Understanding Low Blood Pressure - Treatment

How Do I Know If I Have Low Blood Pressure?

Your doctor can determine if you have significant low blood pressure. Symptoms of dizziness and lightheadedness when you stand up don't necessarily mean that you have postural hypotension, or low blood pressure. A wide range of underlying conditions may cause your symptoms. It's important to identify the cause of low blood pressure so appropriate treatment can be given.

Your doctor will look at your medical history, age, specific symptoms, and the conditions under which the symptoms occurred. He or she may perform repeated evaluation of your blood pressure and pulse rate -- after you've been lying down for at least 5 minutes and after you stand quietly for 1 minute and 3 minutes -- to look for postural hypertension.

Other tests may be performed, such as an ECG (electrocardiogram) to measure heart rate and rhythm problems and an echocardiogram (an ultrasound test to visualize the heart). You may also have blood tests to look for anemia or problems with your blood sugar levels.

More sophisticated home ECG monitoring (a Holter monitor or "event" monitor) may be necessary to check for heart problems that occur intermittently.

An exercise stress test or electrophysiology test (EP test) may also be helpful.

Serious forms of postural hypotension may require a test called a "tilt table" test. This test evaluates the body's reaction to position and changes in position. The person lies on a table, is safely strapped in, and the table is raised to an upright position for up to an hour. Blood pressure, heart rate, and symptoms are recorded. Often, medications are given to help guide treatment.

What Are the Treatments for Low Blood Pressure?

If you have an underlying medical problem that causes low blood pressure, seek treatment for the underlying condition. For many people, chronic low blood pressure can be effectively treated with diet and lifestyle changes.

Initially, your doctor may counsel you to increase your blood pressure by making these simple changes:

• Eat a diet higher in salt.
• Decrease your intake of caffeine.
• Drink lots of nonalcoholic fluids -- a minimum of 8 glasses per day. Sports drinks that are high in sodium and potassium are recommended, especially during exercise or in hot weather.
• Consume extra salt and drink more fluids during hot weather and while sick with a viral illness, such as a cold or the flu.
• Have your doctor evaluate your prescription and over-the-counter medications to identify any that may be causing your symptoms.
• Get regular exercise to promote blood flow.
• Be careful when rising from a lying down or sitting position. To improve circulation, pump your feet and ankles a few times before standing up. Then proceed slowly. When getting out of bed, sit upright on the edge of the bed for a few minutes before standing.
• Elevate the head of your bed at night by 5 to 20 degrees, by placing bricks or blocks under the head of bed.
• Avoid heavy lifting.
• Avoid straining while on the toilet.
• Avoid prolonged exposure to hot water, such as hot showers and spas. If you get dizzy, sit down. It may be helpful to keep a chair or stool in the shower in case you need to sit; to help prevent injury, use a nonslip chair or stool designed for use in showers and bath tubs.
• To avoid problems with low blood pressure and lessen episodes of dizziness after meals, try eating smaller, more frequent meals. Rest after eating. Avoid taking low blood pressure drugs before meals.
• If needed, use elastic support (compression) stockings that cover the calf and thigh. These may help restrict blood flow to the legs, thus keeping more blood in the upper body.
• If you can tolerate coffee without too many side effects, drink coffee in the morning. The amount of caffeine normally found in 2 cups of coffee (250 mg) can decrease low blood pressure in young adults and can be safely used by older adults as well.