Low blood pressure, also known as hypotension, is usually considered a sign of good health and low risk for cardiovascular disease. However, there are times when persistently low blood pressure or a sudden drop can be a sign of an underlying health issue that needs medical attention. Knowing when low blood pressure becomes a problem can help ensure timely intervention and proper care.

Blood pressure readings consist of two numbers:

Systolic pressure (the top number) indicates the pressure in your arteries when your heart pumps blood. Diastolic pressure (the bottom number) reflects the pressure in your arteries while your heart is resting between beats.

The normal reading is usually 120/80 mmHg or less. Hypotension is clinically defined as having blood pressure readings less than 90/60 mmHg. In some patients, low blood pressure will have no adverse health consequences and therefore does not need to be treated. In extreme cases, however, it can limit the flow of oxygen and nutrients to vital organs, resulting in potentially life-threatening complications, such as shock.

Causes of Low Blood Pressure

Hypotension can result from many factors. Some of the factors that cause hypotension are as follows:

• Insufficient fluid intake or excessive fluid loss can lead to decreased blood volume and hence hypotension.
• An injury or internal bleeding may result in hypotension. This happens because blood pressure becomes significantly reduced.
• Some hormonal changes along with the increased blood requirement during pregnancy also causes hypotension.
• Issues like heart failure or arrhythmias can impair blood circulation and result in low blood pressure.
• Certain drugs, including diuretics, antidepressants, and blood-pressure-lowering medications, can induce hypotension.

Symptoms of Hypotension

While low blood pressure may not always cause symptoms, it can sometimes be associated with:

- Dizziness or fainting

- Fatigue and weakness

- Blurred vision

- Nausea

- Confusion or difficulty concentrating

- Shallow breathing

- Palpitations

If the person experiences these symptoms, with the recorded blood pressure reading, the medical services have to be consulted.

Types of Low Blood Pressure

1. Orthostatic Hypotension: This is a kind of hypotension that appears as a result of decreased blood pressure when a person is standing up from lying down or sitting position and primarily affects elderly people.

2. Postprandial Hypotension: This is a drop in blood pressure after eating, more common in older people.

3. Neurally Mediated Hypotension: It is triggered by standing for long periods. This type can affect younger people and is associated with miscommunication between the brain and heart.

When Is Low Blood Pressure Dangerous?

There is no such thing as a universal threshold for very low blood pressure, but a blood pressure reading below 90/60 mmHg can be dangerous and require prompt medical assessment if accompanied by symptoms of fainting, confusion, or shortness of breath. Sudden falls in blood pressure may point to potentially serious underlying causes, which can include:

• Internal bleeding
• Sepsis (severe infection)
• Allergic reactions

Management and Treatment

Treatment of hypotension depends on its cause:

• Hydration Drinking more water can help against dehydration-related hypotension.
• Compression Stockings: These can improve circulation and reduce blood pooling in the lower limbs.
• Dietary Changes: Increasing salt intake under supervision can help increase blood pressure
• Medication Changes: The physician may need to reduce dosages of some medications or replace prescriptions.

For more severe cases, physicians might also administer fludrocortisone or midodrine to increase blood pressure. Shock from hypotension should be treated promptly to ensure proper function of organs.

Can Hypotension Cause Fatigue?

Chronic fatigue syndrome has also been associated with low blood pressure. Prolonged tiredness, despite adequate rest, may require reassessment of blood pressure levels. Fatigue secondary to hypotension will impact functionality and thus requires assessment and treatment of the cause.

When to Seek Medical Care

If your blood pressure readings are low consistently and without symptoms, you probably have nothing to worry about. If you do have symptoms like dizziness, fainting, or confusion, you need to go to the doctor. Blood pressure checks are usually conducted regularly. Once you are aware of your own normal baseline, you will know right away when there is something wrong.

Lifestyle Tips That Support Normal Blood Pressure

1. Other than directly treating hypotension, a healthy lifestyle overall would promote balanced blood pressure levels.
2. Exercise regularly; it promotes cardiovascular health and can help regulate blood pressure.
3. Focus on nutrient-dense foods rich in iron, B vitamins, and electrolytes to support circulatory health.
4. Excessive alcohol consumption dehydrates the body and lowers blood pressure.
5. Practices like yoga and meditation can help maintain a healthy blood pressure range.

Anemia remains one of the least talked about threats to a safe pregnancy in India. The National Family Health Survey-5 data shows that 52.2% of pregnant women in India were anemic. This translates to at least one in two expectant mothers entering pregnancy with insufficient hemoglobin to meet her own and her baby’s needs.

