Meeting Highlights From The Committee For Medicinal Products For Human Use, 18-21 June 2007, Europe Positive Opinions

The European Medicines Agency's (EMEA) Committee for Medicinal Products for Human Use (CHMP) has adopted eleven positive opinions, three of which relate to similar biological medicinal products, recommending the granting of a marketing authorisation for the following medicinal products:

* Atriance (nelarabine), from Glaxo Group Limited, for the treatment of T-cell acute lymphoblastic leukaemia (T-ALL) and T-cell lymphoblastic leukaemia (T-LBL) of patients in second relapse. Atriance is the 40th orphan medicinal product to receive a positive opinion. EMEA review began on 21 June 2006 with an active review time of 203 days. Atriance is the first medicinal product for which an application was submitted using the Product Information Management (PIM) system. PIM enables the electronic exchange of the product information part of a marketing authorisation application in the European Union. Its aim is to increase efficiency of the management and exchange of the product information and to improve the quality and consistency of the published product information.

* Gliolan (5-aminolevulinic hydrochloride), from Medac, for the visualisation of malignant tissue during surgery for malignant glioma in adult patients. Gliolan is the 41st orphan medicinal product to receive a positive opinion. EMEA review began on 24 May 2006 with an active review time of 199 days.

* Flebogammadif [human normal immunoglobulin (IVIg)], from Instituto Grifols S.A., for replacement therapy in immunodeficiency and for immunomodulation in immune-mediated diseases. EMEA review began on 27 September 2006 with an active review time of 177 days.

* Rasilez, Enviage, Sprimeo, Tekturna and Riprazo (aliskiren), from Novartis Europharm Ltd, for the treatment of essential hypertension. EMEA review began on 27 September 2006 for Rasilez and on 25 March 2007 for Enviage, Sprimeo, Tekturna and Riprazo with an active review time of 194 for Rasilez and 77 days for Enviage, Sprimeo, Tekturna and Riprazo.

Positive opinion for similar biological medicinal products

The CHMP adopted positive opinions for three biosimilar medicinal products. Binocrit (Epoetin alfa), from Sandoz GmbH, Epoetin alfa Hexal (Epoetin alfa), from Hexal Biotech Forschungs GmbH, and Abseamed (Epoetin alfa), from Medice Arzneimittel Pütter GMBH & Co, are intended for the treatment of anaemia associated with chronic kidney disease and in oncology patients; and to reduce blood transfusion requirements in oncology patients and prior to elective orthopaedic surgery. All three medicinal products have been shown to be similar to Eprex/Erypo, the reference medicinal product already authorised in the EU, in the applied indications. EMEA review began on 29 March 2006 with an active review time of 205 days.

Extensions of indication

The CHMP gave positive opinions for applications for extensions of indication, adding new treatment options for the following previously approved medicines:

* Arixtra and Quixidar (fondaparinux sodium) 2.5 mg, from Glaxo Group, to extend the indication to add treatment of acute coronary syndromes in patients with unstable angina/non-ST segment elevation myocardial infarction (UA/NSTEMI) for whom an urgent (<120 min) invasive management (PCI) is not indicated; and in patients with ST segment elevation myocardial infarction (STEMI) who are managed with thrombolytics or who initially are to receive no other form of reperfusion therapy. Arixtra 2.5mg is currently authorised for prevention of venous thromboembolic events (VTE) in patients undergoing major orthopaedic surgery; abdominal surgery and who are judged to be at high risk of thromboembolic complications, such as patients undergoing abdominal cancer surgery, and in patients who are judged to be at high risk for VTE and are immobilised. Arixtra (5, 7.5 and 10 mg) is also authorised for the treatment of acute deep vein thrombosis (DVT) and treatment of acute pulmonary embolism (PE), except in haemodynamically unstable patients or patients who require thrombolysis or pulmonary embolectomy.

* Zostavax (Zoster Vaccine, Live), from Sanofi Pasteur MSD, to extend the indication to individuals 50 years of age or older. Zostavax is currently indicated for prevention of herpes zoster and herpes zoster-related post-herpetic neuralgia (PHN) for individuals 60 years of age or older.

New contraindications

Following a literature review describing the interaction of four known inhibitors of CYP3A4 (ketoconazole, lopinavir/ritonavir, clarithromycin, saquinavir) with midazolam, the CHMP recommended to vary the product information for all protease inhibitors to contraindicate the concomitant use with oral midazolam and to provide further directions concerning co-administration with parenteral midazolam in the interaction section of the SPC. The product information for the following protease inhibitors used in the treatment of AIDS/HIV-infections has now been amended: Agenerase, Crixivan, Prezista, Kaletra, Norvir, Telzir and Viracept.

