Q. I have a geriatric patient that says she’s often light-headed, especially when getting up from the dinner table. Any ideas?There’s a possibility your patient has “postprandial hypotension,” or, in layman’s language, low blood pressure after a meal. This is a senior malady; few younger people experience this condition. Other possible symptoms include dizziness, blurred vision, nausea and fainting.
When you eat, blood pours into your digestive system. To maintain your blood pressure, your heart pumps more often and your blood vessels constrict. But these compensatory mechanisms don’t work for some people.
To help prevent postprandial hypotension, one should eat small portions several times a day and limit high-carbohydrate foods such as potatoes, rice, pasta and bread.
There’s another form of low blood pressure called “postural hypotension” that affects some people when they stand up. Also called “orthostatic hypotension,” this is especially common in older adults who are more likely to use high blood pressure drugs. When one experiences postural hypotension, blood pools in the legs.
Drugs for high blood pressure, surgical medications, anti-anxiety agents, diuretics, heart medicines, antidepressants, narcotic painkillers and alcohol commonly cause low blood pressure. Other causes of low blood pressure include dehydration, heart failure, heart arrhythmias, shock from infection, stroke, severe allergic reaction, major trauma, heart attack and advanced diabetes.
The effects of hypotension can lead to falls, which can be serious for seniors. Here are some pointers for avoiding the dangers of low blood pressure:
Some experts define low blood pressure readings lower than 90 as systolic (the first number) or 60 as diastolic (the second number). However, low blood pressure is relative, so doctors often define blood pressure as too low only if there are symptoms.
Low blood pressure without symptoms rarely requires treatment. In symptomatic cases, doctors address the primary problems, such as heart failure. When hypotension is drug-induced, treatment usually involves altering the drug regimen.
It is possible to raise blood pressure when that is required. Here are some ways:
- Eating more salt. However, too much sodium can cause heart failure, especially among seniors. A physician should be consulted before adding salt to the diet.
- Drink more water. Fluids increase blood volume and help prevent dehydration.
- Invest in compression stockings: Used to treat varicose veins, these may also help reduce the pooling of blood in your legs.
- Look into blood pressure-boosting medicines on the market.
If you have a question, please write to
fredcicetti@gmail.com.
With experience as a freelance writer and publicist for major pharmaceutical companies, such as Eli Lilly, Johnson & Johnson, Merck and Pfizer, Fred Cicetti is now a New Jersey-based columnist writing about a variety of senior health issues. His opinions and views do not necessarily reflect those of Therapy Times or Valley Forge Publishing Group. Questions or comments can be directed to editorial@TherapyTimes.com.All Rights Reserved © 2007 by Fred Cicetti.
