Dizziness from Low Blood Pressure: Causes and Solutions

Dizziness due to hypotension?

Dear Doctor, my mother is 61 years old and has a hereditary condition of low blood pressure.
Her blood pressure readings usually show a systolic pressure that does not exceed 80 and a diastolic pressure that hovers around 50.
She has long-term poor sleep quality and has been seeing a psychiatrist for insomnia, taking muscle relaxants before bed to help her fall asleep.
Recently, she has experienced sudden episodes of dizziness, cold sweats, and rapid heartbeat.
These episodes occur sporadically and have happened about 4 to 5 times over the past few years.
Could these dizziness symptoms be caused by low blood pressure? How can this be improved?
Additionally, my mother is petite (148 cm tall and weighs about 47 kg), values health, eats lightly, and has a habit of exercising.
Furthermore, I am unsure if her immune system is somewhat weak, as she frequently experiences oral inflammation.
However, after a recent dental visit, she was diagnosed with periodontal disease and is currently taking antibiotics for treatment.
She has no history of drug allergies, but two years ago, she had an unexplained fever in the middle of the night and experienced a drug allergy while being treated in the emergency room.
After being referred to a larger hospital, the doctors avoided using medications containing Cefazolin and Voren.
I would appreciate your assistance in addressing these concerns.
Thank you!

Sophia, 60~69 year old female. Ask Date: 2015/06/29

Dr. He Dongjin reply Cardiology

Hello, the dizziness symptoms you mentioned could possibly be caused by hypotension.
The prevention of orthostatic hypotension involves rising slowly, especially when getting up from a squatting or lying position, as symptoms can be more pronounced.
It's important to slow down your movements.
Additionally, changes in weather and unstable atmospheric pressure can also lead to acute dizziness.
The use of muscle relaxants or sleep aids may also contribute to this issue.
As for whether there has been a change in your constitution, it's hard to say.
I recommend consulting with an immunologist for further examination.
Changhua Hospital cares about your well-being.

Reply Date: 2015/06/29

More Info

Dizziness can be a troubling symptom, especially when associated with low blood pressure (hypotension). In your mother's case, her history of hereditary low blood pressure, combined with her recent episodes of dizziness, cold sweats, and increased heart rate, suggests that her symptoms may indeed be related to her low blood pressure.

Low blood pressure is generally defined as a systolic blood pressure (the top number) below 90 mmHg or a diastolic blood pressure (the bottom number) below 60 mmHg. Your mother's readings, with systolic pressures often below 80 mmHg and diastolic pressures around 50 mmHg, indicate significant hypotension. This condition can lead to insufficient blood flow to the brain, resulting in dizziness, lightheadedness, and even fainting.

Several factors could contribute to her symptoms:
1. Dehydration: Insufficient fluid intake can lower blood volume, leading to lower blood pressure. Given her small stature and possibly low fluid intake, this could be a contributing factor.

2. Medications: The muscle relaxants she takes for sleep could potentially lower blood pressure as a side effect. It's essential to review all medications with her healthcare provider to ensure they are not exacerbating her hypotension.

3. Sleep Quality: Poor sleep can affect overall health and may contribute to fluctuations in blood pressure. Chronic sleep deprivation can lead to increased stress and hormonal changes that may further lower blood pressure.

4. Diet: While you mentioned she eats light, it's crucial to ensure she is consuming enough salt and fluids, as these can help maintain blood pressure levels. A diet too low in sodium can exacerbate hypotension.

5. Underlying Health Conditions: The presence of periodontal disease and recurrent oral infections may indicate a compromised immune system, which could contribute to her overall health status. Chronic infections can lead to systemic inflammation, which might influence blood pressure regulation.

To address her symptoms and improve her condition, consider the following steps:
1. Medical Evaluation: It's essential for her to see a healthcare provider, preferably a cardiologist or a general practitioner, who can evaluate her blood pressure readings in detail and assess for any underlying conditions. They may recommend tests such as blood work, an echocardiogram, or a tilt table test to understand her blood pressure response better.

2. Hydration and Diet: Encourage her to increase her fluid intake, particularly water and electrolyte-rich beverages. A diet that includes adequate salt (if not contraindicated by other health issues) can help raise blood pressure. Foods rich in potassium, such as bananas and spinach, can also be beneficial.

3. Medication Review: Have her doctor review all medications she is taking, including over-the-counter drugs, to identify any that may contribute to low blood pressure. Adjustments may be necessary.

4. Lifestyle Modifications: Encourage her to engage in regular, moderate exercise, which can help improve cardiovascular health and blood pressure regulation. Additionally, she should avoid sudden changes in posture, such as standing up quickly, which can exacerbate dizziness.

5. Monitoring: Regular monitoring of her blood pressure at home can help track changes and identify patterns. Keeping a log of her symptoms in relation to her blood pressure readings can provide valuable information for her healthcare provider.

6. Addressing Sleep Issues: Since she has a history of poor sleep quality, consider discussing her sleep issues with a sleep specialist. Improving her sleep hygiene may help her overall health and potentially stabilize her blood pressure.

In summary, while her dizziness may be related to low blood pressure, a comprehensive evaluation by a healthcare provider is crucial to rule out any serious underlying conditions and to develop a tailored management plan. With appropriate interventions, it is possible to improve her symptoms and overall quality of life.

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