According to the Centers for Disease Control and Prevention (CDC), 75 million adults in the U.S. have high blood pressure. That amounts to one in every three adults. And according to the American Diabetes Association, two out of three people who have diabetes also have high blood pressure. So, understandably, a lot of attention is focused on helping people lower their blood pressure to a safe level. But what if you have blood pressure that’s too low? What does it mean? And what should you do?
Low blood pressure, defined
We’ve all had our blood pressure checked at the doctor’s office numerous times. The nurse or medical assistant wraps a cuff around your upper arm, pumps it up, and, as it is deflating, listens with a stethoscope. What he or she is listening for is, first, the sound when blood starts flowing as the cuff is released — that’s the systolic, or top number — and then the last sound that’s heard before blood flow returns to normal — that’s the diastolic, or bottom number. An “ideal” blood pressure reading is under 120/80 mmHg. For most people who have diabetes, the goal is less than 140/90 mmHg.
All well and good, but what about low blood pressure? Low blood pressure is also called “hypotension.” Hypotension, according to the National, Heart, Lung, and Blood Institute, is “abnormally low blood pressure,” and, in general, is a blood pressure that is below 90/60 mm Hg.
Why is low blood pressure a concern?
With all the concern around high blood pressure, or hypertension, it almost seems like the lower your blood pressure, the better. After all, high blood pressure isn’t called the “silent killer” for nothing. It’s a leading risk factor for heart attack and stroke, and can also cause kidney disease, blindness, and dementia.
Low blood pressure, however, has its own set of medical concerns. It can lead to dizziness or fainting, increasing the chances of falling and injuring oneself. And too low of a blood pressure may deprive the body of enough oxygen, leading to possible damage to the heart, brain, and kidneys.
What causes blood pressure to be too low?
Some people naturally have blood pressure that can seem to be on the low side. Unless these people have symptoms, a “low” blood pressure is normal for them. But others may have low pressure due to a number of factors, including:
Heart disease: Heart valve problems, a low heart rate, heart failure, and even a heart attack can cause blood pressure to drop, most likely due to the heart’s inability to pump enough blood.
Diabetic neuropathy: People who have diabetes may experience postural hypotension, or low blood pressure occurring when going from sitting or lying down to standing up. This may happen due to a type of nerve damage called autonomic neuropathy.
Neurally mediated hypotension: With this condition, blood pressure drops too low after standing for long periods of time.
Endocrine problems: An underactive thyroid, parathyroid disease, Addison’s disease (adrenal insufficiency), and low blood sugar can cause hypotension.
Pregnancy: Blood pressure may drop during the first 24 weeks of pregnancy.
Medications: Some medications can cause blood pressure to drop too low, such as diuretics, beta blockers, certain antidepressants, erectile dysfunction drugs, and drugs used for Parkinson’s disease.
Dehydration: When your body loses more water than it takes in, you may become, weak, dizzy, and fatigued. If you go into hypovolemic shock, this means that your blood volume is dangerously low and can cause blood pressure to suddenly drop too low. This may be fatal if not treated promptly.
Blood loss: Losing blood from an injury or from internal bleeding causes a drop in blood volume, and therefore, a drop in blood pressure.
Severe infection: A severe infection can occur when bacteria enter the bloodstream (called septicemia). Bacteria produce toxins that affect the blood vessels, which, in turn, can cause blood pressure to drop dangerously low.
Allergic reaction: Also called anaphylactic shock, this may occur when a person has a severe reaction to bee stings, drugs, or certain foods, for example. Trouble breathing, hives, itching, a swollen throat, and a sudden drop in blood pressure can result.
Nutrient deficiencies: Not getting enough vitamin B12 or folate can cause anemia, which, in turn, may lead to low blood pressure.
How do you know if your blood pressure is too low?
If your blood pressure is too low, you’ll very likely know it. Signs and symptoms include:
• Feeling dizzy or lightheaded
• Clammy skin
• Feeling very tired
• Blurry vision
A single episode of low blood pressure generally isn’t cause for alarm. For example, you might get dehydrated when it’s very hot out; drinking fluids will help bring your blood pressure back up to a safe level. However, if you repeatedly have symptoms, it’s time to see your doctor. It helps to keep a record of your symptoms, too, to help your doctor pinpoint the possible cause. And if you don’t have any symptoms and you’re generally in good health, but your blood pressure is on the low side, it’s likely that your “low” blood pressure is simply the right blood pressure for you.
Treating low blood pressure
The treatment of low blood pressure depends on the underlying cause. More urgent medical conditions, such as blood loss, heart attack, infection, or dehydration, need prompt medical attention to resolve the issue. If low blood pressure is due to a medication that you’re taking, your doctor may be able to change your medication to another type. If your thyroid is underperforming, you may need thyroid medication. Drinking more fluids, eating more sodium (yes, more sodium!), wearing compression stockings, and even taking medication, such as fludrocortisone, to boost your blood pressure may all be prescribed.
Other lifestyle changes that may help include drinking more caffeinated beverages, cutting back on alcohol; eating smaller, low-carb meals more often; and moving slowly when going from a lying or sitting position to a standing position.
Talk with your doctor if you think your blood pressure may be too low, or if you have any of the symptoms mentioned above. Treatment is available!
Erin Spineto is an athlete and adventurer with Type 1 diabetes. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more about her.
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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.
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