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.

Although monsoon rains provide relief from the unbearable summer heat, they also increase the risk of infections, dehydration, and diseases that are transmitted through water and that can affect the functioning of your kidneys. Since kidneys play a crucial role in eliminating toxins from your body and maintaining fluid balance, kidney care during the monsoon season becomes necessary.

Stay Hydrated

Though it is cooler during monsoon rains, your body needs enough water to help the kidneys filter the toxins efficiently. Try drinking 2-3 liters of clean water daily, or according to the requirement advised by your doctor. Avoid drinking contaminated water, as it increases the risk of infections in the kidneys.

Eat Healthy and Fresh Food

Eat fresh and cooked food at home instead of junk food that might get contaminated during the monsoon rains. Include seasonal fruits, vegetables, whole grains, and healthy protein sources in your diet. Restrict the intake of excess salt, canned products, and sugar drinks.

Prevent Infections

The monsoon season is prone to UTIs that may eventually reach the kidneys if not treated on time. Keep your body clean, wear dry clothes, and never keep urine in your bladder for a prolonged period. In case you have burning sensations while passing urine, fever, or pain in your lower abdomen, do see a doctor.

Control Health Problems

Individuals suffering from diabetes, hypertension, or pre-existing kidney problems should take special care of themselves throughout the monsoon. They should be taking their medications, measuring their sugar and blood pressure levels, and undergoing regular medical examinations to avoid kidney diseases.

No Self-medication

Analgesics and other OTC medications can cause damage to the kidneys when consumed frequently and without consulting a doctor.

Conclusion

It does not take much effort to maintain the health of your kidneys during the monsoon season. Simple things such as staying well-hydrated, consuming hygienic food, preventing any infection, keeping control of existing illnesses, and taking no medicines unnecessarily will ensure that your kidneys continue to perform at their best. In case of any swelling, change in urine output, fever, or back pain, you must see a doctor right away. The importance of the kidneys is undeniable for your well-being.

(By Dr. Bhanu Mishra, a Consultant- Nephrologist at Fortis Hospital, Shalimar Bagh)

When one hears about plastic surgery, he or she usually associates it with beauty operations designed to improve one's appearance.

Reconstructive plastic surgery is a very particular field of medicine that addresses problems with the restoration of patients' form and functions who suffer from trauma, cancer, birth defects, burns, and complicated wounds. For many people, reconstructive surgery is far from beautification. It is all about getting back to an independent life.

Reconstructive Surgery After Trauma and Cancer

Injuries that can occur following accidents on the road, incidents at industries, electric burns, and animal bites often lead to severe destruction to the skin, muscles, tendons, nerves, blood vessels, and bones. In addition, cancers of the breast, head and neck, mouth, skin, and limb regions are often treated with extensive surgical excisions to provide complete clearance from the disease.

Though these operations are necessary to save lives, they might lead to considerable impairment and deformities in the patients. Reconstructive plastic surgery helps solve these problems.

Advanced Techniques in Modern Reconstruction

Today's reconstruction surgery uses sophisticated methods, including microsurgical free tissue transfer, perforator flaps, local and regional flap reconstruction, split-thickness and full-thickness skin grafting, nerve grafting, tendon reconstruction, and vascular anastomosis.

The application of microsurgery, in particular, has greatly improved the possibilities for performing reconstruction surgeries through transferring viable tissue from one region of the body to another with the re-establishment of blood supply from blood vessels of just one to three millimeters in diameter using a surgical microscope.

Restoring Function After Cancer Surgery

One of the biggest breakthroughs in the field of reconstructive surgery has been in the area of post-cancer treatment. Women who have undergone surgery due to breast cancer have the option to undergo either immediate or delayed breast reconstruction surgery through implants or through autologous tissues to help restore their self-image and mental well-being.

Similarly, patients who have undergone surgery due to oral, jaw, or facial cancer can improve their functionality and social standing through microvascular surgery.

Burn Reconstruction and Functional Recovery

The other significant factor to consider is the importance of reconstructive surgery in the treatment of burns. Severe burns typically lead to contracture scars and limited movement of joints.

