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Low blood pressure (hypotension)

A basic distinction is made between so-called chronic asymptomatic hypotension, which is not considered to be a disease, and other types of hypotension, which cause symptoms. In these types, the blood pressure suddenly drops sharply to low values ​​and causes more or less severe symptoms. The three main types are orthostatic hypotension, neural mediated hypotension, and so-called severe hypotension.

Chronic asymptomatic hypotension

Here, people have permanently low blood pressure without complaints or need for treatment. Young, slim people (especially girls and women) and lean older people are often affected. Usually no cause can be determined, then one speaks of primary hypotension. Pregnancy often results in low blood pressure, which levels off again after birth.

Orthostatic hypotension

This occurs when you get up from sitting or lying down. It occurs when the body is unable to adjust blood pressure and blood distribution quickly enough to suit the change in position. The drop in blood pressure usually only lasts a few seconds or minutes and quickly returns to normal. Orthostatic hypotension can occur in all age groups, but is more common in older people, especially those who are frail or sick. It can be a symptom of another illness.

Neural mediated hypotonia (LMWH)

This occurs when the brain and heart do not communicate properly with each other. It can occur after standing for a long time, but also as a reaction to exciting or frightening situations. This type is more common in children and young adults than in older people.

Severe hypotension

This form is often associated with shock. The blood pressure drops so much that the brain, kidneys and other vital organs are not supplied with enough blood to perform their functions. In extreme cases, a life-threatening state of shock occurs. Possible causes include:

  • Cardiovascular diseases:e.g. acute coronary syndrome, acute heart failure, heart valve defects, cardiac arrhythmias;
  • Diseases that reduce the heart's output capacity:e.g. effusion or tamponade of the pericardium, pneumothorax, pulmonary embolism;
  • Conditions that lead to decreased peripheral vascular constriction and altered blood distribution:e.g. stroke, diabetes mellitus, Parkinson's disease, chronic liver disease;
  • low fluid volume (hypovolaemia) as a result of severe bleeding or excessive fluid loss: e.g. vomiting, diarrhea, kidney disease, certain medications such as diuretics, profuse sweating, extensive burns, ascites;
  • Infections;
  • Medication:e.g. antihypertensive drugs such as beta blockers;
  • hormonal diseases:E.g. hypofunction of the adrenal cortex (Addison's disease), hypothyroidism
  • allergic reaction;
  • Poisoning.