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.

In a shocking viral trend, women in Kenya are reportedly inserting cetirizine, an allergy medication, into their vaginas in an attempt to achieve vaginal tightening and enhance sexual pleasure.

The practice has prompted warnings from pharmacists and health authorities, who caution that the drug is not meant for vaginal use and could pose health risks.

The Pharmaceutical Society of Kenya (PSK) has warned against the practice, stating that the medicine is not intended for vaginal use.

"Cetirizine is an allergy medicine, taken by mouth. It is not approved or tested for any other purpose, and definitely not for vaginal use," the PSK said in a statement issued on Thursday.

It advised women who had tried the practice to stop and seek medical attention if they experienced pain, bleeding, burning, itching, unusual discharge or fever.

What Is The Cetirizine Vaginal Tightening Trend?

Also read: Is Your Allergy Medicine Safe? FDA Recalls Antihistamine Tablets Over Life-Threatening Contamination Concerns

Posts circulating on Kenyan social media, particularly TikTok, claim that cetirizine can reduce vaginal moisture and create a sensation of tightness during sex, BBC reported.

The claims have sparked online debate, with some users endorsing the practice and others questioning its safety.

The trend has also reportedly increased demand for the drug, with local media reporting price rises and shortages at some pharmacies in Nairobi.

What Is Cetirizine And Why Is Its Misuse Dangerous?

Cetirizine is an oral antihistamine used to relieve allergy symptoms such as sneezing, runny nose, itchy eyes and hives.

Kenya's Pharmacy and Poisons Board (PPB) clarified in a public safety alert issued on November 4 that cetirizine is used to treat allergic rhinitis and urticaria. It is intended for oral use and should be taken only as directed by a healthcare professional.

The Board stressed that "the drug is not approved for vaginal use or tightening and that no established scientific evidence supports such claims".

On the other hand, inserting the tablets may cause vaginal irritation, burning, soreness, pain and discomfort. It may also disrupt the vagina's natural protective environment and increase infection risk.

The PSK cautioned against confusing dryness with tightening.

"Dryness is not tightness... instead, it may increase friction, discomfort, and the risk of tissue injury," it said.

Taking more than the recommended cetirizine dose can also cause excessive sleepiness, dizziness, restlessness, confusion, shaking, a rapid heartbeat and difficulty passing urine, the PPB warned.

Kenya's Health Ministry Raises Concern

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Kenya's health ministry had also flagged the trend a day earlier. Ouma Oluga, a senior health official, expressed concern that social media users were dismissing medical warnings without considering the consequences, the BBC reported.

He suggested that authorities could introduce a system to monitor medicine distribution and purchases to identify potential misuse. No formal decision has been announced.

Pharmacists Warn Of Shortages And Misuse

The PSK said it had received reports of increased cetirizine demand, rising prices and shortages at some pharmacies.

It urged retailers not to exploit the trend, warning that people who need the drug for allergies could struggle to access it. Pharmacists were also advised against knowingly dispensing medicines for misuse.

The PPB urged women not to insert cetirizine or other oral medicines into the vagina and to consult healthcare professionals about vaginal dryness or sexual health concerns rather than follow unverified online advice.

Delhi's air quality remained in the Very Poor category on Thursday, with an AQI of 369 as pollution levels continued to rise across the Capital. With Diwali celebrations with firecracker fuel smoke to an already polluted city, concerns about respiratory health are mounting. The timing is alarming as it also coincides with the flu season, when respiratory infections are also circulating.

While air pollution and influenza both affect the respiratory system, it can put additional stress on the lungs. Pollutants can irritate the airways, trigger inflammation and weaken the lungs' natural defence mechanisms, while the influenza virus infects the respiratory tract.

Together, they can aggravate respiratory symptoms and make breathing more difficult, especially in people with pre-existing lung conditions.

According to Dr. Arup Halder, Consultant Pulmonologist at CK Birla Hospitals, CMRI Kolkata, prolonged exposure to air pollution can weaken the respiratory system's immunity.

“Exposure to air pollution, especially for long durations, can weaken the respiratory system's immunity. Fine particulates can become lodged in airways and damage the mechanisms the body has to protect itself. This makes respiratory infections much more likely, especially if viral in nature,” he told HealthandMe.

