The Dangers of Low Blood Pressure: When to Seek Medical Attention, According to a Chief Physician

The article discusses low blood pressure, highlighting its effects on blood vessels and distinguishing between healthy individuals and those at risk, particularly older adults. While low blood pressure can be benign in young, healthy people, it poses risks for the elderly and those with cardiovascular issues. Symptoms like dizziness warrant medical attention, and treatment strategies vary depending on the underlying causes. Experts advise monitoring blood pressure and consulting healthcare providers if values fall below recommended levels.

The following content is published by Focus online*

While high blood pressure is well-known for harming blood vessels, low blood pressure, or hypotension, is often viewed as beneficial. However, this perception isn’t entirely accurate.

According to Robert H. G. Schwinger, Chief Physician of Medical Clinic II at Weiden Hospital and member of the Bavarian Heart Attack Network, it’s crucial to differentiate between hypotension in healthy young individuals and those who are older or unwell.

Understanding Low Blood Pressure: Key Values to Monitor

The World Health Organization (WHO) suggests that ideal blood pressure should be around 120 over 80 mmHg. Medical professionals categorize low blood pressure as values dropping below 100 over 60 mmHg for women and below 110 over 70 mmHg for men.

Exact statistics on the prevalence of low blood pressure remain unclear, but it is generally accepted that fewer people experience low blood pressure compared to high blood pressure. Low blood pressure itself is not classified as a disease and typically only warrants attention when accompanied by symptoms.

Recognizing the Symptoms of Low Blood Pressure

Dizziness is the most prominent symptom of low blood pressure and often appears alongside other indications. It’s essential for anyone experiencing these symptoms to seek medical advice, regardless of their age or health history.

Potential Causes of Low Blood Pressure

Low blood pressure can take several forms based on its root causes:

1. **Primary, Constitutional Low Blood Pressure**: This occurs in specific demographic groups, especially young, tall, and slender women who may lead inactive lifestyles. No particular trigger identifies this type of hypotension.

2. **Secondary Low Blood Pressure**: This variant arises due to certain conditions or lifestyle choices, such as insufficient fluid intake, especially concerning for older adults. Robert Schwinger highlights that dehydration can significantly lower blood pressure.

Other causes might lead to dilated blood vessels, resulting in reduced blood pressure, including overuse of antihypertensive medications such as ACE inhibitors, sartans, beta blockers, or calcium antagonists.

3. **Orthostatic Hypotension**: This recognized form of hypotension is characterized by dizziness upon standing. A significant drop in blood pressure occurs—over 20 mmHg systolic and/or more than 10 mmHg diastolic within three minutes of standing. Symptoms typically resolve immediately when the individual sits or lies down. The causes are generally similar to those of secondary hypotension.

When is Low Blood Pressure Harmless?

The perceived risk level associated with low blood pressure varies considerably. For young and healthy individuals, hypotension is often seen as advantageous, exerting minimal strain on the body and suggesting favorable health outcomes. Schwinger notes that many in this demographic often experience normalization of their blood pressure as they age.

In some cases, low blood pressure may even be beneficial:

For those with heart failure, where the heart muscle is weakened, maintaining lower blood pressure levels may be necessary to ease this strain, allowing some patients to have low readings without symptoms due to their body’s compensatory mechanisms.

Risks Associated with Low Blood Pressure

The scenario changes for older adults, whose vascular health and responsiveness are often diminished. Low blood pressure can lead to severe dizziness and potential dangers, such as falling, especially when navigating stairs.

Additionally, for individuals with cardiovascular conditions like coronary heart disease, excessively low blood pressure can be precarious. Current medical guidance suggests that maintaining blood pressure below 120 or 110 mmHg may increase the risk of heart attacks for those with borderline coronary artery issues, contradicting earlier beliefs that low readings were always protective.

Managing Low Blood Pressure

Normalizing blood pressure is feasible through various measures tailored to the underlying causes. If a health condition triggers low blood pressure, addressing that condition typically results in stability in blood pressure levels. For those taking antihypertensive medications, adjusting dosages under medical supervision can also be beneficial.

The cardiologist recommends practical steps for both young and older adults to combat low blood pressure:

Increasing fluid intake, ensuring adequate consumption of salt and caffeine may help; however, Schwinger advises moderation with salt due to potential adverse effects, including fluid retention, and notes that supportive studies on salt’s benefits for low blood pressure are lacking. A moderate coffee intake is generally acceptable.

Medications for Low Blood Pressure

Regarding pharmaceutical interventions, many over-the-counter remedies are available, often containing alpha sympathomimetics like etilefrin that

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