Low blood pressure (hypotension)

Overview

Hypotension means blood pressure is currently or permanently low, i.e. below 100/60 mmHg. This can lead to dizziness, nausea and paleness. Persons with low blood pressure feel tired, have a rapid heartbeat and a tendency to faint. The cause cannot always be identified, but various underlying diseases, such as heart problems, anaemia and infections, can lead to hypotension.

Symptoms

• Dizziness
• Nausea
• Pale skin
• Tremors
• Rapid heartbeat
• Tendency to faint (brief fainting spells, known as syncope)
• Fatigue, listlessness
• Difficulty concentrating
• Shivering, cold feet and hands

Causes and treatment

Causes

• Primary hypotension
  • Unknown cause (“idiopathic”)
  • Genetic (constitution), typical: young and slim
• Secondary hypotension (with cause/underlying disease)
  • Anaemia
  • Hormone dysregulation
  • Heart diseases
  • Pregnancy
  • Medication (e.g. beta blockers)
  • Reduced blood volume: drinking too little, vomiting/diarrhoea, severe blood loss
  • Infection, sepsis
  • Allergy, anaphylaxis
• Dysregulation of (autonomic) nervous system
  • Nerve damage (e.g. stroke, diabetes, Parkinson’s, MS)
  • Standing for too long
  • Heat exhaustion
  • Sudden change in body position from sitting/lying to standing up
  • Startle response, fear
  • Smells, pain, unusual psychological sensations

Complications

• Injuries caused by falling/fainting
• Sudden extreme drop in blood pressure
  • Life-threatening shock situation
  • Extreme form of secondary hypotension
  • Impaired flow of blood to vital organs
  • Organ failure

Further treatment by your doctor / in hospital

Possible tests

• (Long-term) measurement of blood pressure
• Physical examination and tests (e.g. Schellong test)
• Electrocardiogram (ECG), if necessary
• Further diagnostic tests to exclude a cause

Possible therapies

• Medication
• Herbal remedies
• Physiotherapy, if necessary
• Treatment of underlying disease

What can I do myself?

• Stimulate circulation
  • Alternating cold and hot baths, Kneipp therapy
  • Exercise, sport
• Sufficient fluid intake
  • Water, unsweetened tea
  • Amount (rule of thumb): 30-40ml per kg body weight and day; i.e. approx. 1.5–3 litres
• Eat more salty food, if necessary
• How to treat a sudden collapse
  • Lie patient down flat (the floor is also suitable)
  • Elevate the legs
  • Open tight clothing
  • If there’s no immediate improvement: call emergency number 144

When to see a doctor?

• Noticeable and constant impairment of health
• Regular fainting spells (investigation of cause)
• Constant fatigue
• State of shock (cold sweat, confusion, disorientation)
• Injury caused by a fall, blow to the head
• Vision defects and memory lapses
• Shortness of breath

Synonyms

low blood pressure, hypotension, blood pressure, low, hypotonia, arterial hypotension