Excision, skin grafting, flaps, and scar revision surgeries are key in improving function, aesthetics, and reducing disability. Reconstruction of hands following injuries or burns allows people to carry out their daily tasks and work.

Restoring Hope Beyond Surgery

Reconstruction is not limited to the surgical theater but is best done using a multi-disciplinary team comprising plastic surgeons, oncologists, trauma surgeons, physiotherapists, occupational therapists, psychologists, dietitians, and rehabilitators. Rehabilitation, scar management, physiotherapy, and follow-up are just as important after surgery as the surgery itself.

Reconstructive plastic surgery is thus much more than a field of surgery; it is a specialty whose goal is to restore hope. Through a blend of surgical skills and compassion, it gives people an opportunity to transcend the physical and psychological effects of injuries or cancers. For many people, it changes the experience of survival into that of recovery.

With the onset of the monsoon, the risk of several water-borne, mosquito-borne, and bacterial infections increases significantly due to stagnant water, flooding, poor sanitation, and contaminated food and water.

Many of these diseases can start with mild symptoms similar to the flu, but if they're diagnosed early, you can get the appropriate medical care in time, avoiding serious complications.

Early Symptoms Of Various Monsoon Diseases

One of the important ways to prevent monsoon infections and diseases is to identify warning signs early, Dr. Amit Saraf, Director, Department of Internal Medicine, Jupiter Hospital, told HealthandMe.

Leptospirosis

Leptospirosis gained attention after its cases surged in Kerala recently. The infection has also been reported in Maharashtra, Gujarat, Tamil Nadu, and Karnataka. The bacterial infection typically spreads via contact with water or soil that has been contaminated by the urine of animals infected with leptospirosis, especially during floods.

Initial signs and symptoms include:

• High fever

• Chills

• Intense muscle pain (especially in calves)

• Headache

• Red eyes

• Nausea

• Vomiting

“Wearing protective footwear, avoiding wading in floodwaters, and covering any open wounds will help minimize the risk of infection,” Dr Saraf recommended.

Typhoid

• High fever

• Headache

• Weakness

• Loss of appetite,

• Abdominal pain

• Constipation or diarrhea

• Body aches

Dr. Saraf said: “It can cause serious gastrointestinal issues if not treated. Safe drinking water, good hand hygiene, and freshly cooked food are important preventive measures.”

Cholera

Cholera is a water-borne bacterial disease that commonly occurs during monsoons. It often begins with excessive watery stools, vomiting, leg cramps, and rapid dehydration. Dehydration can quickly become an immediate danger of cholera.

The doctor said: “Prevention includes drinking clean water, eating hygienically prepared food, and practicing proper sanitation and handwashing.”

Dengue

Dengue is one of the most common viral diseases spread by Aedes mosquitoes. Often reported in various Indian states during the monsoon, dengue presents with flu-like symptoms. Dengue usually begins with high fever, severe headache, pain behind the eyes, extreme muscle and joint pain, nausea, skin rash, and fatigue.

Malaria

Malaria, a common monsoon disease, is spread by infected mosquitoes and characterized by the following symptoms:

• Recurrent fever

• Shivering or sweats

• Headache

• Muscle pain

• Weakness

• Nausea

• Vomiting

Dr Saraf said, “Early diagnosis is important to prevent severe diseases. The best ways of preventing mosquito bites are by using mosquito repellents, mosquito nets, and the elimination of breeding sites.”

Chikungunya

Mosquito-borne viral diseases are reported to be the highest during the rainy season. One of them is Chikungunya. The infection is usually marked by sudden high fever and severe joint pain in the limbs. Other early symptoms may include headache, muscle pain, fatigue, and skin rash.

“The infection is usually not deadly but can cause joint pain for weeks or months. Preventive measures include mosquito control and avoidance of mosquito bites,” the expert advises.

Gastrointestinal Infections

During the monsoon period, gastrointestinal infections are also more common as food and water sources are more likely to get contaminated. Early signs of gut infections may include diarrhea, vomiting, cramps, nausea, bloating, fever, and dehydration.

The majority are due to bacteria, viruses, or parasites. The expert said that the risks can be minimized by maintaining food hygiene, drinking boiled or purified water, washing fruit and vegetables before cooking and consuming, and refraining from eating street foods and drinks.