Summaries of opinions for all mentioned products, including their full indication, can be found here .

Action plan following the recall of Viracept and recommendation to suspend the marketing authorisation

The CHMP agreed on an action plan to follow-up patients who were exposed to contaminated Viracept (nelfinavir), from Roche Registration Limited, and recommended the suspension of the marketing authorisation to the European Commission. Viracept is an antiretroviral medicine used to treat HIV-1 infected adults, adolescents and children of 3 years of age and older. The recommendation to suspend Viracept follows the recall of the medicinal product from the European market in early June 2007 because some batches had become contaminated during the manufacturing process with ethyl mesylate, a known genotoxic substance (harmful to DNA).

A separate press release here and a question-and-answer document here with more information are available.

Referral procedures concluded

The CHMP finalised a referral procedure under Article 29 of the Community code on human medicinal products (Directive 2001/83/EC as amended) for lansoprazole 15 and 30 mg Gastroresistant Capsules (lansoprazole), from Teva. The CHMP concluded that bioequivalence with the originator medicinal product has been documented sufficiently and therefore recommended the medicinal product for approval for the treatment of gastro oesophageal reflux disease, ulcers, acid-related dyspepsia and as an adjuvant in the eradication of Helicobacter pylori.

Referrals under Article 29 are normally initiated because of disagreement among the Member States in the context of the mutual recognition procedure.

Referral procedures started

The CHMP started a referral procedure for ergot-derived dopamine agonists (bromocriptine, cabergoline, dihydroergocryptine, lisuride and pergolide), a class of medicines that is primarily used in the treatment of Parkinson's disease. The referral procedure was initiated by the United Kingdom under Article 31 of the Community code on human medicinal products (Directive 2001/83/EC as amended) to re-assess the balance of benefits and risks of all these products in view of the risk of fibrotic disorders and cardiac valvulopathy reported with some of these medicines.

Referrals under Article 31 are initiated in cases involving the interests of the Community or concerns relating to the protection of public health.

The CHMP started a referral procedure for Coxtral gel 3% (nimesulide), from Zentiva, because of concerns regarding equivalence with the originator medicinal product. This procedure was initiated under Article 29 of the Community code on human medicinal products (Directive 2001/83/EC as amended).

The CHMP started a harmonisation referral for Gemzar (gemcitabine), from Lilly, on the request of the European Commission. The procedure was initiated under Article 30 of the Community code on human medicinal products (Directive 2001/83/EC as amended). This type of procedure is initiated with a view to harmonising product information for medicinal products authorised at Member State level.
source:www.medicalnewstoday.com

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

Low Blood Pressure

How is low blood pressure diagnosed and evaluated?

In some individuals, particularly relatively healthy ones, symptoms of weakness, dizziness, and fainting raise the suspicion of low blood pressure. In others, an event often associated with low blood pressure, for example, a heart attack, has occurred to cause the symptoms. Measuring blood pressure, sometimes in both the lying (supine) and standing positions usually is the first step in diagnosing low blood pressure. In patients with symptomatic low blood pressure, there often is a marked drop in blood pressure upon standing, and patients may even develop orthostatic symptoms. Once low blood pressure has been identified as the cause of symptoms, the goal is to identify the cause of the low blood pressure. Sometimes the causes are readily apparent (such as loss of blood due to trauma, or sudden shock after receiving x-ray dyes containing iodine). At other times, the cause may be identified by testing:

* CBC (complete blood count). CBC may reveal anemia from blood loss or elevated white blood cells due to infection.

* Blood electrolyte measurements may show dehydration and mineral depletion, renal failure, or acidosis (excess acid in the blood).

* Cortisol levels can be measured to diagnose adrenal insufficiency and Addison’s disease.

* Blood and urine cultures can be performed to diagnose septicemia and bladder infections, respectively.

* Radiology studies, such as chest x-rays, abdominal ultrasounds and computerized tomography (CT or CAT) scans may detect pneumonia, heart failure, gallstones, pancreatitis, and diverticulitis.

* Electrocardiograms (EKG) can detect abnormally slow or rapid heart beats, pericarditis, and heart muscle damage from either old heart attacks or a reduced supply of blood to the heart muscle that has not yet caused a heart attack.

* Holter monitor recordings are used to diagnose intermittent episodes of abnormal heart rhythms. If abnormal rhythms occur intermittently, a standard EKG performed at the time of a visit to the doctor's office may not show the abnormal rhythm. A Holter monitor is a continuous recording of the heart's rhythm for 24 hours that often is used to diagnose intermittent episodes of bradycardia or tachycardia.

