properly.

Dont stop taking any prescription medications that you think may affect your
blood pressure without your doctors advice.
Because appointments can be brief, and because theres often a lot to
discuss, its a good idea to be prepared for your appointment. Heres some
information to help you get ready for your appointment, and what to expect
from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make

the appointment, be sure to ask if theres anything you need to do in
advance, such as restrict your diet for a blood test.

Write down any symptoms youre experiencing, including any that

may seem unrelated to low blood pressure.

Write down key personal information, including a family history of low

blood pressure and any major stresses or recent life changes.

Make a list of all medications, vitamins or supplements that youre

taking.

Take a family member or friend along, if possible. Sometimes it can

be difficult to remember all the information provided to you during an
appointment. Someone who accompanies you may remember something
that you missed or forgot.

Be prepared to discuss your diet and exercise habits. If you dont

already follow a diet or exercise routine, be ready to talk to your doctor
about any challenges you might face in getting started.

Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help
you make the most of your time together. List your questions from most
important to least important in case time runs out. For low blood pressure,
some basic questions to ask your doctor include:

What is likely causing my symptoms or condition?

What are other possible causes for my symptoms or condition?

What kinds of tests will I need?

Whats the most appropriate treatment?

What foods should I eat or avoid?

Whats an appropriate level of physical activity for me?

How often should I be screened for low blood pressure?

I have other health conditions. How can I best manage them together?

Are there any restrictions that I need to follow?

Should I see a specialist?

Is there a generic alternative to the medicine youre prescribing for me?

Are there any brochures or other printed material that I can take home
with me? What websites do you recommend visiting?

In addition to the questions that youve prepared to ask your doctor, dont
hesitate to ask any other questions you may think of during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer
them may reserve time to go over any points you want to spend more time on.
Your doctor may ask:

When did you begin experiencing symptoms?

Have your symptoms been continuous or occasional?

How severe are your symptoms?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

Have you been diagnosed with any other health conditions?

What medications are you currently taking?

What is your typical daily diet?

How much exercise do you get in an average week?

Do you have a family history of heart disease?

Tests and diagnosis

Tilt table test

The goal in testing for low blood pressure is to find the underlying cause. This
helps determine the correct treatment and identify any heart, brain or nervous
system problems that may cause lower than normal readings. To reach a
diagnosis, your doctor may recommend one or more of the following tests:

Blood pressure test. Blood pressure is measured with an inflatable

arm cuff and a pressure-measuring gauge.
A blood pressure reading, given in millimeters of mercury (mm Hg), has
two numbers. The first, or upper, number measures the pressure in your
arteries when your heart beats (systolic pressure). The second, or lower,
number measures the pressure in your arteries between beats (diastolic
pressure).

Blood tests. These can provide information about your overall health as
well as whether you have low blood sugar (hypoglycemia), high blood
sugar (hyperglycemia or diabetes) or a low number of red blood cells
(anemia), all of which can cause lower than normal blood pressure.

Electrocardiogram (ECG). During this painless, noninvasive test, soft,

sticky patches (electrodes) are attached to the skin of your chest, arms and
legs. The patches detect your hearts electrical signals while a machine
records them on graph paper or displays them on a screen.
An ECG, which can be performed in your doctors office, detects
irregularities in your heart rhythm, structural abnormalities in your heart,
and problems with the supply of blood and oxygen to your heart muscle. It
can also tell if youre having a heart attack or if youve had a heart attack in
the past.
Sometimes, heart rhythm abnormalities come and go, and an ECG wont
find any problems. If this happens, you may be asked to wear a 24-hour
Holter monitor to record your hearts electrical activity as you go about your
daily routine.

Echocardiogram. This noninvasive exam, which includes an ultrasound

of your chest, shows detailed images of your hearts structure and function.
Ultrasound waves are transmitted, and their echoes are recorded with a
device called a transducer, which is held outside your body. A computer
uses the information from the transducer to create moving images on a
video monitor.

Stress test. Some heart problems that can cause low blood pressure
are easier to diagnose when your heart is working harder than when its at
rest. During a stress test, youll exercise, such as walking on a treadmill.
You may be given medication to make your heart work harder if youre
unable to exercise.
When your heart is working harder, your heart will be monitored with
electrocardiography or echocardiography. Your blood pressure also may be
monitored.

