First aid for low blood pressure: what and how to do correctly

Blood pressure is one of the most important indicators of health, depending mainly on vascular tone and the volume of circulating blood. Everyone knows about the dangers of high blood pressure. What do doctors say about low?

The normal blood pressure level at any age is less than 140/90 mmHg. Art. Increased blood pressure above 140/90 mm Hg. Art. called arterial hypertension, or hypertension. This condition is dangerous due to the development of strokes, heart attacks and other cardiovascular complications; it requires treatment and medical supervision even if you do not feel it. What can we say about low blood pressure?

Natalya Polenova—candidate of medical sciences, family doctor, cardiologist, pediatric cardiologist, nutritionist at GMS Clinic.

Hypotension (a blood pressure drop of less than 90/60) is usually not dangerous to health. Constantly low blood pressure levels often occur in young girls of fragile constitution, but this, as a rule, does not affect the quality of life.

Persistent hypotension if you feel well does not require treatment. But, if the pressure drops sharply and this leads to fainting or causes a pre-fainting state, medical attention and additional examination may be required.

Reducing blood pressure in the following situations deserves special attention:

Orthostatic hypotension is loss of consciousness when there is a sudden change in body position from horizontal to vertical, for example when suddenly rising from bed. Because of this, the volume of circulating blood is redistributed and the blood supply to the brain is temporarily reduced. This condition often occurs in pregnant women due to changes in the circulatory system and a shift in the center of gravity. Therefore, during pregnancy, it is important to avoid sudden movements and carefully get out of the car or get up from a chair.

Taking medications to lower blood pressure. The goal of antihypertensive therapy is to achieve a sustained reduction in blood pressure below 140/90 mmHg. Art., but without episodes of sharp decline. An inappropriate dosage of the drug can cause hypotension - this leads to weakness, fatigue during physical activity and dizziness. In this case, it is necessary to conduct daily monitoring of blood pressure and adjust therapy.

Fainting is a short-term loss of consciousness due to impaired blood supply to the brain. For complete loss of consciousness, a sudden cessation of cerebral blood flow for 6–8 seconds is sufficient.

Types of fainting:

• reflexive, due to fear, pain, heat or stuffiness;
• orthostatic, with a sharp transition to a vertical position;
• cardiogenic, for diseases of the heart or blood vessels, as well as due to heart rhythm disturbances.

After a sudden loss of consciousness, especially if it is a repeated occurrence, you should seek medical help. You may need to consult a therapist, cardiologist, or neurologist. In addition, it is important to undergo examinations: Holter monitoring, record an ECG and conduct an MRI of the brain. And also examine the level of sugar, iron and thyroid hormones.

What is blood pressure

Blood pressure (BP) is one of the health constants by which one can judge the state of the body.
This concept is associated with the constant work of the heart muscle, which, like a pump, pumps blood into large vessels. As blood flows through arteries, it puts pressure on their walls. Blood pressure indicators depend on the elasticity of the walls of blood vessels and the volume of blood entering them at the time of contraction of the heart muscle.

Normal blood pressure in an adult is 120/80 mm. Hg Art. The first number is the pressure at the moment of maximum contraction of the heart muscle, it is called systolic or upper. The second characterizes blood pressure at maximum relaxation of the heart - this is the lower or diastolic pressure.

Normal pressure indicates a sufficient level of oxygen in the blood and high elasticity of the walls of blood vessels.

Blood pressure indicators are affected not only by the work of the heart and the condition of blood vessels; they can change under the influence of a number of factors, for example, emotional state, weather, physical activity.

Blood pressure needs to be constantly monitored. And immediately contacting a doctor in the event of a persistent decrease or increase will allow you to identify health problems at an early stage and avoid the risks of developing serious pathologies.

Arterial hypotension - symptoms and treatment

During the day, blood pressure changes depending on body position, breathing, stress, physical condition, medications taken, how much a person eats and drinks, and the time of day. Physiologically, BP is usually lowest at night and rises sharply upon awakening.

The human body has certain mechanisms to maintain blood pressure and blood flow at normal levels. These mechanisms are interconnected: the walls of the arteries, determining the level of blood pressure, send signals to the heart, arterioles, veins and kidneys to regulate blood flow. Blood pressure primarily depends on peripheral resistance of blood vessels and cardiac output.