Pregnant women with iron-deficiency anemia may feel unusually tired, weak or short of breath. Some women may suffer from dizziness, headaches, palpitations or reduced ability to concentrate. However, symptoms can be subtle and this is why routine antenatal screening is important even if the woman feels well.

Left unaddressed, it raises the risk of preterm birth, low birth weight, postpartum haemorrhage, and maternal fatigue severe enough to affect daily functioning and recovery after delivery.

Severe anaemia can also reduce a woman's ability to tolerate blood loss during delivery, making even an otherwise uncomplicated birth potentially more challenging.

Why pregnancy makes it worse? Well, blood volume expands by nearly 50% during pregnancy, and the growing fetus draws heavily on maternal iron stores, especially in the second and third trimesters. Most Indian women begin pregnancy with iron stores already depleted by poor dietary intake, frequent pregnancies, or heavy menstrual blood loss. So, the added demand tips many into overt anaemia.

Do's:

1. Start Antenatal Care early. You should get a baseline haemoglobin test at your first antenatal visit, and repeat this each trimester or more if needed.

2. Iron and folic acid tablets must be taken in accordance with the prescription given. It is best to start with them before conceiving or as soon as possible in the pregnancy process, preferably in discussion. The dietary consumption may not always be sufficient to cater to the increased demands during pregnancy.

3. Pair iron-rich foods with vitamin C. A squeeze of lemon with dal or leafy greens meaningfully improves absorption. Indian gooseberry (amla), guava, oranges and tomatoes improve absorption of non-heme iron from plant based foods.

4. Include iron-dense foods regularly like leafy greens, jaggery, dates, legumes, eggs. If non-vegetarian, eat lean meat or fish, meat or poultry.

5. Treat underlying causes. Get heavy periods, worm infestations or unexplained fatigue evaluated before conception if possible.

6. Ask about your ferritin level, not just haemoglobin, since ferritin reveals depleted iron stores earlier.

Anaemia is not always caused by iron deficiency. B12 or folic acid deficiency, problems with haemoglobin production, infections, and many other medical conditions can also be contributing factors.

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Don'ts:

1. Do not stop iron supplements simply because you feel better. Treatment usually needs to continue for the recommended period to replenish iron stores.

2. Don't take iron tablets with tea, coffee or milk. These block absorption. Space them at least an hour apart.

3. Do not skip supplements because of nausea or constipation. Ask your doctor for alternate formulations instead of foregoing the supplements.

4. Don't assume fatigue is ‘normal pregnancy tiredness’ without a haemoglobin check. Persistent breathlessness, dizziness or a racing heart need evaluation.

5. Don't self-medicate with over-the-counter iron doses. Both too little and too much iron can cause harm.

6. Don't ignore mild anaemia on the assumption that it will ‘sort itself out’. It typically worsens as pregnancy progresses and has to be actively treated.

Anemia in women is mostly preventable and treatable early. Regular antenatal check ups, proper supplementation, balanced diet and timely treatment can go a long way in reducing its impact on the mother and baby. The key message is simple, really. Screen early, do not wait for symptoms, treat appropriately and maintain adequate iron stores throughout pregnancy.

Blood tests are often a source of dread for people in our society. While many people dread the needle stick, most are scared of what the results may show. Even before consulting a physician, most people nowadays would consult an AI-powered platform to verify and interpret the values of their blood tests. However, such online searches most often give rise to more uncertainties and confusion rather than answering the basic queries. Thus, this article is an attempt to shed some light on the basics of common blood test results.

LIPID PROFILE

Lipid profile is one test that everyone should do, at least occasionally, after the age of 40. This is a silent epidemic, and without blood tests, no clinical symptoms can reliably identify raised lipid parameters. There are multiple parameters printed in the report, but the main values we are looking for are total Cholesterol, triglycerides, LDL, and HDL. There are many others, but the interpretation of those is best left to your physician. Total Cholesterol should be less than 200, triglycerides less than 150, and the “bad” cholesterol, or LDL, should be below 100. On the other hand, HDL, the “good” cholesterol, should be above 40 for men and above 50 for women. So, for HDL, we want the values to be higher! However, whether deranged lipid parameters warrant treatment and, if so, for how long, will be the clinical decision of your doctor.

