Hypotension: Difference between revisions

'''Hypotension''' is low [[blood pressure]], especially in the [[arteries]] of the left sided [[systemic circulation]].<ref>[http://www.thefreedictionary.com/hypotension TheFreeDictionary > hypotension]. Citing: The American Heritage Science Dictionary Copyright 2005</ref> [[Blood pressure]] is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the [[Systole|systolic]] blood pressure (the top number) and the [[Diastole|diastolic]] blood pressure (the bottom number), which are the maximum and minimum blood pressures, respectively<ref>{{Cite web|url=https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm|title=High Blood Pressure Fact Sheet{{!}}Data & Statistics{{!}}DHDSP{{!}}CDC|date=2019-01-09|website=www.cdc.gov|language=en-us|access-date=2020-01-15}}</ref>. A [[systole (medicine)|systolic]] blood pressure of less than 90 millimeters of mercury (mm Hg) or [[Diastole#Diastolic pressure|diastolic]] of less than 60&nbsp;mm Hg is generally considered to be hypotension.<ref name="NHLBI2008">{{cite web|url=http://www.nhlbi.nih.gov/health/dci/Diseases/hyp/hyp_whatis.html |title=Diseases and Conditions Index – Hypotension |accessdate=September 16, 2008 |date=September 2008 |publisher=National Heart Lung and Blood Institute }}</ref><ref name="Mayo2009def">{{cite web | url = http://www.mayoclinic.com/health/low-blood-pressure/DS00590 | title = Low blood pressure (hypotension) — Definition | accessdate = October 19, 2010 | author = Mayo Clinic staff | date = May 23, 2009 | work = MayoClinic.com | publisher = Mayo Foundation for Medical Education and Research}}</ref> Different numbers apply to children<ref>{{Cite journal|last=Flynn|first=Joseph T.|last2=Kaelber|first2=David C.|last3=Baker-Smith|first3=Carissa M.|last4=Blowey|first4=Douglas|last5=Carroll|first5=Aaron E.|last6=Daniels|first6=Stephen R.|last7=Ferranti|first7=Sarah D. de|last8=Dionne|first8=Janis M.|last9=Falkner|first9=Bonita|last10=Flinn|first10=Susan K.|last11=Gidding|first11=Samuel S.|date=2017-09-01|title=Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents|url=https://pediatrics.aappublications.org/content/140/3/e20171904|journal=Pediatrics|language=en|volume=140|issue=3|doi=10.1542/peds.2017-1904|issn=0031-4005|pmid=28827377}}</ref>. However, in practice, blood pressure is considered too low only if noticeable symptoms are present.<ref name="Mayo2009causes">{{cite web | url = http://www.mayoclinic.com/health/low-blood-pressure/DS00590/DSECTION=causes | title = Low blood pressure (hypotension) — Causes | accessdate = October 19, 2010 | author = Mayo Clinic staff | date = May 23, 2009 | work = MayoClinic.com | publisher = Mayo Foundation for Medical Education and Research}}</ref>

Hypotension is the opposite of [[hypertension]], which is high blood pressure<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/965761862|title=Physiology|last=Costanzo, Linda S., 1947-|others=Preceded by: Costanzo, Linda S., 1947-|isbn=978-0-323-51189-6|edition=Sixth edition|location=Philadelphia, PA|oclc=965761862}}</ref>. It is best understood as a [[physiologic]]al state rather than a disease<ref name=":0" />. Severely low blood pressure can deprive the brain and other vital organs of oxygen and nutrients, leading to a life-threatening condition called [[Shock (circulatory)|shock]]<ref>{{Cite web|url=https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm|title=High Blood Pressure Fact Sheet{{!}}Data & Statistics{{!}}DHDSP{{!}}CDC|date=2019-01-09|website=www.cdc.gov|language=en-us|access-date=2020-01-15}}</ref>.

For many people, excessively low blood pressure can cause dizziness and fainting or indicate serious heart, endocrine or [[neurological disorders]]<ref>{{Cite journal|last=Joseph|first=Adrien|last2=Wanono|first2=Ruben|last3=Flamant|first3=Martin|last4=Vidal-Petiot|first4=Emmanuelle|date=2017-04|title=Orthostatic hypotension: A review|url=https://www.ncbi.nlm.nih.gov/pubmed/28577744|journal=Nephrologie & Therapeutique|volume=13 Suppl 1|pages=S55–S67|doi=10.1016/j.nephro.2017.01.003|issn=1872-9177|pmid=28577744}}</ref>.

Treatment of hypotension may include the use of [[intravenous fluids]] or [[vasopressors]]<ref>{{Cite journal|last=Hunter|first=Benton R.|last2=Martindale|first2=Jennifer|last3=Abdel-Hafez|first3=Osama|last4=Pang|first4=Peter S.|date=2017-09|title=Approach to Acute Heart Failure in the Emergency Department|url=https://www.ncbi.nlm.nih.gov/pubmed/28865801|journal=Progress in Cardiovascular Diseases|volume=60|issue=2|pages=178–186|doi=10.1016/j.pcad.2017.08.008|issn=1873-1740|pmid=28865801}}</ref>. When using vasopressors, trying to achieve a [[mean arterial pressure]] (MAP) of greater than 70&nbsp;mm&nbsp;Hg does not appear to result in better outcomes than trying to achieve a MAP of greater than 65&nbsp;mm&nbsp;Hg in adults.<ref name=Hy2017>{{cite journal|last1=Hylands|first1=M|last2=Moller|first2=MH|last3=Asfar|first3=P|last4=Toma|first4=A|last5=Frenette|first5=AJ|last6=Beaudoin|first6=N|last7=Belley-Côté|first7=É|last8=D'Aragon|first8=F|last9=Laake|first9=JH|last10=Siemieniuk|first10=RA|last11=Charbonney|first11=E|last12=Lauzier|first12=F|last13=Kwong|first13=J|last14=Rochwerg|first14=B|last15=Vandvik|first15=PO|last16=Guyatt|first16=G|last17=Lamontagne|first17=F|title=A systematic review of vasopressor blood pressure targets in critically ill adults with hypotension.|journal=Canadian Journal of Anaesthesia|date=July 2017|volume=64|issue=7|pages=703–715|pmid=28497426|doi=10.1007/s12630-017-0877-1}}</ref>