Arterial hypotension is a condition in which a person’s blood pressure (BP) decreases significantly below normal values. Hypotension can be considered an acute or chronic drop in pressure below 100/60 mm. rt. Art. for men and 90/60 mm. rt. Art. for women.

In some cases, tonometer readings characterizing arterial hypotension do not always indicate pathology - the cause of low pressure may also be the individual adaptive abilities of the body. When the pressure drops to 90/60 mm. rt. Art. arterial hypotension is diagnosed in all cases. Low blood pressure – how long is it? The figures given are only approximate indicators, they may differ for some people, and there is no answer to the question “what pressure is considered low” that satisfies all patients.

This article will discuss the classification of arterial hypotension, its symptoms and features, and also provide advice on what to do if your blood pressure drops.

Physiological arterial hypotension

Physiological arterial hypotension is a condition in which a person’s systolic and/or diastolic blood pressure is below generally accepted normal values, but despite this, they are not considered pathological. This feature may arise due to an individual version of the blood pressure norm (a special “working” blood pressure).

In addition, many athletes and residents of some regions (the Arctic, the tropics, highlands, etc.) also often experience low blood pressure, the causes of which are the body’s adaptive abilities.

Acute arterial hypotension

Acute arterial hypotension is a condition in which the pressure can become very low (as a rule, it occurs suddenly, sometimes minutes count), often presenting a danger to the patient’s life and requiring emergency medical attention.

Low heart pressure in acute form, which is a disease, is called pathological.

An acute decrease in pressure, which is particularly dangerous, can be expressed in the following forms:

• Collapse

A form of vascular insufficiency caused by a change in circulating blood volume and/or an immediate drop in vascular tone. In addition to lowering blood pressure, collapse is dangerous due to hypoxia (oxygen starvation) of the brain and decreased blood supply to all vital organs.

A sharp, sustained and prolonged drop in systolic (upper) blood pressure, accompanied by a sharp decrease in blood supply to vital organs.

Causes of acute arterial hypotension

The reasons for a sharp drop in blood pressure include the following factors and disorders:

• loss of large volume of blood;
• dehydration of the body;
• poisoning and intoxication conditions;
• state of anaphylactic shock;
• severe injuries (especially traumatic brain injuries);
• alcohol or drug intoxication;
• disturbances in the functioning of the heart.

The most common reasons for low blood pressure are body structure features: women with a thin build suffer from arterial hypotension several times more often. Low blood pressure is also common in women during pregnancy, which is associated with the body’s adaptive abilities - it simply does not have time to “rebuild” its work in accordance with the person’s new weight. Anemia may also be the cause of constant low blood pressure during this period.

Arterial hypertension, if not treated correctly, can cause low blood pressure. In this case, after emergency measures, a mandatory adjustment of drugs that lower blood pressure is required, which should only be carried out by a qualified specialist. Self-adjustment of these medications can lead to severe and irreversible consequences on the functioning of the cardiovascular system.

Old age is a relative risk factor for the development of arterial hypotension; in official medicine, people with low blood pressure are often found in young and even teenage years.

Vegetative-vascular dystonia as a cause of low blood pressure, compared with the age factor, occurs several times more often. Poor functioning of the central nervous system affects the disruption of communication between the heart and other organs, which ultimately leads to arterial hypotension.

Chronic arterial hypotension

Hypotonic disease is chronic arterial hypotension, requiring constant support of the body with appropriate medications. May have one of the following forms or a combination of them:

1. Neurocirculatory arterial hypotension is a disease that worsens the patient’s well-being, but does not exclude the possibility of his recovery.
2. Orthostatic hypotension (OH) is a pathology in which weak pressure is observed only when the patient abruptly moves from a horizontal to a vertical position. This condition is explained by a disruption (reduction) of blood flow to the brain. It has a short period of action - the time during which the first symptoms of low blood pressure appear and their complete disappearance occurs is usually several minutes. Most often, patients suffer from orthostatic hypotension in the morning, immediately after sleep. OH is dangerous not only by the possibility of loss of consciousness, but also by an increased risk of stroke, especially in older people.
3. Essential arterial hypotension is a disease with an independent course, the cause of which, as a rule, is neuroses, stress, high intellectual stress, etc. This diagnosis primarily affects the vasomotor center of the brain.

When determining the type of arterial hypotension in women (primary or secondary) during gestation, the time of its appearance is taken into account. Secondary hypotension will be a disease that appears during pregnancy itself (with some exceptions); all other forms of this pathology belong to primary arterial hypotension.

Causes of chronic arterial hypotension

Persistent low blood pressure is not always an independent disease - it often occurs as a consequence or complication of another previously diagnosed diagnosis or pathological condition. Causes of low blood pressure include:

• osteochondrosis of the cervical spine;
• some diseases of the gastrointestinal tract - stomach ulcers, pancreatitis, etc.;
• anemia;
• hepatitis;
• cystitis;
• tuberculosis;
• rheumatism;
• alcoholism;
• diabetes mellitus and other diseases of the endocrine system;
• diseases of the respiratory system;
• cirrhosis of the liver;
• intoxication;
• side effects of certain medications (in this case, their abolition would be an appropriate solution);
• disorders of blood supply and functioning of the cardiovascular system;
• lack of vitamins E, C and B5.