CBC

CBC means complete blood count. This is the most basic test done for every patient. In this test, we check for levels of haemoglobin, total leukocyte count, differential white cell count, platelet count, and ESR. Besides, there are numerous other parameters printed in your report, like MCV, MCH, MCHC, RDW, and PDW. But let’s first look at the basic parameters. Haemoglobin is perhaps the most important parameter to look at. It shows how much oxygen your blood can carry. Low hemoglobin is called anemia. If you have anaemia, you need to get treatment ASAP. The standard normal values of hemoglobin depend on age and gender and also physical states like pregnancy. The normal hemoglobin of an adult male will be different from that of an adolescent girl. There are many different causes of anaemia in our society, like iron deficiency, worm infestation, thalassemia, and kidney disease. Your doctor will do further tests to elucidate the cause.

The next most important parameter is total leukocyte count. This gives an indication of whether you have any infection or inflammation. Conversely, in some conditions like Typhoid, the counts may be low despite fulminant infection. Platelet count is also important in infections like dengue, where it may get dangerously low. We need to check platelet count repeatedly, sometimes even twice or thrice the same day, in dengue infection. Platelet count may be low in some forms of blood cancer too.

The other parameters like MCV and RDW are too complex to be discussed in this short article. Suffice it to say, they are deranged in conditions like Thalassemia, sickle cell disease, vitamin B12 deficiency, and hereditary Red cell membrane disorders.

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And finally, the ESR is a very non-specific parameter. It can be raised in multiple conditions, ranging from cancer to inflammation. It is usually interpreted in unison with other necessary tests.

Dr Rudrajit Paul, Consultant Physician, Manipal Hospital, Kolkata

“All That” star Christy Knowings has died after reportedly suffering an asthma attack that led to cardiac arrest and brain damage.

The 46-year-old actress was hospitalized on August 7 after the attack and placed on life support, TMZ reported.

According to TMZ, citing family sources, Knowings suffered cardiac arrest following the asthma attack. Her family decided to take her off life support on August 11.

Knowings, who was born on February 25, 1980, in the Bronx, is the second former All That cast member to die this year, following the fatal hit-and-run death of Kianna Underwood in January in Brooklyn.

In a Facebook post, Knowings’ aunt wrote that her niece was an “outstanding actress, comedian, twin sister” and an “amazing daughter.”

Knowings’ reported death after complications from an asthma attack is a reminder that while asthma can often be managed, it should not be taken lightly, health experts told HealthandMe.

What Is Asthma? How Severe Can It Turn?

Dr. Abhijit Ahuja, Consultant Pulmonologist, Saifee Hospital, Mumbai, explained that asthma is a condition that makes it difficult to breathe because the airways become inflamed and narrow.

Many people with asthma can control their symptoms with medication. However, an asthma attack can sometimes become severe and life-threatening.

During an asthma attack, symptoms suddenly worsen and usual medication may not provide enough relief. A person may experience difficulty breathing, wheezing, chest tightness, severe coughing or trouble speaking.

“If you use your inhaler but still have trouble breathing, you need to go to the hospital right away,” Dr Ahuja said.

When the airways become so narrowed that the body does not receive enough oxygen, the asthma attack can turn severe. The lungs may also be unable to remove carbon dioxide properly.

“If this keeps happening, it can hurt parts of the body like the brain and the heart,” Dr Ahuja said.

A severe asthma attack can lead to difficulty breathing, loss of consciousness, brain injury and cardiac arrest.

When Can an Asthma Attack Be Deadly?

Dr. Taniya Mehta, Consultant Respiratory Medicine, Sterling Hospitals, Gujarat, told HealthandMe that while most asthma attacks can be treated, a very severe attack can become deadly when the airways become so tight that the lungs cannot get enough oxygen.

“If treatment isn't given quickly, low oxygen levels can cause the lungs to stop working, damage the brain, cause the heart to stop and lead to death,” she said.

Signs That an Asthma Attack Is an Emergency

Seek emergency medical help if a person has:

• Breathing difficulty or wheezing that is rapidly getting worse.
• Trouble speaking more than a few words because of breathing difficulty.
• No improvement after using a quick-relief inhaler.
• Blue, grey or very pale lips, fingernails or skin, which may indicate low oxygen.
• Severe confusion or loss of consciousness.

Who Is More Likely to Have a Severe Asthma Attack?

People may be at greater risk if they:

• Have had a severe or life-threatening asthma attack before.
• Need to use their quick-relief inhaler frequently.
• Do not use their asthma medicines as prescribed.
• Do not have their asthma under control.
• Cannot recognise when their symptoms are getting worse.

Do Not Wait Out a Severe Asthma Attack

Deadly asthma attacks are uncommon, but they can happen quickly, the doctors warned.

Taking asthma medication as prescribed, knowing how to use inhalers correctly, attending follow-up appointments and undergoing lung tests when needed can help keep asthma under control.