Peripheral vascular resistance is the total resistance of the entire vascular system to the flow of blood that is ejected by the heart into the arteries. The muscle tissue in the walls of arterioles allows these blood vessels to dilate or contract. The stronger the arterioles contract, the higher their resistance to blood flow and the more the blood pressure increases, because in order to push blood through a narrower lumen, more pressure must be applied. Conversely, when arterioles dilate, resistance to blood flow decreases, leading to a drop in blood pressure. The degree of narrowing or dilation of arterioles can be regulated by nerves, hormones, and medications.

At the same time, the regulatory mechanisms of the heart change cardiac output (the amount of blood pumped by the heart into the arteries in one minute). Blood pressure can increase due to increased heart rate and therefore more blood being pumped into the arteries. Veins can dilate, narrow, and deposit (accumulate) more blood. That is, the more blood the heart pumps per minute, the higher the pressure will be, as long as the diameter of the arteries remains unchanged. The volume of blood during each beat depends on the force of contraction and the function of the valves. The total volume of blood in the arteries may depend on the volume of fluid in the body, the volume of fluid removed through the kidneys, and the use of medications.

The kidneys, in turn, respond to these changes by increasing or decreasing the amount of urine excreted, which changes blood volume, affecting blood pressure [6].

All these adaptive mechanisms maintain blood pressure within normal limits.

The physiological tendency towards hypotension and a low pulse in athletes is nothing more than a protective reaction of the body to constant physical activity. With constant exercise that requires endurance, the cardiovascular system undergoes a restructuring: it begins to work in a more economical mode. This hypotension is called high-training hypotension [31].

Theories of the occurrence of pathological AHT

Endocrine. In accordance with this theory, the disease can have adrenal, pituitary and hypothyroid origin. The reasons are:

• decreased synthesis of hormones that increase blood pressure (catecholamines, vasopressin, mineralocorticoids, adrenocorticotropic hormone, thyroid hormones);
• decreased sensitivity of vascular and cardiac receptors to these hormones.

This leads to a decrease in total peripheral vascular resistance, circulating blood volume and cardiac output.

Vegetative theory. According to it, the occurrence of arterial hypotension is associated with an increase in the activity of the cholinergic system and a decrease in the activity of the adrenergic system [4][17]. In this case, the following occurs in blood plasma and daily urine:

• the content of acetylcholine increases, a substance that is involved in the transmission of impulses in different parts of the brain, while its small concentrations facilitate this transmission, and its large concentrations inhibit it;
• the level of catecholamines decreases - active substances that directly or indirectly increase the activity of the endocrine glands, stimulate the hypothalamus and pituitary gland, which are involved in maintaining blood pressure levels.

Neurogenic. According to this theory, under the influence of psychogenic factors there is a change in neurodynamic processes in the cerebral cortex, a violation of the relationship between the processes of excitation and inhibition both in the cortex and in the subcortical autonomic centers [14]. This leads to hemodynamic disturbances, the most important of which is considered to be capillary dysfunction with a decrease in total peripheral resistance. The mechanism for the development of arterial hypotension is to reduce the tonic (contractile) effects of the sympathetic nervous system on the walls of blood vessels and the heart.

The humoral theory suggests that arterial hypotension is caused by an increase in the level of kinins (low molecular weight peptides that cause contraction and relaxation of smooth muscles), prostaglandins A and E (a group of lipid physiologically active substances formed enzymatically in the body), which have a vasodilating effect.

According to the metabolic theory , AHT is associated with a metabolic disorder of substances with hypo- and hypertensive effects. The causes may be dystrophic changes in organs and tissues (due to chronic intoxication, infections, starvation). In this case, the drop in blood pressure is associated with a decrease in the production and/or effects of active metabolites with a hypertensive effect (endothelin, thromboxane A2, angiotensinogen, etc.), a decrease in the tone of the myocytes of the arteriolar walls, and a decrease in the contractile function of the heart muscle. Sometimes the cause is a decrease in water content in the body. Taken together, these factors cause a persistent decrease in blood pressure.

