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Physical constitution or pathological?

Low blood pressure and unconsciousness

People who have always had low blood pressure, hardly ever feel impaired by it and as a rule do not need any medication. This is not the case with pregnant women and elderly people. If unconsciousness occurs, a doctor is called for.
Marta Campbell
Isabel Weinert
06.03.2020  09:30 Uhr

In the case of low blood pressure during pregnancy, the blood flow in the placenta may not suffice which means that the foetus is not adequately supplied.

If elderly people complain of giddiness, blackout, sudden palpitation and perspiration, it is imperative to consult a doctor. What is supposed to be poor circulation could well be cardiac arrhythmias.

Hypotension can stem from certain diseases such as heart or infectious diseases as well as endocrine and vascular diseases. Medical professionals then refer to a secondary hypotension. The treatment of a secondary hypotension is reserved for the physician. He will try to bring the primary disease under control. Some medication also reduces the blood pressure, for example psychotropic drugs, diuretics and antihypertensive agents. Particularly at the start of treatment of high blood pressure, some patients may suffer from circulatory problems.

In many people no cause can be found for their low blood pressure. For those, the »nominal value« is simply by nature somewhat lower. Medics refer to an essential hypotension, if, when resting, the blood pressure is regularly below 100/60 mmHg. Especially in the mornings, some of those affected feel weak and first of all need a coffee to get going. Others often suffer from insomnia, tiredness, concentration disorders, cold hands and cold feet.

Medication is second place

Medication only has a subordinate role in the treatment of hypotension. PTA and chemists can recommend physical action, which can be contrast showers (alternating between hot and cold) with subsequent dry brushing, as well as endurance sports. After sport, sunbathing or sauna it is important to replace the lost fluid, i.e. to drink plenty. Drug treatment should only be applied in cases where these measures do not suffice or are not feasible.

Symptoms can only be improved by medication but cannot remedy the cause. Etilefrin (Effortil®) stimulates α- as well as β receptors, raising the tone of the veins as well as the pumping force of the heart.

The α-sympathomimetic Midodrine (Gutron®) can be obtained on prescription. It tonifies arteries and veins which raises the systolic blood pressure by approximately 20 mmHg. In folk medicine camphor is said to have an invigorating effect. It stimulates the respiratory and vasomotor centre thereby increasing the blood pressure in the short term. If these preparations are available as drops, patients should take them while still in bed some time before getting up. This helps to suppress or to alleviate the symptoms which are particularly noticeable in the mornings.

Regulation is affected

The orthostatic hypotension, which mainly occurs on change of position, needs to be differentiated from the constitutional or essential hypotension. The human body can change from lying or sitting to a standing position without the blood sinking in the legs. This capability is called orthostasis reaction. Here, the sympathetic nervous system reacts as quick as lightning, narrows the blood vessels and increases the heartbeat. These mechanisms do not function well in the case of the orthostatic hypotension. The venous backflow to the heart is reduced. The result: giddiness, tinnitus, decreased physical and mental performance and in the worst case a short fainting fit. When customers tell the chemist about fainting or a blackout, they are normally worried. Such a sudden short blackout results from a temporary ischemia in the brain, the consequence being loss of consciousness. Medics call this phenomenon syncope. As a rule, this occurrence lasts less than 20 seconds. It can come »out of the blue« or be announced by nausea, flushing, giddiness, soft knees, warm or sweating palms, diminishing vision or a queasy feeling in the stomach. The biggest problem that can arise from such a short-lasting unconsciousness are bruises or even fractures when falling.

Wrong rhythm

If the heart is responsible for the blackout this is mostly based on cardiac arrhythmia. The heartbeat is briefly skipping or the heart beats so fast that the blood cannot flow sufficiently. After a few seconds, unconsciousness will set in. The duration of the blackout depends on the duration of the cardiac arrhythmia. Both, fast and slow cardiac arrhythmias, i.e. tachyarrhythmia as well as bradyarrhythmia can reduce the blood flow in the brain to such an extent that a syncope will occur. Such arrhythmias can be dangerous and can lead to sudden cardiac death. In the case of recurring blackouts, those affected urgently need to see a doctor so that he can clarify the cause and initiate treatment. Apart from arrhythmia, also epileptic fits or a blood glucose level that is too low can be the cause.

German/Deutsch English/Englisch
Blutdruck blood pressure
Blutleere ischemia
Blutzucker glucose, blood sugar
Epilepsie epilepsy
Herzrhythmus heart rhythm, cardiac rhythm
Hypotonie hypotension
Konzentrationsmangel lack of concentration
Kreislauf circulation
Niedriger Blutdruck low blood pressure
Ohnmacht unconsciousness, blackout
Orthostatisch orthostatic
Physikalische Maßnahmen physical action, physical measures
Sauna sauna
Schlafstörung insomnia
Schwangerschaft pregnancy
Schwindel giddyness, dizziness
Senior elderly person, senior citizen
Sonnenbad sunbathing
Wechselduschen contrast shower (hot/cold showers)

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