Low Blood Pressure

How is low blood pressure treated?

Low blood pressure in healthy subjects without symptoms or organ damage needs no treatment. 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 since 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. If bleeding is continuing, it needs to be treated as well.

* Septicemia 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 heparin initially and oral warfarin later.

* Pericardial fluid can be removed by a procedure called pericardiocentesis.

* Postural hypotension can be treated by increasing water and salt intake, using compression stockings to compress the leg veins and reduce the pooling of blood in the veins, and, in some patients, the use of a medication called proamatine (Midodrine). 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 is an anticholinesterase medication that works on the autonomic nervous system, especially when a person is standing up. Side effects of pyridostigmine include minor abdominal cramping or increased frequency of bowel movements. Increasing salt intake can lead to heart failure in patients with existing heart disease and should not be undertaken without consulting a doctor.

Low Blood Pressure At A Glance

* 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 light-headedness, 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 failure of the kidneys.
* Common causes of low blood pressure include a reduced volume of blood, heart disease, and medications.
* Low blood pressure is suspected on the basis of the symptoms it produces and can be confirmed by measuring blood pressure (unless the symptoms are intermittent).
* 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.
source:www.medicinenet.com