Causes of low blood pressure

A decrease in blood pressure by no more than 20 mm Hg. Art. - this is a relative norm; usually these fluctuations are temporary and do not affect general well-being. Pathology is indicated when for a long time the readings do not exceed 100/60 mmHg. Art. This condition is called arterial hypotension and is divided into several types:

• Physiological. Low pressure at rest is often observed among professional athletes, people working in hazardous industries, and living in high mountain areas with a rarefied atmosphere. It is also observed in those living in conditions of very low or high temperatures, for example, in the Far North or in regions with a tropical climate. This type of hypotension is called adaptive or compensatory.
• Pathological, that is, arising against the background of systemic diseases or decreased physical activity. This condition leads to poor circulation. Disruption of the mechanisms of blood pressure regulation and the development of hypotension can occur due to hormonal imbalance, for example, with hypothyroidism or adrenal dysfunction. Hereditary predisposition also plays a major role. Another reason for a sudden decrease in blood pressure may be an acute allergic reaction - anaphylactic shock.
• Neurogenic - diagnosed mainly in adolescence, often as a result of brain injuries or autonomic disorders. This type of hypotension occurs due to dysfunction of the nervous system or problems with cerebral circulation.
• Medication. The reason for a sharp decrease in blood pressure is often due to uncontrolled use of drugs to lower blood pressure or diuretics.

Low blood pressure can be a symptom of various diseases, in this case they speak of secondary arterial hypotension. A decrease in pressure is typical for osteochondrosis, inflammatory infectious diseases, heart failure, stomach ulcers and a number of others.

A sharp decrease in pressure can occur against the background of anaphylactic shock, severe bleeding, intoxication of the body, and prolonged dehydration. The tonometer will show low blood pressure values ​​in case of chronic fatigue, constant lack of sleep, depression.

Hypotension can also be a consequence of poor nutrition, when a person, in order to quickly lose weight, switches to a diet with a significant calorie deficit. In women, blood pressure often drops when there is heavy bleeding during menstruation.

Important! The choice of drugs to increase and decrease blood pressure cannot be made independently or on the advice of friends. This can aggravate the situation and lead to irreversible consequences.

Only a doctor can understand the reasons for the decrease in pressure and prescribe the correct treatment after conducting a comprehensive examination.

For what reasons does blood pressure most often drop?

There are two main types of arterial hypotension – physiological and pathological. In the first case, the patient feels absolutely normal, he does not express any complaints, since the indicators are quite normal for him. In such a situation, assistance is not required. If low blood pressure is a sign of a specific disease, the clinical picture includes additional symptoms that significantly impair a person’s quality of life, suggesting a concomitant disease.

Primary, or essential hypotension develops for reasons that are inexplicable to modern medicine. Doctors suggest the influence of a sum of factors: individual genetic characteristics, reduced (sometimes increased) physical activity, excessive emotional and mental stress, poor nutrition.

When the cause of hypotension is a specific disease, we are talking about secondary (symptomatic) hypertension, which develops as a result of:

• vegetative-vascular dystonia;
• spinal cord injuries and diseases;
• endocrine disorders (hyperthyroidism, hypoglycemia, Addison's disease);
• taking certain medications or poisoning with them (most often occurs with an overdose of drugs to treat a hypertensive crisis);
• dehydration due to fever, prolonged vomiting or diarrhea, increased sweating (hyperhidrosis);
• infectious diseases;
• allergic reactions;
• acute or chronic blood loss;
• fasting (postprandial hypotension).

A special type of this condition is considered to be orthostatic hypotension, in which symptoms of low blood pressure appear with a sudden change in body position, for example when standing up. The condition is more common in older people.

Symptoms of Low Blood Pressure

Low blood pressure can lead to dizziness.
Photo: cookie_studio / freepik.com Manifestations of hypotension depend on the causes of its occurrence and the form of the disease. If the pressure drops due to an existing disease, then the main symptoms will be precisely the signs of the underlying pathology. These will be supplemented by a constant feeling of fatigue, general weakness, irritability, rapid pulse, headache, and increased sweating.