Dr. Suresh Sagadevan, Senior Interventional Pulmonologist at Gleneagles Hospital, Chennai, told HealthandMe that pollution can also interfere with the lungs' natural cleaning mechanisms.

He said that the respiratory tract contains tiny hair-like structures called cilia, which help remove dust and germs. Polluted air can affect their functioning, making it easier for respiratory viruses to infect the airways. However, pollution does not directly cause influenza nut it can compromise the respiratory system's ability to defend itself against such infections.

What Happens When Particulate Matter And Flu Affect The Lungs Together?

Also read: Delhi Air Pollution: Feeling Anxious As AQI Rises? Experts Explain The Mental Health Toll Of Breathing Toxic Air

Particulate matter and influenza together can intensify inflammation in the respiratory system.

Fine particulate matter, like PM2.5, can penetrate deep into the lungs. It can cause inflammation and oxidative stress. At the same time, influenza viruses infect the cells lining the respiratory tract.

"When both exposures occur together, the existing inflammation can become more intense, potentially worsening coughing, breathing difficulty and airway irritation. In simple terms, the lungs are dealing with two different stresses at the same time," said Dr. Sagadevan.

Dr. Halder added that PM2.5 can also interfere with the body's ability to ward off irritants from the respiratory tract, while influenza can make breathing challenging.

Facing both together can be challenging for people whose respiratory or immune systems are already compromised.

Can Diwali Pollution Make Flu Symptoms Worse?

Also read: Air Pollution In Delhi: Experts Warn Of Red Eyes, Itching, Watering In Children

Firecracker smoke can aggravate an already infected and overwhelmed respiratory system. People with flu may experience excessive coughing, wheezing, chest tightness and breathlessness when they get exposed to high levels of pollution.

"Increased Diwali-related pollution will definitely worsen respiratory symptoms for individuals with the flu, especially during this period. The gases and particulate matter from firecracker smoke can lead to chest congestion and difficulty in breathing. In some cases, the pollution can worsen existing asthma and other lung-related conditions and trigger respiratory issues," said Dr. Halder.

Dr. Sagadevan said that people with asthma, chronic obstructive pulmonary disease (COPD) and other pre-existing respiratory conditions need to be particularly careful by limiting exposure.

Who Is Most Vulnerable When Flu Season Coincides With High Pollution?

Certain groups of people may face a greater risk when respiratory infections coincide with elevated pollution levels. These include:

• Children: Their lungs are still developing, making them more vulnerable to air pollution.

• Older adults: Age-related changes can reduce respiratory capacity and make it harder to cope with added stress on the lungs.

• Pregnant women: They need to take extra precautions against respiratory infections and environmental pollutants.

• People with asthma or COPD: Pollution can trigger flare-ups, worsen airway inflammation and aggravate breathing difficulties.

• Immunocompromised individuals: A weak immune system can make it harder to fight infections and increase the risk of severe illness.

Dr. Halder explains that older adults and people with weak immunity may be more susceptible to more serious flu symptoms. Meanwhile, those with existing lung conditions may experience worsening respiratory symptoms even with short periods of pollution exposure.

Pollution Effects Vs Flu: Symptoms

Also read: Supreme Court Allows Green Crackers In Delhi-NCR Ahead Of Diwali: Are They Really Safe For Your Health?

Pollution-related respiratory irritation and influenza can lead to similar symptoms, making it difficult to distinguish between the two. However, their onset and symptoms can differ.

Pollution-related irritation develops shortly after exposure to polluted air. Common symptoms include:

• Throat irritation or discomfort
• Burning or watering eyes
• Dry cough
• Sneezing
• Wheezing
• Chest discomfort

Flu, on the other hand, is a viral infection that mostly causes a sudden onset of symptoms, including:

• Fever
• Body aches and muscle pain
• Headache
• Fatigue
• Cough
• General weakness

"However, both can occur together, and symptoms may overlap. Persistent fever, worsening breathlessness or significant weakness should prompt medical evaluation," says Dr. Sagadevan.

Dr. Halder also recommends consulting a medical professional when symptoms make it difficult to determine whether the problem is pollution-related irritation or an infection.

