Low Blood Pressure Causes, Symptoms, Treatment, Pathogenesis

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Low blood pressure is less than 90/60, its medical term is ‘Hypotension’. In healthy people, low blood pressure without any symptoms does not need to be treated. But low blood pressure can be a sign of an underlying problem especially in the elderly where it may cause inadequate blood flow to the heart, brain, and other vital organs.

Postural hypotension or orthostatic hypotension – It is a sudden drop of blood pressure most commonly occurring in someone who’s rising from a lying down or sitting position to standing. Another type of low blood pressure can occur when someone stands for a long period of time. This is called neurally mediated hypotension. When it leads to passing out, it is called vasovagal syncope.
Read – Hypertension Causes, Types, Symptoms, Ayurvedic Treatment

Causes

It may be associated with the following:
· Pregnancy
· Hormonal problems such as hypothyroidism, diabetes, or low blood sugar
· Some over-the-counter medications
· Some prescription medicines such as for high blood pressure, depression or Parkinson’s disease
· Heart failure
· Heart arrhythmias
· Widening or dilation of the blood vessels
· Heat stroke
· Liver disease

What Causes a Sudden Drop in Blood Pressure?

· Loss of blood from bleeding
· Low body temperature
· High body temperature
· Heart muscle disease causing heart failure
· Sepsis
· Severe dehydration
· A reaction to medication or alcohol
· A severe allergic reaction called anaphylaxis
Read – Dizziness: Causes, Symptoms, Ayurvedic Remedies, Treatment

Symptoms

· Dizziness
· Lightheadedness
· Unsteadiness
· Blurring of vision
· Weakness
· Fatigue
· Nausea
· Cold, clammy skin
· Fainting
· Pale skin

Treatment

· Eat a diet higher in salt.
· Drink lots of nonalcoholic fluids.
· Limit alcoholic beverages.
· 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 medications to see if any of them are causing your symptoms.
· Get regular exercise to promote blood flow.
· Be careful when rising from lying down or sitting. 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 placing bricks or blocks under the head of the bed.
· Avoid heavy lifting.
· Avoid straining while on the toilet.
· Avoid standing still in place for long periods of time.
· Avoid prolonged exposure to hot water, such as hot showers and spas.
· Try eating smaller, more frequent meals. Cut back on carbohydrates. Rest after eating. Avoid taking drugs to lower blood pressure before meals.
· If needed, use elastic support stockings that cover the calf and thigh. These may help restrict blood flow to the legs, thus keeping more blood in the upper body.
Read more about Low blood pressure – Modern view

Hypotension In Ayurveda

Bhrama – means giddiness. This is one of the main symptoms of hypotension. Many medicines which alleviate dizziness also reduce symptoms of symptomatic hypotension.

Kapha kshaya and vata vriddhi – decrease in kapha and increase in vata might alter the balance system of the body leading to dizziness. Stability is provided by the balance between these two entities. Kapha kshaya can also cause hypoglycemia which is one of the causes for hypotension.
Read – Symptoms Of Vata Dosha Increase And Imbalance – Vata Vruddhi Lakshana

Hypofunction of vyana vataVyana vata is responsible for distribution of blood uniformly in the body. To push the blood to the periphery (systole) it needs the support of the chest doshas, mainly ranjaka pitta in the blood and udana vayu. To bring the blood back to the heart (diastole) and prevent pooling of blood in the lower limbs leading to postural hypotension, vyana vayu should get support of avalambaka kapha. If there is imbalance of these chest entities, the vyana vata functions will be imbalanced.

Deficit production and function of ranjaka pitta – if the liver and spleen produces deficit ranjaka pitta the push and pull of blood from and to the heart will be imbalanced. This might lead to hypotension. Liver disease has been mentioned as one of the causes for hypotension.

Hridroga – among the symptoms of heart disease, murcha (fainting) has been mentioned. This could be due to hypotension. Heart failure is one of the causes for hypotension.