Physiological hypotension is most often a common condition for a person, and he may not experience any discomfort.

With a sharp decrease in blood pressure, a person may lose consciousness or complain of:

• dizziness;
• vision problems;
• lack of confidence when walking;
• difficulty breathing.

In this condition, there is significant paleness of the skin, unsteadiness of gait, some confusion, and inhibited speech are possible.

An acute condition requires immediate medical attention.

Important! If you notice a change in a person's facial expressions, loss of orientation, severe shortness of breath or excessive agitation with signs of hallucinations, call an ambulance immediately. These symptoms are characteristic of pre-stroke and pre-infarction conditions - in them every minute is precious.

How to increase blood pressure quickly and effectively

Source: Raeann Buskey/Pixy.org
Only a doctor can prescribe medications for high blood pressure. But it is possible to help a person in an acute situation and alleviate his condition during a sudden attack of hypotension without medications.

Coffee

Drinking a cup of strong, freshly ground coffee is the best solution. Caffeine has a pronounced vasoconstrictor effect, so it reduces blood pressure well and has a tonic effect.

Massage

Impact on some biologically active points irritates the nerve endings and activates the blood circulation process. Massage has a beneficial effect on all body systems, accelerating metabolism and toning blood vessels.

Important! Massage is a procedure for actively influencing the body and should be trusted to professionals with medical education. Incorrect massage technique can cause significant harm to health.

Massage can improve mood, relieve spasms, relieve headaches and joint pain, and normalize sleep.

Increasing blood pressure with nutrition

If low blood pressure is not associated with internal diseases, then it can be easily normalized by including some foods in the diet:

• green tea - it tones well and improves blood circulation;
• kefir, fermented baked milk, yogurt, cottage cheese and other fermented milk products;
• celery root, which can be added to salads or other dishes;
• strawberries, fresh vegetables and fruits - carrots, tomatoes, pumpkin, apples;
• beet juice.

The diet for hypotension is aimed at increasing the overall tone of the body, replenishing the deficiency of vitamins and minerals, accelerating metabolic processes and normalizing the water-salt balance.

Pharmacy tinctures

Herbal tinctures are widely used to increase blood pressure and generally strengthen the body. To be safe and avoid the risk of incorrect dosage, it is better to buy tinctures at a pharmacy and strictly follow the directions on the package. And in the future, it is better to consult a doctor and choose the formulations that he recommends.

Ginseng tincture

Ginseng root has been used medicinally for over two thousand years. One of the main properties of this plant is its ability to regulate blood pressure. Depending on the dosage, ginseng root tincture is used to both increase and decrease blood pressure.

A decrease in blood pressure when taking the tincture occurs due to:

• increasing the overall tone of the body;
• strengthening the walls of blood vessels;
• improved appetite;
• normalization of emotional state;
• acceleration of metabolic processes.

Before taking ginseng tincture, you should consult your doctor and make sure there are no contraindications.

Eleutherococcus tincture

It is a proven remedy for nervous disorders, problems with the immune system and low blood pressure.

It is believed that the product improves performance and speeds up metabolism. It is prescribed for general exhaustion of the body, physical overload, anemia, and atherosclerosis. The biologically active substances contained in the tincture increase vascular tone and normalize blood pressure.

The dosage and duration of treatment is determined by the doctor based on the severity of symptoms and the absence of contraindications.

Schisandra tincture

Chinese lemongrass is a type of climbing vine. Its fruits, which contain essential oils, organic acids and microelements beneficial to the body, are used in medicine.

Schisandra tincture increases vascular tone and has a general tonic effect. The product can be used to quickly raise blood pressure and normalize well-being.

Important! All herbal products can only be used as adjuvant therapies. They should be taken only after consultation with your doctor at the recommended dosage.

How does low blood pressure manifest in humans?

Regardless of the cause of arterial hypotension, this condition is characterized by impaired vascular tone and a sharp weakening of cardiac activity.
As a result, the blood supply to brain cells decreases, which begin to experience oxygen starvation. The most common symptoms of low blood pressure include:

• dizziness, darkening and spots before the eyes;
• noise in ears;
• pale skin and increased sweating;
• nausea;
• tachycardia (rapid heartbeat), which occurs as compensation for the restoration of blood flow;
• headache;
• constant weakness, drowsiness, fatigue;
• syncope (loss of consciousness, fainting);
• menstrual cycle disorders in women.

