The ANSWER – What causes LOW Blood Pressure in Elderly?

When it comes to medical conditions related to blood pressure, most of us often think of high blood pressure (hypertension). However, a person’s blood pressure can also drop too low and cause problems. What causes low blood pressure in elderly people? There are numerous causative factors we will look into in this article. On every heartbeat, a person’s blood pushes against their arteries, resulting in what is known as blood pressure.

Having low blood pressure (lower than 120/80) can result in some problems or point to some underlying issues, especially in elderly people. This article will look at the symptoms, causes, effects, and tips to prevent hypotension.

Symptoms of Low Blood Pressure

Depending on the severity of the condition, seniors might show few, mild, or easily discernible symptoms. Here are a few common signs and symptoms of low blood pressure [1].

  • Difficulty concentrating
  • Distorted or blurred vision
  • Dizziness
  • Fainting
  • Fatigue
  • Nausea

In more severe hypotension cases, the elderly person might exhibit signs of shock, which is a serious medical condition that might result from reduced blood flow throughout one’s body. Shock can also damage a person’s body at a cellular level. Keep in mind that a person in shock often needs urgent medical care. Here are some symptoms of shock to look out for.

  • Clammy skin
  • Disorientation or confusion
  • Rapid heartbeat
  • Shallow or rapid breathing
  • Weak pulse

Underlying Causes of Low Blood Pressure

Here are several factors [2] that can lead to hypotension in seniors.

Reduced Blood Volume

A significant decline in a person’s blood volume can result in a blood pressure drop. The blood volume decline can be caused by internal bleeding, dehydration, or major trauma. A considerable reduction in blood volume is a condition that requires immediate medical attention.

Medications

Certain medications can cause low blood pressure in seniors. These include beta-blockers, diuretics, hypertension drugs, drugs for Parkinson’s disease, narcotics, alcohol, and erectile dysfunction drugs. If you notice a change in blood pressure after taking certain medications, please consult your doctor for professional advice.

Heart Problems

Some heart conditions can result in low blood pressure. These include bradycardia (low heart rate), heart failure, heart attack, and heart valve disorders. These conditions limit the blood the heart can pump to the rest of the body, a situation that might result in significantly reduced blood pressure.

Endocrine Problems

Endocrine problems that might lead to low blood pressure include diabetes, low blood sugar, adrenal insufficiency, parathyroid disease, and hypothyroidism, among others. Some of these conditions result from problems with the body’s endocrine hormone-producing system.

Severe Infection (Septic Shock)

Septic shock is a medical condition in which bacteria leave an infection site and enter a person’s bloodstream. The bacteria then releases toxins that affect blood circulation vessels, a situation that can quickly become life-threatening. Some common original infection sites include the urinary tract, abdomen, and lungs.

Allergic Reaction (Anaphylaxis)

Anaphylactic shock is a condition that can be at times fatal and occurs in people who are super sensitive to certain foods, medicines, or compounds such as bee stings. Anaphylaxis is usually characterized by lowered blood pressure, swollen throat, itching, hives, and breathing problems. If the older adult you take care of suffers from anaphylaxis, it is important to get immediate medical attention.

Neural-mediated Hypotension

Neurally-mediated hypotension results from standing for too long and manifests in symptoms such as fainting, nausea, and vomiting. The condition can result from miscommunication between a person’s brain and their heart. Additionally, nutritional deficiencies such as those involving vitamins B-12 can also result in hypotension.

How Are the Elderly Affected by Low Blood Pressure

Hypotension can affect a senior in different ways [3] depending on the specific variant of low blood pressure. Here is a look at the four major types of hypotension in elderly people.

Postural Hypotension

Postural hypotension, also known as orthostatic hypotension, occurs when there is an abrupt blood pressure drop when a person stands up suddenly. If an elderly person was sleeping or sitting and then stood up abruptly, the heart might be unable to adjust the blood flow to suit the posture change. This poor adjustment can result in inadequate blood supply to the brain, resulting in loss of consciousness or dizziness.

Postural hypotension can result from recreational and prescription drugs or underlying medical conditions such as those affecting the endocrine system or heart.

Neurocardiogenic Syncope

This condition occurs when the elderly person loses consciousness, faints, or experiences a concussion due to a significant drop in blood pressure resulting from a nervous system communication breakdown. When the heart receives incorrect signals from the CNS, the blood vessels do not constrict and dilate as they are supposed to, affecting the blood pressure. Neurocardiogenic Syncope is also known as vaso-vagal syncope or neurally-mediated hypotension.

Postprandial Hypotension

The term prandial refers to food consumption. Sometimes, an elderly person can experience low blood pressure after consuming a large meal. This drop occurs as a result of increased blood flow to the digestive system, depriving other organs of sufficient blood. Postprandial hypotension can result in dizziness and fatigue.

Severe Shock-linked Hypotension

Shock is one of the most extreme cases of low blood pressure. When a senior goes into shock, their blood pressure drops to extremely low levels, depriving the brain and other organs of the blood required to function properly.

When to See a Doctor

Typically, a single low blood pressure reading is never a cause for alarm, especially when not accompanied by any other symptoms. However, if the senior is experiencing nausea, lightheadedness, and dizziness alongside a low-pressure reading, it is advisable to consult a doctor. To help with the diagnosis, it is important to keep a record of events leading up to the hospital visit.
Here is a look at some of the tests [4] your doctor might recommend in case of a blood pressure drop.

Blood Tests

A blood test can be used to diagnose hyperglycemia, hypoglycemia, or low red cell count, all causative factors for low blood pressure. Typically, blood tests do not take too long and can be quite vital in establishing what causes a senior’s drop in blood pressure.

Electrocardiogram (ECG)

An Electrocardiogram is a non-invasive test during which electrodes are attached to a person’s legs, arms, and chest. The electrode patches detect the person’s heart signals and display them on a screen or onto a graph paper. This test is designed to detect any irregularities or structural issues with the person’s heart. It can also be used to diagnose current or past heart attacks.

Tilt Table Test

If a person experiences postural or neurally mediated hypotension, a tilt table test can be used to determine how the person’s body reacts to positional changes. During the tilt table test, the patient lies on a table with their upper body raised on a table’s tilted section. The test then simulates movements from a horizontal to a vertical position.

Tips to Prevent Hypotension

Here are a few measures you can take to prevent or reduce the effects of low blood pressure.

  • Reducing alcohol intake and increasing water intake: Alcohol can lead to dehydration, which can lower blood pressure. On the other hand, water keeps a person hydrated and increases the blood volume, thus minimizing the occurrence of hypotension.
  • Make gentle movements: For seniors who experience postural hypotension, it is important to move between positions gently. Additionally, make a habit of sitting with your legs crossed.
  • Eat several small meals: Your blood pressure can drop considerably after one huge meal. To prevent this, consume several small meals instead of one big one. You should also limit your intake of bread, pasta, rice, potatoes, and other high-carb foods.
  • Exercise regularly: Exercising for about 30 to 60 minutes each day can help raise your heart rate and reduce the possibility of hypotension.

Conclusion

Low blood pressure can point towards underlying conditions in a senior. It can also lead to discomfort related to dizziness, loss of consciousness, or fatigue. If you notice your loved one exhibiting the symptoms outlined in this guide, get them medical attention. The preventative and treatment options described can also alleviate some of the effects of hypotension.

Citations

  1. https://www.medicalnewstoday.com/articles/319506#symptoms
  2. https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/low-blood-pressure-when-blood-pressure-is-too-low
  3. https://www.narayanahealth.org/low-blood-pressure/
  4. https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/diagnosis-treatment/drc-20355470
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