Vata Prakopa – one of the symptoms of vata prakopa is dilatation of blood vessels. When this occurs in the lower portion of the body, there is blood pooling leading to hypotension. Nerve disorders causing hypotension are included in this.

Rakta Kshaya and Pandu Roga – deficit production of blood or loss of blood may lead to deficient blood supply to brain and heart leading to hypotension. Sira shaitilya i.e. laxity of blood vessels is one of the symptoms of deficit blood. This will lead to blood pooling and postural hypotension.
Read – Decrease Of Tissues – Dhatu Kshaya – Reasoning, Symptoms

Apatarpana – less nutrition causes less blood formation and less nutrition to the heart and brain. This leads to hypotension.

Samprapti pathogenesis

Dosha – kapha-pitta kshaya, vata prakopa (imbalance in the axis of udana vata, vyana vata, avalambaka kapha and ranjaka pitta)
Dushya – rakta, rasa
Srotas – rasa-raktavaha srotas
Sroto dushti lakshana – sanga
Roga marga – abhyantara (heart, brain and liver are visceral organs), madhyama (heart is a vital organ)
Sadhya Asadhyata – sadhya i.e. curable
Read – Rasa Dhatu: Definition, Formation, Circulation, Imbalance Diseases, Treatment

Chikitsa – treatment principles

Bhrama Chiktisa – following the treatment lineup of dizziness
Pandu roga chikitsa / rakta kshaya chikitsa / rakta prasadana chikitsa – treating for anemia or blood loss, restoration of blood tissue if these conditions are associated with hypotension
Vata shamaka / vatanulomaka chikitsa – Vata pacifying treatments and measures to regulate the normal course of movement of vata are preferred.
Hridya aushadhas – medicines to support and strengthen the heart and blood vessels if heart disease / failure is involved in causation of hypotension.
Santarpana and balya Chikitsa – nourishing foods and medicines which improve digestion, enhance production and distribution of nutritive juices are included. Strength enhancing medicines and foods are also given.

Panchakarma

Snehapana – Regular intake of small quantities of one among the Saraswatha Ghrita, Brahmi Ghrita, Indukanta Ghrita, Panchagavya Ghrita, Kalyanaka Ghrita, Ksheerabala Tailam 101 – will calm and balance vata and pitta.

Nasya – nasal instillation of Ksheerabala Tailam 101, Anu Tailam, Shadbindu Tailam, Mahamasha tailam etc

Nitya Virechana – regular purgation with medicated oils to control vata, especially apana vata will check the pooling of blood in lower limbs.

Upakarmas

Shirodhara and Shirobasti – to calm the nerves and vayu when they are responsible for causation of hypotension are given.

Medicines

Sutashekara Rasa
Mukta Bhasma
Shatavari Kalpa
Ashwagandha Rasayana
Amritarishta / Amrita satva
Amalaki churna
Triphala Churna
Arjunarishta
Prabhakara Vati
Ksheerapaka – milk processed with Terminalia arjuna, Withania somnifera or Sida cordifolia
Lodhrasava
Punarnava Mandura
Dhatri loha
Draksharishta
Gandharvahastadi Kashayam
Chyavanaprasha
Navayasa Loham

Proprietary Ayurvedic Medicines

Tablet Abhraloha
Capsule F-Cal
Tablet Heaemol Forte
Syrup Hemi-C
Manoll
Capsule Neobliss
Capsule Refill
Amiriprash
Ashwagandha Kalp
Capsule Aswal Plus
Capsule Ayuplus
Capsule Chyavan Cap
Drakshojem
Capsule Herbomen
Imis Tonic
Kesari Kalp Royal
Ojola

Diet

Shankapushpi
Amla fruit
Grapes
Ashwagandha
Arjuna
Bala
Old Barley
Red rice
Soup of green gram
Mandura
Old ash gourd
Pomegranate

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