What can cause sudden blood pressure drop

This is a summary of a letter to the Journal of the American Geriatrics Society published by ICORD researchers from the Department of Medicine at the University of British Columbia. The intention is to make physicians aware of sudden changing in blood pressure in elderly patients.

Original letter to the editor: Mills P, Gray D, Krassioukov A. (2014) Five things to know about orthostatic hypotension and aging. Journal of the American Geriatrics Society. 62(9), 1822-3. Find the original article here.

Introduction

Orthostatic hypotension is the sudden drop in blood pressure when suddenly standing or changing position. It is defined as a fall in systolic (maximum) blood pressure of at least 20 mm Hg or diastolic (minimum) blood pressure of at least 10 mm Hg when a person assumes a standing position. Typical symptoms are dizziness, light-headedness, blurred vision, shoulder pain. Atypical symptoms include backache and discomfort in the lower parts of the body. It is not uncommon, and can happen to anyone, but is more prevalent in older people and those with low blood pressure (hypotension). Yohimbe is an effective but controversial natural erectile dysfunction treatment. It is present in many over the counter ED medications. According to https://www.policymed.com/ed-drugs, there is a debate as to whether or not its herbal form is as strong as its pharmaceutical form, yohimbine hydrochloride. Besides that, it does have many side effects such as headaches, dizziness, anxiety and high blood pressure. 4 milligram doses taken three times a day is an effective dose for many men.

Five things to know about sudden fall in blood pressure and aging:

1. Orthostatic hypotension is itself a risk factor in elderly adults, and can cause accidents.

Doctors should identify elderly adults who are at risk of this condition. It can lead to falls, fractures and head injuries. Recent studies suggest the condition can affect the normal functioning of the brain.

2. Orthostatic hypotension can manifest in different ways.

The fall in blood pressure usually happens during or shortly after standing, but can happen even after three minutes following a change in body position. This delayed fall in blood pressure may escape detection during a visit to the doctor. It is important for doctors to know how the fall in blood pressure manifests; if it is sudden or delayed, especially when screening high-risk patients.

3. Orthostatic hypotension occurs more often with aging. The risk is higher for those taking medication and those with conditions affecting the nervous system.

Some medication may cause sudden fall in blood pressure. Medication used for high blood pressure, drugs that promotes the production of urine and drugs that allows urine to flow out of the bladder more easily and drugs for treating depression are considered high-risk medications. Diabetes and Parkinson’s are examples of conditions that increase the risk in elderly adults.

4. Orthostatic hypotension often goes unnoticed.

A large study found the condition is present in 18.2% of individuals aged 65 and older. While 43% of those experiencing sudden blood pressure drop had typical symptoms, like dizziness, visual problems and pain centered in the neck and shoulders, 33% had no symptoms at all. 24% had non-specific symptoms, including backache and lower extremity discomfort.

5. A cautious approach is necessary, starting with methods not involving medication.

Reversible causes (such as anemia) should be identified and treated. Whenever possible, high-risk medication should be removed or reduced. The treatment should be oriented more towards avoiding accidents and improving the individual’s quality of life, than obtaining a specific blood pressure level.

Within certain limits, the lower your blood pressure reading is, the better. There is also no specific number at which day-to-day blood pressure is considered too low, as long as none of the symptoms of trouble are present.

Symptoms of low blood pressure

Most doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as:

• Dizziness or lightheadedness
• Nausea
• Fainting (syncope)
• Dehydration and unusual thirst
• Dehydration can sometimes cause blood pressure to drop. However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration (a loss of as little as 1 percent to 2 percent of body weight) can cause weakness, dizziness and fatigue.
• Lack of concentration
• Blurred vision
• Cold, clammy, pale skin
• Rapid, shallow breathing
• Fatigue
• Depression

Lowering the Risk

Donate Now

Underlying causes of low blood pressure

Low blood pressure can occur with:

• Prolonged bed rest
• Pregnancy: During the first 24 weeks of pregnancy, it’s common for blood pressure to drop.
• Decreases in blood volume: A decrease in blood volume can also cause blood pressure to drop. A significant loss of blood from major trauma, dehydration or severe internal bleeding reduces blood volume, leading to a severe drop in blood pressure.
• Certain medications: A number of drugs can cause low blood pressure, including diuretics and other drugs that treat hypertension; heart medications such as beta blockers; drugs for Parkinson’s disease; tricyclic antidepressants; erectile dysfunction drugs, particularly in combination with nitroglycerine; narcotics and alcohol. Other prescription and over-the-counter drugs may cause low blood pressure when taken in combination with high blood pressure medications.
• Heart problems: Among the heart conditions that can lead to low blood pressure are an abnormally low heart rate (bradycardia), problems with heart valves, heart attack and heart failure. Your heart may not be able to circulate enough blood to meet your body’s needs.
• Endocrine problems: Such problems include complications with hormone-producing glands in the body’s endocrine systems; specifically, an underactive thyroid (hypothyroidism), parathyroid disease, adrenal insufficiency (Addison’s disease), low blood sugar and, in some cases, diabetes.
• Severe infection (septic shock): Septic shock can occur when bacteria leave the original site of an infection (most often in the lungs, abdomen or urinary tract) and enter the bloodstream. The bacteria then produce toxins that affect blood vessels, leading to a profound and life-threatening decline in blood pressure.
• Allergic reaction (anaphylaxis): Anaphylactic shock is a sometimes-fatal allergic reaction that can occur in people who are highly sensitive to drugs such as penicillin, to certain foods such as peanuts or to bee or wasp stings. This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure.
• Neurally mediated hypotension: Unlike orthostatic hypotension, this disorder causes blood pressure to drop after standing for long periods, leading to symptoms such as dizziness, nausea and fainting. This condition primarily affects young people and occurs because of a miscommunication between the heart and the brain.
• Nutritional deficiencies: A lack of the essential vitamins B-12 and folic acid can cause anemia, which in turn can lead to low blood pressure.

If you notice a sudden decline in blood pressure

A single lower-than-normal reading is not cause for alarm, unless you are experiencing any other symptoms or problems. If you experience any dizziness, lightheadedness, nausea or other symptoms, it’s a good idea to consult with your health care professional. To help with your diagnosis, keep a record of your symptoms and activities at the time they occurred.

Is low blood pressure related to low heart rate? Find out.

Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.