* Patient-activated event recorder. If the episodes of bradycardia or tachycardia are infrequent, a 24-hour Holter recording may not capture these sporadic episodes. In this situation, a patient can wear a patient-activated event recorder for up to four weeks. The patient presses a button to start the recording when he or she senses the onset of an abnormal heart rhythm or symptoms possibly caused by hypotension. The doctor then analyzes the recordings at a later date to identify the abnormal episodes.

* Echocardiograms are examinations of the structures and motion of the heart using ultrasound. Echocardiograms can detect pericardial fluid due to pericarditis, the extent of heart muscle damage from heart attacks, diseases of the heart valves, and rare tumors of the heart.

* Ultrasound examinations of the leg veins and CT scans of the chest can detect deep vein thrombosis and pulmonary embolism.

* Tilt-table tests are used to evaluate patients suspected of having postural hypotension or syncope due to abnormal autonomic nerves. During a tilt-table test, the patient lies on an examining table with an intravenous infusion running while the heart rate and blood pressure are monitored. The table then is tilted upright for 15 minutes to 45 minutes. Heart rate and blood pressure are monitored every few minutes. The purpose of the test is to try to reproduce postural hypotension. Sometimes a doctor may administer Isuprel intravenously to induce postural hypotension. For more, please read our Tilt-table Test procedure article.

source:www.medicinenet.com

Low Blood Pressure

Is low blood pressure bad for your health?

People who have lower blood pressures have a lower risk of strokes, kidney disease, and heart diseases. Athletes, people who exercise regularly, people who maintain ideal body weights, and non-smokers, tend to have lower blood pressures. Therefore, low blood pressure is desirable as long as it is not low enough to cause symptoms and damage to organs in the body.

What are low blood pressure signs and symptoms?

When the blood pressure is not sufficient to deliver enough blood to the organs of the body, the organs do not work properly and may be permanently damaged. For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel light-headed, dizzy, or even faint. Going from a sitting or lying position to a standing position often brings out the symptoms of low blood pressure. This occurs because standing causes blood to “settle” in the veins of the lower body, and this can lower the blood pressure. If the blood pressure is already low, standing can make the low pressure worse to the point of causing symptoms. (The development of light-headedness, dizziness, or fainting upon standing caused by low blood pressure is called orthostatic hypotension. Normal individuals are able to compensate rapidly for the low pressure created by standing with the responses discussed previously and do not develop orthostatic hypotension.)

When there is insufficient blood pressure to deliver blood to the coronary arteries (the arteries that supply blood to the heart’s muscle), a person can develop chest pain (angina) or even a heart attack. When insufficient blood is delivered to the kidneys, the kidneys fail to eliminate wastes from the body, for example, urea and creatinine, and an increase in their levels in the blood occur (e.g., elevations of blood urea nitrogen or BUN and serum creatinine, respectively).

Shock is a life-threatening condition where persistently low blood pressure causes organs such as kidney, liver, heart, lung, and brain to fail rapidly.
source:www.medicinenet.com

Low Blood Pressure

Is low blood pressure bad for your health?

People who have lower blood pressures have a lower risk of strokes, kidney disease, and heart diseases. Athletes, people who exercise regularly, people who maintain ideal body weights, and non-smokers, tend to have lower blood pressures. Therefore, low blood pressure is desirable as long as it is not low enough to cause symptoms and damage to organs in the body.

What are low blood pressure signs and symptoms?

When the blood pressure is not sufficient to deliver enough blood to the organs of the body, the organs do not work properly and may be permanently damaged. For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel light-headed, dizzy, or even faint. Going from a sitting or lying position to a standing position often brings out the symptoms of low blood pressure. This occurs because standing causes blood to “settle” in the veins of the lower body, and this can lower the blood pressure. If the blood pressure is already low, standing can make the low pressure worse to the point of causing symptoms. (The development of light-headedness, dizziness, or fainting upon standing caused by low blood pressure is called orthostatic hypotension. Normal individuals are able to compensate rapidly for the low pressure created by standing with the responses discussed previously and do not develop orthostatic hypotension.)

When there is insufficient blood pressure to deliver blood to the coronary arteries (the arteries that supply blood to the heart’s muscle), a person can develop chest pain (angina) or even a heart attack. When insufficient blood is delivered to the kidneys, the kidneys fail to eliminate wastes from the body, for example, urea and creatinine, and an increase in their levels in the blood occur (e.g., elevations of blood urea nitrogen or BUN and serum creatinine, respectively).