Valsalva maneuver. This noninvasive test checks the functioning of

your autonomic nervous system by analyzing your heart rate and blood
pressure after several cycles of a type of deep breathing: You take a deep
breath and then force the air out through your lips, as if you were trying to
blow up a stiff balloon.

Tilt table test. If you have low blood pressure on standing, or from faulty
brain signals (Eludrocor mediated hypotension), your doctor may suggest a
tilt table test, which evaluates how your body reacts to changes in position.
During the test, you lie on a table thats tilted to raise the upper part of your
body, which simulates the movement from horizontal to a standing position.

Treatments and drugs

Compression stockings

Low blood pressure that either doesnt cause signs or symptoms or causes
only mild symptoms, such as brief episodes of dizziness when standing, rarely
requires treatment.
If you have symptoms, the most appropriate treatment depends on the
underlying cause, and doctors usually try to address the primary health
problem dehydration, heart failure, diabetes or hypothyroidism, for example
rather than the low blood pressure itself.
When low blood pressure is caused by medications, treatment usually
involves changing the dose of the medication or stopping it entirely.
If its not clear whats causing low blood pressure or no effective treatment
exists, the goal is to raise your blood pressure and reduce signs and
symptoms. Depending on your age, health status and the type of low blood
pressure you have, you can do this in several ways:

Use more salt. Experts usually recommend limiting the amount of salt
in your diet because sodium can raise blood pressure, sometimes
dramatically. For people with low blood pressure, that can be a good thing.
But because excess sodium can lead to heart failure, especially in older
adults, its important to check with your doctor before increasing the salt in
your diet.

Drink more water. Although nearly everyone can benefit from drinking
enough water, this is especially true if you have low blood pressure.
Fluids increase blood volume and help prevent dehydration, both of which
are important in treating hypotension.

Wear compression stockings. The same elastic stockings commonly

used to relieve the pain and swelling of varicose veins may help reduce the
pooling of blood in your legs.

Medications. Several medications, either used alone or together, can

be used to treat low blood pressure that occurs when you stand up
(orthostatic hypotension).
For example, the drug Eludrocortisones is often used to treat this form of
low blood pressure. This drug helps boost your blood volume, which raises
blood pressure.
Doctors often use the drug midodrine (Orvaten) to raise standing blood
pressure levels in people with chronic orthostatic hypotension. It works by
restricting the ability of your blood vessels to expand, which raises blood
pressure.

Lifestyle and home remedies

Depending on the reason for your low blood pressure, you may be able to take
certain steps to help reduce or even prevent symptoms. Some suggestions
include:

Drink more water, less alcohol. Alcohol is dehydrating and can lower
blood pressure, even if you drink in moderation. Water, on the other hand,
combats dehydration and increases blood volume.

Follow a healthy diet. Get all the nutrients you need for good health by
focusing on a variety of foods, including whole grains, fruits, vegetables,
and lean chicken and fish.
If your doctor suggests using more salt but you dont like a lot of salt on
your food, try using natural soy sauce or adding dry soup mixes to dips
and dressings.

Go slowly when changing body positions. You may be able to

reduce the dizziness and lightheadedness that occur with low blood
pressure on standing by taking it easy when you move from a prone to a
standing position.
Before getting out of bed in the morning, breathe deeply for a few minutes
and then slowly sit up before standing. Sleeping with the head of your bed
slightly elevated also can help fight the effects of gravity.
If you begin to get symptoms while standing, cross your thighs in a
scissors fashion and squeeze, or put one foot on a ledge or chair and lean
as far forward as possible. These maneuvers encourage blood to flow from
your legs to your heart.

Eat small, low-carb meals. To help prevent blood pressure from

dropping sharply after meals, eat small portions several times a day and
limit high-carbohydrate foods such as potatoes, rice, pasta and bread.
Your doctor also may recommend drinking caffeinated coffee or tea with
meals to temporarily raise blood pressure. But because caffeine can cause
other problems, check with your doctor before drinking more caffeinated
beverages.
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http://www.webmd.com/heart/understanding-low-blood-pressure-basics

What Is Low Blood Pressure?