With long-term hypotension due to chronic oxygen starvation of the brain, encephalopathy develops, which is characterized by impaired memory, concentration, and intelligence. Another dangerous complication can be traumatic brain injury after a fall due to frequent loss of consciousness.

In most cases, hypotension is characterized by a gradual development of symptoms, which allows you to notice signs of low blood pressure in time and provide first aid.

How to increase blood pressure urgently

Source: CC0 Public Domain
If the pressure has dropped sharply, and there are no medications at hand, it can be quickly increased using the following methods:

• eat something salty, for example, a pickled cucumber, a tomato or a slice of well-salted lard;
• drink a lot of plain clean water;
• Brew strong coffee and drink in small sips.

In case of repeated attacks, you should consult a general practitioner or cardiologist and undergo a comprehensive examination.

Diagnostics

During the initial examination, a general practitioner or cardiologist assesses the constitution and nutritional status, and conducts a physical examination of the respiratory and cardiovascular systems. In addition to standard blood pressure measurements, 24-hour blood pressure monitoring is recommended to obtain a complete picture. A diagnostic search involves the appointment of a set of laboratory and instrumental methods:

• Blood tests.
  The hemogram often has a reduced content of hemoglobin and red blood cells, and with infectious shock, high leukocytosis is observed. During a biochemical blood test, attention is paid to the level of total protein, electrolytes, and cholesterol. For symptoms of anemia, serum iron, ferritin, and transferrin levels are examined.
• Hormonal studies.
  If persistently low blood pressure is detected, the level of thyroid hormones T3 and T4 and the pituitary hormone TSH must be measured. The concentration of catecholamines and adrenal steroid hormones is determined in the blood and urine. According to the indications, the level of insulin and C-peptide is assessed.
• ECG.
  Used as a screening method to assess the electrical activity of the heart. If cardiac arrhythmias and signs of myocardial ischemia are detected on the cardiogram, echocardiography is necessary. With echocardiography, the contractility of the heart is assessed and structural anomalies are found.
• Neurological examination.
  In the absence of other causes of low blood pressure, the patient is referred to a neurologist. To assess the functioning of the autonomic nervous system, the doctor performs breath-holding tests during inhalation and exhalation, orthostatic and clinostatic tests.

Increased blood pressure without medication

A contrast shower will help raise your blood pressure.
Photo: andranik.h90 / freepik.com Some people do not trust traditional medicine and prefer to be treated with folk remedies. If you feel unwell due to a sudden drop in blood pressure, for example, due to a sudden change in weather or a long flight, you can try to raise it without medication:

• take a contrast shower;
• eat a few slices of dark chocolate;
• drink a couple of cups of strong natural coffee - yes, coffee can really help quickly.

However, if hypotension is associated with existing diseases, it is better to avoid such express methods so as not to harm the body.

Medicines for high blood pressure

Medicines to increase blood pressure are prescribed in emergency cases or for prolonged hypotension. The choice of drug is based on the nature of the disease and examination results.

The main groups of drugs for lowering blood pressure:

• Caffeine-based drugs are used to urgently increase blood pressure in critical situations. They are administered intramuscularly or intravenously by emergency or hospital doctors. Caffeine is contraindicated in cases of cardiac arrhythmias and heart failure.
• Analeptics that affect the respiratory and vasomotor centers of the brain.
• Glucocorticoids - increase blood pressure by constricting blood vessels; they are used quite rarely due to the large number of side effects.
• Adrenergic agonists that affect the muscles of the heart, blood vessels and some other drugs.

Any drugs to increase blood pressure are used only as prescribed by a doctor and strictly in the dosage prescribed by him.

News

This is the name given to the development of fainting when loss of consciousness occurs after abruptly getting up from a place, remaining in a state of motionless standing for a long time, or performing heavy physical work.

What are the causes of orthostatic hypotension? Hypotension, or orthostatic shock, occurs due to dysregulation of blood pressure when it drops sharply and blood supply to the brain is reduced.