Shock is a life-threatening condition where persistently low blood pressure causes organs such as kidney, liver, heart, lung, and brain to fail rapidly.
source:www.medicinenet.com

How is blood pressure generated?

During relaxation of the heart (diastole) the left ventricle of the heart fills with blood returning from the lungs. The left ventricle then contracts and pumps blood into the arteries (systole). The blood pressure during contraction of the ventricle (systolic pressure) when blood is being actively ejected into the arteries is higher than during relaxation of the ventricle (diastolic pressure). The pulse that we can feel is caused by the contraction of the left ventricle. (Please read the How the Heart Works article for more.)

Blood pressure is determined by two factors: 1) The amount of blood pumped by the left ventricle of the heart into the arteries, and 2) the resistance to the flow of blood caused by the walls of the arterioles (smaller arteries).

Generally, blood pressure tends to be higher if more blood is pumped into the arteries or if the arterioles are narrow and stiff. (Narrow and stiff arterioles, by resisting the flow of blood, increase blood pressure.)

Blood pressure tends to be lower if less blood is being pumped into the arteries or if the arterioles are wider and more flexible and resisting the flow of blood less.

Thus, if arteries are narrowed and stiff, for example, from atherosclerosis, blood pressure must increase to maintain the flow of blood. On the other hand, if arteries are wider and flexible, a lesser blood pressure can maintain the flow of blood at a normal level.

How does the body maintain normal blood pressure?

The body has mechanisms to alter or maintain blood pressure and the flow of blood. There are sensors in the walls of the arteries and heart that sense blood pressure. These sensors are called baroreceptors. Baroreceptors sense blood pressure and then send signals to the heart, the arterioles, the veins, and the kidneys that cause them to make changes that lower or increase blood pressure. There are several ways in which blood pressure can be adjusted--by adjusting the amount of blood pumped by the heart into the arteries (cardiac output), the amount of blood contained in the veins, the arteriolar resistance, and the volume of blood.

* The heart can speed up and contract more frequently, and it can eject more blood with each contraction. Both of these responses increase the flow of blood into the arteries and increase blood pressure.

* The veins can expand and narrow. When veins expand, more blood can be stored in the veins and less blood returns to the heart for pumping into the arteries. As a result, the heart pumps less blood, and blood pressure is lower. On the other hand, when veins narrow, less blood is stored in the veins, more blood returns to the heart for pumping into the arteries, and, therefore, the heart pumps more blood and blood pressure is higher.

* The arterioles can expand and narrow. Expanded arterioles create less resistance to the flow of blood and decrease blood pressure while narrowed arterioles create more resistance and raise blood pressure.

* The kidney can respond to changes in blood pressure by increasing or decreasing the amount of urine that is produced. Urine is primarily water that is removed from the blood so that when the kidney makes more urine, the amount (volume) of blood that fills the arteries and veins decreases, and this lowers blood pressure. If the kidneys make less urine, the amount of blood that fills the arteries and veins increases and this increases blood pressure. Compared with the other mechanisms for adjusting blood pressure, changes in the production of urine affect blood pressure slowly over hours and days. (The other mechanisms are effective in seconds.)

For example, low blood volume due to bleeding into the intestine can cause low blood pressure. The body quickly responds to the low blood volume and pressure by the following adjustments which all increase blood pressure:

* The heart rate increases and the forcefulness of the heart’s contractions increase, thus more blood is pumped through the heart.
* Veins narrow to return more blood to the heart for pumping.
* Blood flow to the kidneys decrease to reduce the formation of urine, and increase the volume of blood in the arteries and veins.
* Arterioles narrow to increase resistance to blood flow

These adaptive responses will keep the blood pressure in the normal range unless blood loss becomes so severe and protracted that the responses are overwhelmed.
source:www.medicinenet.com

How is blood pressure generated?

During relaxation of the heart (diastole) the left ventricle of the heart fills with blood returning from the lungs. The left ventricle then contracts and pumps blood into the arteries (systole). The blood pressure during contraction of the ventricle (systolic pressure) when blood is being actively ejected into the arteries is higher than during relaxation of the ventricle (diastolic pressure). The pulse that we can feel is caused by the contraction of the left ventricle. (Please read the How the Heart Works article for more.)

Blood pressure is determined by two factors: 1) The amount of blood pumped by the left ventricle of the heart into the arteries, and 2) the resistance to the flow of blood caused by the walls of the arterioles (smaller arteries).

Generally, blood pressure tends to be higher if more blood is pumped into the arteries or if the arterioles are narrow and stiff. (Narrow and stiff arterioles, by resisting the flow of blood, increase blood pressure.)

