Our previous post discussed the causes of low blood pressure. It will be evident from there, that there are diverse low blood pressure causes. Treatments of low blood pressure (called hypotension in medicine) focus on the cause of low blood pressure and varies from patient to patient. Let us take each cause and its treatment. However, do read low blood pressure  where the basic information on this topic is discussed.

I have explained below

  • Low blood pressure home treatments,
  • Medical treatments of each cause,
  • Treatment for low blood pressure given in the elderly, and
  • Emergency treatment of low blood pressure.

Low Blood Pressure Treatments

Here each cause of low blood pressure is discussed from its treatment point of view. The treatment of low blood pressure, which can be done at home, is then varied accordingly.

1. Reduction in blood volume is treated by administration of I.V. fluids and electrolytes and blood if necessary.

2. Medications: Low blood pressure due to medications is treated by careful evaluation of the patient to find out if a change of medicine or its dosage is required.

3. Pulmonary embolism is an emergency and besides other supportive treatment, anticoagulants like heparin or warfarin are given to dissolve the clot.

4. Bradycardia caused by medication is accordingly treated by changing the medicine or its dosage.

5. Tachycardia may be due to atrial fibrillation or ventricular tachycardia and can be treated with oral medication. However. in stubborn cases, atrial fibrillation may require an electric  defibrillator and ventricular tachycardia may require an implantable defibrillator.

6. Pericarditis can be treated by a surgical procedure whereby the pericardial fluid is removed and treatment is given for the inflamed pericardium.

7. Postural Hypotension (also called orthostatic hypotension) is caused by the pooling of the blood in the lower extremities when a person gets up after lying down or sitting down for a long time. Normally, the blood does return to the heart due to the body’s own mechanism, but in patients with postural hypotension, this does not happen.

Due to retention of blood in the lower extremities, the brain gets less blood supply and you may experience dizziness.

Treatments of postural hypotension with dizziness

  • Postural or orthostatic hypotension and the onset of its symptom of dizziness are best treated immediately by sitting or lying down immediately. The dizziness disappears as fast as it had appeared. Always stand up from a sitting down or lying down position gradually. Sleep with your leg end of the bed raised to encourage blood flow to the heart and the brain.
  • Make lifestyle changes like drinking adequate water throughout the day (10 to 12 glasses), avoiding alcohol, and exercising especially to strengthening the leg muscles.
  • Use compression stockings to avoid pooling of blood in the legs, so that the return of blood to the heart is normal.
  • Your doctor may prescribe medications such as fludrocortisone and midodrine (ProAmatine).  They help by increasing blood volume and limiting the ability of the arteries to expand thereby increasing blood pressure and blood flow throughout the body.

Home treatments for low blood pressure and its symptoms of dizziness and light-headedness:

  • Such patients are encouraged to drink more coffee as caffeine causes constriction of the veins.
  • They are also advised to increase intake of salt.
  • Such patients should get up slowly. Any change of posture should be gradual.
  • Medicines given for such cases have side effects and you must follow up with your physician.

Drugs for low blood pressure treatment

If natural remedies do not work, drugs are used to treat the low blood pressure with symptoms.

  • Fludrocortisone works by promoting sodium retention by the kidney, thereby causing fluid retention. This increases blood volume and helps increase blood pressure. Sodium retention results in loss of potassium. It is necessary, therefore, to take potassium supplements when on Fludrocortisone therapy.  However, even in low doses, it is poorly tolerated by older patients in the long-term treatment with hypotensive disorders.
  • Midodrine is used in patients who have difficulty doing their daily duties due to postural hypotension. It increases the blood pressure by activating the alpha-adrenergic receptors of the small blood vessels, producing an increase in vascular tone and elevation of blood pressure. It reduces the symptoms of dizziness and fainting caused by symptomatic postural hypotension.

Treatment of low blood pressure in the elderly

Postural hypotension is a common problem seen in senior and elderly people and it can cause significant complications.

Causes of acute and chronic postural hypotension differ. The acute form may be due to medications, blood loss or adrenal gland damage. The chronic form is usually due to altered blood pressure regulatory mechanisms and autonomic nervous system dysfunction.

While hypotensive patients with no symptoms usually require no treatment, those with symptoms require medical intervention.

  • Your doctor may avoid potentially hypotensive medications
  • Promote venous blood return from the peripheral parts of the body to the heart by certain exercises and by applying physical counter-maneuvers that increase muscle skeletal tone, e.g. leg crossing and muscle tensing. This is done by crossing the legs and standing firmly on both the legs. This is an important part of the management of low blood pressure in the elderly patients, which increases the mean arterial pressure.

Emergency treatment for low blood pressure

Low blood pressure due to shock is usually a medical emergency and is treated in the hospital.

  • The patient is first placed supine and his legs raised to allow more blood to flow to the heart.
  • Intravenous infusion with blood or normal saline is given depending on the merit of the case.
  • Medications such as dobutamine, dopamine and norepinephrine are administered to increase the pumping action of the heart and increase blood pressure.
  • Other medicines such as antibiotics may be given if required.

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