Treatment of secondary arterial hypertension involves, first of all, eliminating the cause that caused it. In order to find out why a person’s blood pressure drops in such cases, additional laboratory and diagnostic tests will be required.

Symptoms of arterial hypotension

Symptoms of low blood pressure are also typical for other diseases of the cardiovascular system. Patients with hypotension typically report the following complaints:

• dizziness (sometimes reaching the point of fainting);
• paleness and numbness of the skin, as well as other signs of VSD;
• general weakness and fatigue;
• blurred vision;
• increased breathing.

Migraine attacks, as a sign of a drop in pressure, have some specific features: they bother the patient after mental and physical stress (but can appear immediately after sleep), have a long-lasting (sometimes up to 2-3 days) effect, and are intensified by sound and light influence , symmetrical on both sides. By its nature, such a headache is usually throbbing and dull. The area of ​​low pressure (the location of pain) is the forehead, temples, and crown.

Another common symptom of low blood pressure is nausea and vomiting. They are found mainly in weather-sensitive people, patients suffering from sunstroke or dehydration. Low blood pressure caused by poisoning or overdose of blood pressure-lowering drugs is also often accompanied by nausea. The development and duration of this symptom can vary; in some patients, nausea in acute forms of the disease can last for several hours.

Symptoms of low blood pressure include other disorders of the gastrointestinal tract: bloating, belching, constipation and intestinal colic.

Symptoms of low blood pressure with orthostatic hypotension are practically no different from the general symptoms of the disease: tinnitus, dizziness, darkening of the eyes, lethargy, a feeling of chronic fatigue, inability to assume a relaxing position. Some patients with hypotension experience a feeling of lack of air and are forced to take a deep breath, but they do not experience shortness of breath, and in most cases there are no causes that cause it. Low blood pressure in all of these cases can be supplemented directly by the diseases of the cardiovascular system themselves.

In some patients, at the initial stage of the disease there may be no signs of low blood pressure, but this is rather the exception to the rule.

Arterial hypotension in children

A predisposition to arterial hypotension in children develops during the period of fetal formation. It is caused by disturbances in the normal course of pregnancy in the mother of the child. Low blood pressure in this case usually makes itself felt only when the child reaches adolescence; it is caused by the following factors:

• hormonal changes in the body;
• overwork due to schoolwork;
• low level of physical activity;
• infectious diseases (complaints of low blood pressure usually occur during the recovery period);
• unbalanced diet and eating disorders;
• headache;
• nausea.

Signs of low blood pressure in children with mild hypotension disappear when engaged in play, after sleep and a walk in the fresh air. If the cause of acute arterial hypotension in a child is overwork, in many cases a short break is sufficient to eliminate it.

Among all forms of hypotension, orthostatic hypotension is most common in children. When a child develops a chronic form of the disease, his feelings of suspicion and resentment intensify, he becomes whiny and absent-minded. In high school age, this disease is usually expressed not only in the form of low blood pressure, but also pain in the heart.

Arterial hypotension in the elderly

Elderly people are much more likely to suffer from the opposite disease – arterial hypertension. There are also situations when a patient has suffered from hypotension all his life, and with an appropriate lifestyle at retirement age, it goes away on its own due to a natural increase in blood pressure.

Arterial hypotension in elderly patients usually has an orthostatic form. Improper “relief” of such conditions or failure to pay due attention to them can lead to stroke and even dementia (senile dementia).

In older people, low blood pressure is often observed with an overdose of antihypertensive drugs. Due to pressure drop below 100/60 mm. rt. Art. patients with hypertension require medication adjustments.

Low heart pressure due to other cardiovascular diseases may be manifested by a decrease in only systolic or diastolic blood pressure, and not both indicators at once.

Systolic hypotension

In some patients, low blood pressure is caused by a violation of only one indicator - systolic or diastolic. As in the case of general arterial hypotension, the norm for such blood pressure is different for everyone. 100 mm. rt. Art. – the average statistical minimum value for an ordinary healthy person who is not an athlete and does not live in specific climatic conditions.

The causes of low systolic pressure include the following diseases and pathological conditions:

• bradycardia (especially if it is presented to the patient in combination with arrhythmia);
• heart valve dysfunction;
• diabetes;
• pregnancy (especially the first trimester);
• increased physical activity.

Diastolic, i.e. lower blood pressure, with low upper pressure, hypotension remains normal. Upper pressure 100 mm. rt. Art. not always hypotension (due to the individual characteristics of the patient and his living conditions), but if it occurs periodically, it would not be superfluous to consult a doctor.

Diastolic hypotension

The lower blood pressure is recorded at the moment of relaxation of the heart muscle. Low diastolic pressure is considered such if the difference between the upper and lower blood pressure is more than 60-70 mm. rt. Art.

Symptoms of the diastolic form of hypotension include drowsiness, a feeling of powerlessness, lethargy, dizziness and nausea. Patients who have been diagnosed with low diastolic pressure are irritable and often become tearful.

