For those who are not familiar, hypotension is basically another word for low blood pressure. “Usually, when there is hypotension there is a reason, like too much medication for the blood pressure; volume depletion, which is dehydration; not enough fluids or someone who is sick with shock or another severe illness,” said Dr. Thomas F. Dr. Whayne, cardiologist of UK Gill Heart Institute at the University of Kentucky. Even a trained athlete who gets dehydrated could become hypotensive.

Cases vary. “For a person with blood pressure of 90 over 60, that is normal; but someone with higher pressure that drops to that has a problem,” said Dr. Whayne. It is important to understand what is happening in the body. “It is an abnormal reflex that starts initially with a sympathetic output like you would suddenly have if you were almost hit by a car and were scared or in a big rush; to help you move quickly, which triggers an abnormal response where there is a marked slowing of the heart instead of a speed-up,” said Dr. Whayne. This is also associated with a drop in blood pressure when it is not what you wanted.

Another issue is more of a common vasovagal syncopy or lightheadedness. “Some people have fainted dead away having their blood drawn which is an abnormal vagal reflex where they drop their blood pressure and slow their heart rate from the stress of having blood drawn,” said Dr. Whayne. Unfortunately, there are not good medicines for raising blood pressure but the good news is there are some variables you can control. “The most common thing readers will see is somebody that is extremely hot or dehydrated,” said Dr. Whayne.

Take precautions. “Stay wellhydrated because it increases the blood pressure when there is more fluid in the body,” said Cassie Weig, school health coordinator for Lexington-Fayette County Health Department. Keep moving as well. “If you sit for a long time the blood will tend to pool in your legs so your upper body is not getting as much blood because you are sitting in that position so we ask you to move around and change positions frequently,” said Weig. With athletics coaches, people used to be tough and endure an entire football practice in the late summer to get ready for fall without fluids and some kids have died in the past. “Make sure these kids get a little break and get fluids as even a housewife who is out working in the yard in the summer needs to stop, take a break and drinks some fluids,” said Dr. Whayne.

Be sure there are electrolytes in the drink and that it is not just water. “Alcohol functions as a diuretic so you do not want to be drinking a lot of it,” said Dr. Whayne A lot of factors are individualized. “Somebody whose pressure normally runs low and functions well is fine if they are used to it but for somebody who is used to higher and suddenly goes lower they will faint,” said Dr. Whayne Consider the potential consequences. “In Kentucky if the state gets wind that you had a fainting spell you have lost your license for at least three months,” said Dr. Whayne.

As people get older, their blood pressure may drop from standing for a period of time. “Part of the reason is that gravity wants to go to your feet and what keeps you from fainting and draining it away from your head is that you have reflexes that are triggered by standing up that increase pressure and keep blood in your head where it is needed for consciousness,” said Dr. Whayne Other issues include orthostatic hypotension and serious hypotension where someone is in shock and ends up in the hospital with severe sepsis, infection, fever or sweating a lot. “Blood loss is another disastrous cause of hypotension,” said Dr. Whayne.

Do not think hypotension is just a warm weather issue. “Out in the snow, especially trying to shovel for someone who is unaccustomed to exercise it can trigger a tremendous sympathetic output and a big influx,” said Dr. Whayne This is a significant problem. “It can cause a myocardial infarction and somebody having a heart attack because their heart is not working right and they are likely to have low blood pressure,” said Dr. Whayne Prolonged bed rest is equally complicated. “Somebody who is sick when they finally start to ambulate and stand up, they are not used to it and reflexes do not work as well so they are likely to become hypotensive,” said Dr. Whayne You have to observe astronauts when they return from a flight in space for this reason because they have been weightless and are not used to gravity. Be cautious by following the strategies of staying hydrated, keeping moving and getting up slowly. In some cases hypotension is preventable

By Jamie Lober, Staff Writer