Hypotension is the medical term for low blood pressure (less than 90/60).
A blood pressure reading appears as two numbers. The first and higher of the
two is a measure of systolic pressure, or the pressure in thearteries when
the heart beats and fills them with blood. The second number measures
diastolic pressure, or the pressure in the arteries when the heart rests
between beats.
Optimal blood pressure is less than 120/80 (systolic/diastolic). In healthy
people, low blood pressure without any symptoms is not usually a concern
and does not need to be treated. But low blood pressure can be a sign of an
underlying problem -- especially in the elderly -- where it may cause
inadequate blood flow to the heart, brain, and other vital organs.

Chronic low blood pressure with no symptoms is almost never serious. But
health problems can occur when blood pressure drops suddenly and
the brain is deprived of an adequate blood supply. This can lead todizziness or
lightheadedness. Sudden drops in blood pressure most commonly occur in

someone who's rising from a lying down or sitting position to standing. This
kind of low blood pressure is known aspostural hypotension or orthostatic
hypotension. Another type of low blood pressure can occur when someone
stands for a long period of time. This is called neurally mediated hypotension.
Postural hypotension is considered a failure of the cardiovascular system
or nervous system to react appropriately to sudden changes. Normally, when
you stand up, some blood pools in your lower extremities. Uncorrected, this
would cause your blood pressure to fall. But your body normally compensates
by sending messages to your heart to beat faster and to your blood vessels to
constrict. This offsets the drop in blood pressure. If this does not happen, or
happens too slowly, postural hypotension results.
The risk of both low and high blood pressure normally increases with age due
in part to normal changes during aging. In addition, blood flow to the heart
muscle and the brain declines with age, often as a result of plaque buildup in
blood vessels. An estimated 10% to 20% of people over age 65 have postural
hypotension.

What Causes Low Blood Pressure?

The cause of low blood pressure isn't always clear. It may be associated with
the following:

Pregnancy
Hormonal problems such as an

underactive thyroid(hypothyroidism), diabetes, or low blood

sugar (hypoglycemia)

Some over-the-counter medications

Some prescription medicines such as for high blood

pressure,depression or Parkinsons disease

Heart failure

Heart arrhythmias (abnormal heart rhythms)

Widening, or dilation, of the blood vessels

Heat exhaustion or heat stroke
Liver disease
What Causes a Sudden Drop in Blood Pressure?
Sudden drops in blood pressure can be life-threatening. Causes of this type of
hypotension include:

Loss of blood from bleeding

Low body temperature
High body temperature
Heart muscle disease causing heart failure
Sepsis, a severe blood infection
Severe dehydration from vomiting, diarrhea, or fever
A reaction to medication or alcohol
A severe allergic reaction, called anaphylaxis
Who Gets Postural Hypotension?
Postural hypotension, which is low blood pressure when standing up
suddenly, can happen to anyone for a variety of reasons, such asdehydration,
lack of food, or being overly fatigued. It can also be influenced by genetic
make-up, aging, medication, dietary and psychological factors, and acute
triggers, such as infection and allergy.
Postural hypotension occurs most frequently in people who are taking drugs
to control high blood pressure (hypertension). It can also be related to
pregnancy, strong emotions, hardening of the arteries (atherosclerosis),
or diabetes. The elderly are particularly affected, especially those who
have high blood pressure or autonomic nervous system dysfunction.
Hypotension after meals is a common cause of dizziness and falls after
eating. This is most common after large meals containing a lot of

carbohydrates. Its believed to be caused by blood pooling into the vessels of

the stomach and intestines.
Several drugs are commonly associated with postural hypotension. These
medications can be divided into two major categories:

Drugs used to treat high blood pressure, such as diuretics, beta-

blockers, calcium-channel blockers, and angiotensin-converting enzyme

(ACE) inhibitors

Drugs that have hypotension as a side effect, including nitrates,erectile

dysfunction medications, drugs for Parkinson's disease, antipsychotics,
neuroleptics, anti-anxiety agents, sedative-hypnotics, and
tricyclic antidepressants

What Causes Low Blood Pressure? continued...