Blood pressure tends to be lower if less blood is being pumped into the arteries or if the arterioles are wider and more flexible and resisting the flow of blood less.

Thus, if arteries are narrowed and stiff, for example, from atherosclerosis, blood pressure must increase to maintain the flow of blood. On the other hand, if arteries are wider and flexible, a lesser blood pressure can maintain the flow of blood at a normal level.

How does the body maintain normal blood pressure?

The body has mechanisms to alter or maintain blood pressure and the flow of blood. There are sensors in the walls of the arteries and heart that sense blood pressure. These sensors are called baroreceptors. Baroreceptors sense blood pressure and then send signals to the heart, the arterioles, the veins, and the kidneys that cause them to make changes that lower or increase blood pressure. There are several ways in which blood pressure can be adjusted--by adjusting the amount of blood pumped by the heart into the arteries (cardiac output), the amount of blood contained in the veins, the arteriolar resistance, and the volume of blood.

* The heart can speed up and contract more frequently, and it can eject more blood with each contraction. Both of these responses increase the flow of blood into the arteries and increase blood pressure.

* The veins can expand and narrow. When veins expand, more blood can be stored in the veins and less blood returns to the heart for pumping into the arteries. As a result, the heart pumps less blood, and blood pressure is lower. On the other hand, when veins narrow, less blood is stored in the veins, more blood returns to the heart for pumping into the arteries, and, therefore, the heart pumps more blood and blood pressure is higher.

* The arterioles can expand and narrow. Expanded arterioles create less resistance to the flow of blood and decrease blood pressure while narrowed arterioles create more resistance and raise blood pressure.

* The kidney can respond to changes in blood pressure by increasing or decreasing the amount of urine that is produced. Urine is primarily water that is removed from the blood so that when the kidney makes more urine, the amount (volume) of blood that fills the arteries and veins decreases, and this lowers blood pressure. If the kidneys make less urine, the amount of blood that fills the arteries and veins increases and this increases blood pressure. Compared with the other mechanisms for adjusting blood pressure, changes in the production of urine affect blood pressure slowly over hours and days. (The other mechanisms are effective in seconds.)

For example, low blood volume due to bleeding into the intestine can cause low blood pressure. The body quickly responds to the low blood volume and pressure by the following adjustments which all increase blood pressure:

* The heart rate increases and the forcefulness of the heart’s contractions increase, thus more blood is pumped through the heart.
* Veins narrow to return more blood to the heart for pumping.
* Blood flow to the kidneys decrease to reduce the formation of urine, and increase the volume of blood in the arteries and veins.
* Arterioles narrow to increase resistance to blood flow

These adaptive responses will keep the blood pressure in the normal range unless blood loss becomes so severe and protracted that the responses are overwhelmed.
source:www.medicinenet.com

Low Blood Pressure

Low Blood Pressure
(Hypotension)
Blood pressure is the pressure of blood within the arteries of the body. Blood pressure is the driving force that causes blood to flow through the body from the arteries (where the pressure is high), through organs, and into the veins (where the pressure is low). Blood pressure is generated by the pumping of blood by the heart into the arteries as well as by the resistance to the flow of blood by the arteries. The systolic blood pressure (the top number) represents the pressure in the arteries as the muscle of the heart contracts and pumps blood into the arteries. The diastolic blood pressure (the bottom number) represents the pressure in the arteries as the muscle of the heart relaxes after it contracts.

Systolic blood pressure for most healthy adults falls between 90 and 120 millimeters of mercury (mm Hg). Normal diastolic blood pressure falls between 60 and 80 mm Hg. (By convention, an individual’s blood pressure is written as systolic/diastolic blood pressure, e.g., 120/80). Current guidelines define normal blood pressure as lower than 120/80. Blood pressures between 120/80 and 140/90, which used to be considered “pre-hypertension,” now are considered too high. High blood pressure increases the risk of developing heart disease, kidney disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke.

Low blood pressure is blood pressure that is so low that it is causing symptoms or signs due to the low flow of blood through the arteries and veins. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidney; the organs do not function normally and may be permanently damaged. It should be noted that unlike high blood pressure, which is defined on the basis of blood pressure alone, low blood pressure is defined primarily by signs and symptoms of low blood flow. In fact, some individuals may have a blood pressure of 90/50 and have no signs or symptoms of low blood pressure, and, therefore, not have low blood pressure while others who normally have a blood pressure of 130/80 may develop symptoms and signs of low blood pressure if their blood pressure drops to 100/60.
source:www.medicinenet.com