Hypotension; Blood pressure - low; Postprandial hypotension; Orthostatic hypotension; Neurally mediated hypotension; NMH DefinitionLow blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body may not get enough blood. Normal blood pressure is mostly between 90/60 mmHg and 120/80 mmHg. The medical word for low blood pressure is hypotension. CausesBlood pressure varies from one person to another. A drop of as little as 20 mmHg can cause problems for some people. There are different types and causes of low blood pressure. Severe hypotension (shock) can be caused by sudden loss of blood (shock), severe infection, heart attack, or severe allergic reaction (anaphylaxis). Orthostatic hypotension means your blood pressure drops when you shift from lying down to standing. This type of low blood pressure usually lasts only a few seconds or minutes. If this type of low blood pressure occurs after eating, it is called postprandial orthostatic hypotension. This type most often affects older adults, those with high blood pressure, and people with Parkinson disease. Neurally mediated hypotension (NMH) most often affects young adults and children. It can occur when a person has been standing for a long time. Children usually outgrow this type of hypotension. Certain medicines and substances can lead to low blood pressure, including:
Other causes of low blood pressure include:
SymptomsSymptoms of low blood pressure may include:
Exams and TestsThe health care provider will examine you to determine the cause of your low blood pressure. Your vital signs (temperature, pulse, rate of breathing, and blood pressure) will be checked frequently. You may need to stay in the hospital for a while. The provider will ask questions, including:
The following tests may be done:
TreatmentLower than normal blood pressure in a healthy person that does not cause any symptoms often does not need treatment. Otherwise, treatment depends on the cause of your low blood pressure and your symptoms. When you have symptoms from low blood pressure, sit or lie down right away. Then raise your feet above heart level. Severe hypotension caused by shock is a medical emergency. You may be given:
Treatments for low blood pressure after standing up too quickly include:
People with NMH should avoid triggers, such as standing for a long period of time. Other treatments include drinking fluids and increasing salt in your diet. Talk to your provider before trying these measures. In severe cases, medicines may be prescribed. Outlook (Prognosis)Low blood pressure can usually be treated with success. Possible ComplicationsFalls due to low blood pressure in older adults can lead to a broken hip or spine fracture. These injuries can reduce a person's health and ability to move about. Sudden severe drops in your blood pressure starves your body of oxygen. This can lead to damage of the heart, brain, and other organs. This type of low blood pressure can be life threatening if not treated right away. When to Contact a Medical ProfessionalIf low blood pressure causes a person to pass out (become unconscious), seek treatment right away. Or call 911 or the local emergency number. If the person is not breathing or has no pulse, begin CPR. Call your provider right away if you have any of the following symptoms:
PreventionYour provider may recommend certain steps to prevent or reduce your symptoms including:
visHeaderReferencesCalkins H, Everett TH, Chen P-S. Hypotension and syncope. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 71. Schrigern DL. Approach to the patient with abnormal vital signs. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 7. | |
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Review Date: 2/2/2023 Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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