Common causes of naturally occurring postural hypotension include:

Dehydration and electrolyte loss, which may result

from diarrhea, vomiting, excessive blood loss duringmenstruation, or other

conditions

Age-associated decline in blood pressure regulation, which may be

worsened by certain health conditions or medications
Certain diseases can also cause postural hypotension. These include:

Central nervous system disorders, such as Shy-Drager syndrome

ormultiple system atrophy

Nerve problems, such as peripheral neuropathy or autonomic

neuropathy

Cardiovascular disorders

Alcoholism

Nutritional diseases

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http://www.webmd.com/heart/understanding-low-bloodpressure-treatment
How Do I Know if I Have Low Blood Pressure?
Low blood pressure is not always a sign of a problem. But if you have
symptoms of low blood pressure, your doctor can diagnose the condition and
uncover the cause. Symptoms of dizziness and lightheadedness when you
stand up from sitting or lying down -- with a decrease in your blood pressure -may indicate a condition calledpostural hypotension. A wide range of
underlying conditions may also cause your symptoms. It's important to identify
the cause of low bloodpressure so appropriate treatment can be given.
The doctor will look at your medical history, age, specific symptoms, and the
conditions under which the symptoms occurred. He or she will do aphysical
exam and may repeatedly check your blood pressure and pulse rate -- after
you've been lying down for a few minutes, right after you stand up, and within
a few minutes after you stand quietly.
Other tests may be performed, such as an ECG (electrocardiogram) to
measure heart rate and rhythm and an echocardiogram (an ultrasoundtest to
visualize the heart). You may also have blood tests to look foranemia or
problems with your blood sugar levels.
More sophisticated home ECG monitoring (a Holter monitor or "event"
monitor) may be necessary to check for heart problems that come and go.

Echocardiogram Animation

Watch Now
An exercise stress test or, less commonly, an electrophysiology test (EP test)
may also be helpful.
Some forms of postural hypotension may require a test called a "tilt table" test.
This test evaluates the body's reaction to changes in position. The person lies
on a table, is safely strapped in, and the table is raised to an upright position
for up to an hour. Blood pressure, heart rate, and symptoms are recorded.
Often, medications are given to help guide treatment.

What Are the Treatments for Low Blood Pressure?

For many people, chronic low blood pressure can be effectively treated with
diet and lifestyle changes.
Depending on the cause of your symptoms, your doctor may tell you to
increase your blood pressure by making these simple changes:

Eat a diet higher in salt.

Drink lots of nonalcoholic fluids.

Limit alcoholic beverages.
Drink more fluids during hot weather and while sick with a viral illness,

such as a cold or the flu.

Have your doctor evaluate your prescription and over-the-counter

medications to see if any of them are causing your symptoms.

Get regular exercise to promote blood flow.

Be careful when rising from lying down or sitting. To help improve

circulation, pump your feet and ankles a few times before standing up. Then
proceed slowly. When getting out of bed, sit upright on the edge of the bed for
a few minutes before standing.

Elevate the head of your bed at night by placing bricks or blocks under
the head of bed.

Avoid heavy lifting.

Avoid straining while on the toilet.

Avoid prolonged exposure to hot water, such as hot showers and spas.
If you get dizzy, sit down. It may be helpful to keep a chair or stool in the
shower in case you need to sit; to help prevent injury, use a nonslip chair or
stool designed for use in showers and bath tubs.

To avoid problems with low blood pressure and lessen episodes

ofdizziness after meals, try eating smaller, more frequent meals. Cut back on
carbohydrates. Rest after eating. Avoid taking drugs to lower blood pressure
before meals.

If needed, use elastic support (compression) stockings that cover

thecalf and thigh. These may help restrict blood flow to the legs, thus keeping
more blood in the upper body.

What Are the Treatments for Low Blood Pressure?

continued...
Medications for Low Blood Pressure

If these measures don't lessen the problem, you may need medication.
The following drugs are often used in treating low blood pressure.

Fludrocortisone . Fludrocortisone is a medication that seems to help

most types of low blood pressure. It works by promoting sodium retention by

the kidney, thereby causing fluid retention and some swelling, which is
necessary to improve blood pressure. But this sodium retention also causes a
loss of potassium. So when taking fludrocortisone, it's important to get enough
potassium each day. Fludrocortisone has none of the anti-inflammatory
properties ofcortisone or prednisone and does not build muscle like anabolic
steroids.

Midodrine . Midodrine activates receptors on the smallest arteriesand

veins to produce an increase in blood pressure. It is used to help increase
standing blood pressure in people with postural hypotension related
to nervous system dysfunction. More studies are underway, however, to see
how effective this treatment is.
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