The causes of this form of hypotension include the following diseases and pathological conditions:

• renal or heart failure;
• vegetative-vascular dystonia;
• allergic diseases;
• states of shock;
• disorders of the thyroid gland.

Low diastolic pressure requires finding out the cause that caused it and eliminating it as much as possible.

Diagnosis of arterial hypotension

Arterial hypotension is easily diagnosed using the blood pressure measurement procedure, but it is impossible to identify the disease immediately at the first measurement. To make a diagnosis or refute it, blood pressure monitoring is used for a period of time determined by the attending physician.

With low blood pressure and high pulse, patients are advised to undergo an ECG upon presentation and consult a cardiologist due to possible disturbances in the functioning of the heart. In such patients, hypotension can be combined with arrhythmia, extrasystole (untimely contraction of the heart or its individual chambers), and bradycardia.

In addition to an ECG, the doctor may prescribe an ultrasound examination of the heart to determine cardiac output and phonocardiography to study heart sounds.

Treatment of arterial hypotension

Periodic reduction of pressure to 100/60 mm. rt. Art. in most cases, this is a reason to start therapy. Only a qualified specialist should determine how to normalize low blood pressure and choose the appropriate treatment plan. Even if hypotension in isolation may seem uncomplicated, it may require special understanding of what to do if your blood pressure drops suddenly.

Most often, arterial hypotension is not an independent disease, but a sign of other health problems. Treatment should be aimed at eliminating the cause of the drop in blood pressure. For example, if hypotension is caused by blood loss, it is necessary to stop the bleeding and replenish the volume of circulating blood. If arterial hypotension occurs due to dehydration, it is necessary to replenish the water balance in the body.

The following drugs are used to treat hypotensive conditions:

• herbal medicines based on eleutherococcus, ginseng, etc. (herbal adaptogens). Available in the form of tinctures, tablets and capsules. Tinctures are intended for both systemic and “emergency” use. Herbal adaptogens do not affect heart rate and in many cases are the drug of choice for patients with low blood pressure and high pulse;
• caffeine sodium benzoate. Available in the form of tablets and injection solutions. Its use is not recommended for low blood pressure and high pulse, since the drug has a cardiotonic effect and increases heart rate;
• Cordiamin. Available in the form of drops and solutions for injection. Used only in a hospital setting for an emergency increase in blood pressure.

Be careful if headaches occur in the area of ​​low blood pressure: Citramon or Askofen, which is often used to eliminate them, contains caffeine-sodium benzoate. Do not overdose them!

Doctors also have more powerful drugs in their arsenal to increase blood pressure when it drops sharply. These are adrenaline, norepinephrine, mesaton, dopamine. These products are only used in life-threatening situations.

Portal expert, first category doctor Nevelichuk Taras.

What to do in case of fainting?

Sometimes acute attacks of hypotension result in fainting. If you or a loved one have such a disease, you need to know what to do if low blood pressure results in fainting. People who have fainted can be helped almost anywhere. To do this you need to perform the following steps:

1. Lay the patient down with the legs elevated. If fainting occurs in a vehicle, sit the victim so that the head is tilted as far as possible towards the knees.
2. Free the victim from anything that can compress the body - tie, belt, etc.
3. If possible, lightly splash the face with cold water, then pat the patient on the cheeks and force him to breathe deeply.
4. Let the victim smell the cotton wool with ammonia.

If the pressure has dropped, it is not recommended to give validol to victims of fainting associated with this drop.

Lifestyle with arterial hypotension

Hypertension does not always require drug therapy. Understanding how to live with low blood pressure is very simple. All that is required for this is to observe a healthy lifestyle, adhere to proper nutrition, sleep and rest during stress. Physical activity should be moderate. The best exercises for hypotension are running on a treadmill, exercise on an exercise bike and swimming in the pool. The listed loads help increase vascular tone.

In case of arterial hypotension, it is advisable to follow the following rules:

1. Sleep should not only be complete, but also long-lasting. Low heart pressure requires normal rest to normalize indicators - you need to sleep 1-2 hours more than a healthy person.
2. To give blood vessels (which inevitably weaken with this disease) tone, the amount of liver, eggs, fruits and vegetables consumed in the diet should be increased. The food you eat should be mostly protein.
3. In case of hypotension, a contrast shower helps to maintain blood pressure in a normal state. The water temperature should be lowered gradually over several weeks. After taking such a shower, to achieve an even greater effect, you can rub yourself well with a towel.
4. Immediately inform your doctor of any changes in your condition and adhere to all prescribed instructions.
5. If you are often stressed, try to avoid situations that cause stress as much as possible.
6. Before going to bed, patients with arterial hypotension are recommended to soak their feet in cool water for 1-3 minutes, accompanied by sudden movements, then put on woolen socks and walk around the room a little. Patients with this disease also benefit from periodic visits to physiotherapy prescribed by a physiotherapist. You can significantly improve your condition with this disease with the help of sanatorium-resort treatment.

Before declaring hypotension, the doctor must establish for an individual patient his low blood pressure, since the standard pressure is 100 mmHg. rt. Art. will not be a threshold for everyone.