Orthostatic hypotension can develop in the following situations:

• decrease in the total volume of blood circulating in the body - hypovolemia,
• decreased cerebral vascular tone,
• exposure to certain medications and substances.

Hypovolemia can develop due to the loss of a large amount of blood due to injuries, bleeding, and in women - with heavy menstruation.

Blood plasma volume decreases with profuse sweating during fever and excessive physical exertion, especially in hot conditions.

A lot of fluid also leaves the body when there is excessive urination, which occurs during some diseases.

During vomiting and diarrhea, the body also loses fluid, which must be compensated.

All these factors lead to a decrease in the volume of circulating blood, as a result of which orthostatic collapse occurs.

The tone of cerebral vessels, especially their timely contraction and expansion, ensures the normal functioning of the body. Vascular tone is regulated by the nervous system. When this regulation is disrupted for one reason or another, orthostatic shock may develop.

Impairment of nerve fiber impulses occurs during a number of diseases, such as diabetes mellitus, vegetative-vascular dystonia, pulmonary artery thrombosis, atherosclerosis, anemia, adrenal tumors, as well as during prolonged bed rest.

Vascular tone can be altered by hormonal imbalances that occur during puberty, pregnancy and menopause.

Orthostatic shock can be a side effect of certain medications (antihypertensive drugs, fast-acting diuretics, nitrates, antiparkinsonian drugs, narcotics, etc.).

Risk factors:

• emotional stress,
• stress,
• depressive states,
• severe fatigue, including mental fatigue,
• physical, psychological,
• consumption of alcoholic beverages.։

What are the symptoms of orthostatic hypotension?

When suddenly rising from a lying position, after prolonged standing, as well as after excessive physical exertion, the following phenomena are observed:

• development of sudden severe general weakness,
• pale skin,
• dizziness,
• visual impairment (symptoms of tulle curtain, “midges”),
• possible nausea, vomiting,
• characterized by clouding of consciousness, fainting,
• possible limb spasms,
• At times there is involuntary urination.

How to diagnose orthostatic hypotension?

This condition is diagnosed by measuring blood pressure while standing (low) and lying down (normal), followed by comparison of the values.

Orthostatic hypotension is diagnosed if the difference is (in mmHg):

• systolic – 20 mm Hg. and higher,
• diastolic – 10 mm Hg. and higher.

In addition, pay attention to the presence of symptoms of cerebral circulatory failure - pallor, fainting, etc.

For diagnosis, a special test is used - an orthostatic test. It is carried out as follows - a person is placed on a rotating table and left to lie for 5 minutes, after which the table is sharply raised to a vertical position.

The following examinations are also carried out:

• clinical blood test (detection of anemia),
• biochemical blood test (assessment of the activity of internal organs),
• determination of hormones in the blood,
• examination of the heart condition, detection of autonomic disorders (Holter monitoring),
• neurological tests.

Treatment is prescribed depending on the mechanisms of development of the pathology.

Why is orthostatic hypotension dangerous?

Conditions of orthostatic hypotension cannot be ignored. They may be a manifestation of a serious pathology that requires treatment.

Constant oxygen starvation associated with insufficient blood supply to the brain is dangerous for memory deterioration and the development of neurological disorders. In older people, this condition threatens the development of stroke and dementia (dementia).

In addition, sudden fainting can cause injury due to a fall.

Some prevention techniques:

If symptoms develop, it is necessary to reconsider the regimen of medications taken due to the possible connection of symptoms with the side effects of these drugs.

You should not make sudden movements, you should avoid physical exertion, prolonged standing, and, if possible, emotional experiences.

If the patient has been on long-term bed rest, a gradual exit from such a regime is necessary. Before getting out of bed, you need to do a few simple exercises while lying down, then sitting.

In your diet, you need to somewhat limit meat dishes, especially fatty, hot spices. We must give up alcoholic drinks. You should drink enough water to avoid dehydration.

If episodes recur, you should consult a doctor!

Tips and tricks

Arterial hypotension is a dangerous condition that can be a harbinger of serious problems with cerebral circulation and the first sign of an impending stroke or heart attack. There are different ways to increase blood pressure, but all of them must be approved by your doctor.

