Current Medical Issues

CLINICAL QUERIES
Year
: 2016  |  Volume : 14  |  Issue : 4  |  Page : 83--84

Clinical questions: Responses to queries from readers: Blood Pressure


Kirubah V David 
 Professor, Department of Family Medicine, CMC, Vellore, India

Correspondence Address:




How to cite this article:
David KV. Clinical questions: Responses to queries from readers: Blood Pressure.Curr Med Issues 2016;14:83-84


How to cite this URL:
David KV. Clinical questions: Responses to queries from readers: Blood Pressure. Curr Med Issues [serial online] 2016 [cited 2019 Dec 13 ];14:83-84
Available from: http://www.cmijournal.org/text.asp?2016/14/4/83/194453


Full Text

Question 2

What is the treatment for hypotension in a 30 - year-old man with BP of 90/50 mm Hg since 8 years? He is otherwise asymptomatic and does his routine job in the village looking after cattle.

Dr. Gayatri R. Banerjee, Bargarh, Odisha.

Answer:

Hypotension is a relative term because the blood pressure of an individual varies with age, underlying stage of life, activity, and medications. Any blood pressure below the normal baseline for that individual with distressing symptoms such as dizziness, nausea, fainting spells, cold clammy skin, breathlessness or palpitation, and increased thirst needs to be evaluated for a cause. The management of hypotension includes treating the cause rather than the physical finding.

If the individual is asymptomatic, he/she needs to be counseled on adequate hydration, especially if the occupation includes increased sun exposure; further management is usually not required. A fall in blood pressure of 20 mmHg below baseline can often cause symptoms. The normal blood pressure according to current guidelines is 120/80 mmHg; however, systolic BP up to 90 and diastolic up to 60 mmHg are acceptable, especially if the patient is asymptomatic and otherwise normal.

Common causes of symptomatic hypotension are as follows:

Physiological causes like pregnancy: In pregnancy, the circulatory system expands and can cause hypotension. This returns to the prepregnancy level after deliveryDiseases of the cardiovascular system such as acute myocardial infarction, congestive cardiac failure, arrhythmias, and diseases of the heart valveDiseases of the endocrine system such as hypoparathyroidism, hypoglycemia, and Addison's diseaseDehydration secondary to diarrhea and vomitingAcute blood loss due to internal and external hemorrhageSevere infection like sepsisAnaphylaxisIron deficiency anemia and B12 and folate deficiency.If the patient is asymptomatic and has no other clinical findings on physical examination, he/she needs to be counseled to prevent dehydration.