Low Blood Pressure: Symptoms and Differences from Heart Failure

Low blood pressure?

Hello, doctor.
I used to have a habit of studying at night, which made my schedule quite irregular, and I would compensate by sleeping more during the day.
Recently, I've noticed that my blood pressure is quite low, with a systolic pressure of 78 and a diastolic pressure of 55.
Previously, it was around 90 over 60.
I don't feel unwell, but I've been experiencing dizziness and a heavy feeling in my head, along with headaches.
When I engage in light exercise, I feel faint and my hands turn pale.
I also sometimes notice decreased urination upon waking.
After researching online, I found that my symptoms align closely with autonomic nervous system dysfunction and resemble heart failure, although I don't feel any discomfort in my heart.
I often feel like my brain isn't getting enough oxygen, especially at the top of my head.
What are the differences between the symptoms of autonomic nervous system dysfunction and heart failure? Which condition do you think I might be leaning towards? I'm quite worried.
Thank you.

Xiao Jia, 20~29 year old female. Ask Date: 2012/09/21

Dr. Li Han reply Cardiology

Hello, Xiao Jia.
Regarding your question...
Recently, your blood pressure has been quite low, with a systolic pressure of 78 mmHg and a diastolic pressure of 55 mmHg.
Is this considered hypotension? Additionally, you have been experiencing dizziness, a heavy head, and headaches; you feel faint when you jog, and your hands turn pale; sometimes you notice decreased urination upon waking up.
Could this be related?
Generally speaking, hypotension is defined as a systolic blood pressure of less than 90 mmHg, and it should also be accompanied by signs of inadequate organ or tissue perfusion.
There are many potential causes for this, with heart issues being just one possibility.
Your past blood pressure readings were not high, with a systolic of 90 mmHg and a diastolic of 60 mmHg, and you did not feel unwell; this indicates that such relatively low blood pressure may be appropriate for you personally.
As your physiological needs change, your blood pressure and heart rate should correspondingly increase.
To be honest, the symptoms you mentioned can occur not only in individuals with low blood pressure but also in those with normal blood pressure.
It might be helpful to relax and take several more blood pressure readings.
If this concern continues to trouble you, consider consulting your family physician.
The Changhua Hospital of the Ministry of Health and Welfare cares about your well-being.

Reply Date: 2012/09/21

More Info

Low blood pressure, or hypotension, can manifest in various ways and may lead to symptoms such as dizziness, fainting, and fatigue. Your reported blood pressure of 78/55 mmHg is indeed on the lower end of the spectrum, especially considering that your previous readings were around 90/60 mmHg. While low blood pressure can be a normal variant for some individuals, it can also indicate underlying health issues, particularly when accompanied by symptoms like dizziness and fatigue.

The symptoms you describe, such as feeling dizzy, having a heavy head, and experiencing paleness in your hands during physical activity, suggest that your brain may not be receiving adequate blood flow, which can lead to a sensation of lightheadedness or even fainting. This is especially concerning when you mention that these symptoms have become more pronounced with changes in your sleep patterns and lifestyle.

It's important to differentiate between symptoms of low blood pressure and those of heart failure. Heart failure typically presents with symptoms such as shortness of breath, fatigue, swelling in the legs or abdomen, and persistent cough or wheezing. In contrast, low blood pressure symptoms are more related to inadequate blood flow to the brain and other organs, leading to dizziness, fainting, and weakness. While both conditions can cause fatigue and weakness, heart failure is often accompanied by more systemic symptoms due to fluid overload and reduced cardiac output.

Autonomic nervous system dysfunction, or dysautonomia, can also lead to symptoms similar to those of low blood pressure. This condition affects the regulation of blood pressure and heart rate, often resulting in orthostatic hypotension (a drop in blood pressure upon standing) and other symptoms like dizziness and palpitations. It can be triggered by various factors, including stress, dehydration, and prolonged periods of inactivity.

Given your symptoms and the significant drop in blood pressure, it would be advisable to seek medical attention. A healthcare provider can conduct a thorough evaluation, including a physical examination, blood tests, and possibly an echocardiogram or stress test, to assess your heart function and rule out any serious conditions. They may also consider monitoring your blood pressure in different positions (lying down, sitting, standing) to evaluate for orthostatic hypotension.

In the meantime, there are several strategies you can employ to manage low blood pressure symptoms. Staying well-hydrated, increasing your salt intake (if not contraindicated), and avoiding sudden changes in posture can help. Additionally, incorporating regular, gentle exercise can improve circulation and overall cardiovascular health. It's also essential to maintain a consistent sleep schedule to help regulate your body's circadian rhythms.

In summary, while low blood pressure can lead to symptoms that may mimic those of heart failure or autonomic dysfunction, the two conditions have distinct characteristics. Given your concerns and symptoms, it is crucial to consult a healthcare professional for a comprehensive evaluation and tailored management plan. Your health and well-being are paramount, and addressing these symptoms early can help prevent potential complications.

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