Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton and Kim Jackson  

Introduction[edit | edit source]

Hypotension (low blood pressure) patient getting her blood pressure checked.png

Hypotension is:

  • A decrease in systemic blood pressure below accepted low values. While there is not an accepted standard hypotensive value, pressures less than 90/60 are recognized as hypotensive.
  • A relatively benign condition that is under-recognized mainly because it is typically asymptomatic. It only becomes a concern once pumping pressure is not sufficient to perfuse key organs with oxygenated blood. This leads to symptoms impacting the quality of life of a patient.[1]
  • Orthostatic hypotension (OH) is a subtype of hypotension. OH is defined as a sudden drop in blood pressure upon standing from a sitting or supine position. It is also known as postural hypotension.

Etiology[edit | edit source]

"Swooning", syncope or fainting

Some people have low blood pressure all the time, and it is normal for them. Other people experience a sudden drop in blood pressure or have low blood pressure that may be linked to a health problem.

Many systems of the body, including organs, hormones, and nerves, regulate blood pressure. Eg the autonomic nervous system sends the “fight-or-flight” signal that, depending on the situation, tells the heart and other systems in the body to increase or decrease blood pressure. Problems with the autonomic nervous system, eg Parkinson’s disease, can cause low blood pressure.

Other causes of low blood pressure include:

Older adults are more likely to develop low blood pressure as a side effect of medicines taken to control high blood pressure.[2]

Epidemiology[edit | edit source]

Highly variable and depends on the exact etiology. In general:

  • Elderly patients are more prone to non-traumatic, symptomatic hypotensive episodes.
  • More physically active and healthy patients will have lesser resting asymptomatic blood pressures.[1]

Dementia[edit | edit source]

Dementia 2.jpg

Chronic low blood pressure increases the risk of age-related cognitive decline. For example, a study published in 2017 followed more than 24,000 people for up to 27 years. This study showed that low blood pressure is a significant predictor of cognitive decline and the probability of developing dementia. This was independent of age, gender, weight, cardiovascular, kidney or diabetic status.[3]

Exercise Considerations[edit | edit source]

Individuals with hypotension can exercise safely if a few precautions are taken. Exercise may even help increase blood pressure values slightly. The biggest area of concern for individuals with hypotension is quick postural changes.

  • Exercises (eg yoga) in which you transition from one position to another quickly or have your head below the level of your heart, can negatively impact your blood pressure values. This can intensify symptoms and could result in fainting.
  • Individuals should be careful to make postural transitions slowly.
  • Avoiding exercises in which the head is below heart level may be necessary for some individuals, especially if they notice intensified symptoms[4].
  • Drops in blood pressure are fairly common after exercise for short periods of time, especially if an individual exercises at their maximal level.
  • Systolic pressure levels will decrease to an individual's resting level for five to six minutes after exercise is discontinued and will then drop to a lower level than they measured pre-exercise[4].

The role of the Calf Muscles[edit | edit source]

Low diastolic pressure can arise as a result of medication use, heart failure or other health complications. But, in most people, it is simply a matter of low cardiac output. And low cardiac output occurs when not enough blood is being returned to the heart from the lower body.

The soleus muscles plays a critical role in maintaining normal blood pressure during sedentary activities and is known by some as the secondary heart. These deep postural muscles are most active during activities such as sustained squatting or toe standing. [5].

References[edit | edit source]

  1. 1.0 1.1 1.2 Sharma S, Hashmi MF, Bhattacharya PT. Hypotension. InStatPearls [Internet] 2020 May 23. StatPearls Publishing.Available from:https://www.ncbi.nlm.nih.gov/books/NBK499961/ (last accessed 13.12.2020)
  2. NIH Low BP Available from:https://www.nhlbi.nih.gov/health-topics/low-blood-pressure (accessed 13.12.2020)
  3. The Conversation Low blood pressure could be a culprit in dementia, studies suggest Available from:https://theconversation.com/low-blood-pressure-could-be-a-culprit-in-dementia-studies-suggest-122032 (last accessed 13.12.2020)
  4. 4.0 4.1 Healthfully Exercise and hypotension Available from:https://healthfully.com/calculate-intracranial-pressure-8756534.html (accessed 13.12.2020)
  5. Corp Wellness Soleus Muscles Health - Preventing Secondary Heart Failure Available from:https://www.corporatewellnessmagazine.com/article/soleus-muscles-secondary-heart-failure (accessed 13.12.2020)