Any problems with the heart and blood vessels must be addressed comprehensively, and self-medication is unacceptable here. You should also not rely too much on traditional medicine - medicinal herbs can be part of a therapeutic complex only as auxiliaries.

To normalize blood pressure, you should avoid stressful situations, get enough sleep, give up bad habits and pay attention to a proper diet.

How to improve blood pressure permanently

Regular physical activity is needed to maintain normal blood pressure.
Photo: tertyshnyk_oksana / freepik.com To consolidate success, you can make changes to your lifestyle and increase your blood pressure for a long time. For example, you can:

• Switch to a diet with a high salt content - but only a little, it is important not to go beyond the adequate recommendations;
• Reduce consumption of alcoholic beverages;
• In hot weather, drink more fluids;
• Ask the doctor to evaluate the medications the person is prescribed to take. Perhaps some of them have hypotension as a side effect;
• Play sports - at least 150 minutes of physical activity per week;
• Reduce the time you spend standing still.

If necessary, your doctor may recommend elastic compression stockings that cover the calf and thigh. They will help limit blood flow to your legs—and keep more blood in your upper body.

Treatment of hypotension

If a patient experiences the above symptoms, try (if possible and if you have the appropriate skills) to measure the person’s blood pressure using a tonometer. If the results are below normal, it is necessary to immediately provide the victim with first aid. When, despite your efforts, the condition does not improve, it is recommended to call the emergency team.

First aid

First aid for hypotension is provided according to the following algorithm:

1. Place the person on a hard, level surface. Raise your lower limbs and lower your head slightly to ensure blood flow to the central organs - the brain and heart. This position is called anti-shock.
2. Provide fresh air. To do this, open a window if you are indoors and clear your airways by loosening tight clothing.
3. If the patient has medications for hypotension, help him take them.
4. Give the victim some hot sweet tea or coffee. You can also offer to eat something salty.

If the patient has lost consciousness, follow these steps:

1. Provide anti-shock position.
2. Do not hit the victim on the cheeks. Sprinkle it with cold water or give it a sniff of ammonia. Just don’t put a bottle of caustic liquid under his nose. Accidentally touching and overturning a bottle can cause serious chemical burns to the nasal mucosa. Just drop a little of the substance on a napkin or handkerchief and bring it to your nostrils - this will be quite enough.
3. If the person does not regain consciousness within 1-2 minutes, call an ambulance.

When you experience an attack of hypotension for the first time, you should immediately contact your doctor at the clinic for a preventive examination.

Emergency actions

The paramedic of the emergency team at the prehospital stage should act according to the following protocol:

1. Place the patient in an anti-shock position if this has not been done previously.
2. Determine the presence of breathing disorders and, if necessary, begin oxygen therapy with artificial ventilation.
3. Provide peripheral venous access (catheterization).
4. Start infusion of NaCl solution 0.9% at a rate of 40 ml/kg/h. If necessary, administer colloids (20 ml/kg/hour).
5. Every 15 min. monitor pressure, saturation, pulse in the carotid artery.
6. If infusion therapy is not effective, administer intravenous vasopressors (“Norepinephrine” 2-8 mcg/min. or “Dopamine” 10-15 mcg/min.), having previously dissolved them in 400 ml of 0.9% NaCl solution.
7. Stop decompensating bradycardia or other arrhythmias.
8. If hypothermia develops, carry out warming measures.
9. In the absence of positive dynamics, hospitalize the patient.

In a hospital setting, it is necessary to catheterize a second peripheral or central vein while continuing infusion therapy with colloids or crystalloids. Do not stop administering vasopressors, the doses of which can be increased if necessary. When SaO2 (saturation) is low, oxygen supply must be provided. If there are no positive changes, extensive diagnostic measures should be carried out to search for other possible causes of hypotension and prescribe specific treatment.

Sources

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3. Michel Burnier, Edward Pivin, Fatma Megdiche. Neue Ziele für die Behandlung von Bluthochdruck? [Electronic resource] // Swiss Medical Forum ‒ Schweizerisches Medizin-Forum, March 2021.
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