How To Protect Your Lungs During Diwali And Flu Season

Reducing exposure to polluted air and taking precautions against respiratory infections can help protect lung health during the festive season.

Both doctors recommend the following measures:

1. Limit outdoor exposure: Avoid spending long periods outdoors, especially after firecracker bursting and during periods of heavy smoke.

2. Wear a well-fitting N95 mask: If you need to step outside when pollution levels are high, use a properly fitted N95 mask to reduce exposure to fine particulate matter.

3. Keep windows closed: Close doors and windows during periods of heavy smoke to limit the entry of outdoor pollutants. Ventilate indoor spaces when outdoor air quality improves.

4. Avoid outdoor exercise: Vigorous physical activity increases the amount of air you breathe in, increasing exposure. Avoid exercising outdoors when air quality is poor.

5. Avoid firecrackers and second-hand smoke: Staying away from firecracker smoke can reduce exposure to harmful pollutants.

6. Get vaccinated against influenza: Stay up to date with flu vaccinations to reduce the risk of influenza and its complications.

7. Maintain hand hygiene: Wash your hands regularly for infection prevention.

8. Seek medical attention: Do not ignore worsening fever, cough, wheezing or breathing difficulties, especially if you have an existing respiratory condition.

Dr. Sagadevan concludes, "Air pollution and influenza can independently affect respiratory health, but their coexistence can place additional stress on the lungs. During the festive season, protecting our lungs through pollution avoidance, vaccination and timely medical care should be a priority."

Metformin is the first-line treatment for type 2 diabetes in adults and children aged 10 years and above. The drug has also found applications in managing Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS). But a recent study says that it may have some potential use in a non-metabolic health condition: Long COVID.

Researchers found that people who were prescribed metformin shortly after testing positive for COVID-19 had a significantly lower risk of developing Long COVID than those prescribed other medications.

How Was The Study Conducted?

Also read: 'It’s The Best-Studied Vaccine In Human History': Former CDC Adviser Busts Common Myths About COVID Vaccines

The study, titled Metformin at the Time of COVID-19 Infection and Risk of Long COVID: A Target Trial Emulation Study, was published in the Journal of Medical Virology recently.

Researchers have been exploring metformin's antiviral and anti-inflammatory effects, especially during the early stages of COVID-19 infection. They are specifically investigating if metformin could reduce the risk of Long COVID if taken soon after contracting the infection.

The researchers examined health records of more than 21 million people from the US National COVID Cohort Collaborative (N3C). They identified adults who had tested positive for COVID-19 between March 2020 and September 2023. They compared two groups:

Metformin group: People who received a new prescription for metformin within six days of their documented COVID-19 infection.

Comparison group: People who received prescriptions for other medications, including fluvoxamine, fluticasone, ivermectin or montelukast, during the same period.

The researchers excluded people who were already taking metformin or had conditions like diabetes, PCOS or gestational diabetes that could explain why they were prescribed the drug.

After statistical adjustments to make the groups more comparable, the researchers compared 248 people in each group. They then tracked the development of Long COVID or death over the following 180 days (six months).

Also read: Can Low-Dose Naltrexone Ease Long COVID Symptoms? New Study Examines The Evidence

Can Metformin Help Reduce The Risk Of Long COVID?

People who were prescribed metformin within six days of a COVID-19 infection had a 53% lower relative risk of Long COVID or death compared to those on other medications.

“Metformin prescription within the week following documented SARS-CoV-2 infection was associated with a 53% reduction in LC/D [long COVID or death] over 6 months in this primarily Omicron-infected sample,” wrote the authors, led by researchers from the University of Minnesota Medical School.

The study found that the risk of Long COVID or death within six months was 4.0% in the metformin group as 10 out of 248 people developed symptoms.

In the comparison group, the number was 8.5% as 21 out of 248 people presented symptoms of Long COVID. Overall, the weighted chance of Long COVID or death in patients on metformin or control treatment within six days of diagnosis was 6.3%. The absolute difference between the two groups was 4.5 percentage points.

“These results are also consistent with a recent sequential target trial analysis in the United Kingdom that assessed metformin started within 90 days of infection, HR [hazard ratio] 0.36,” the authors wrote. “The replication of results in clinical trials is important for informing treatment guidelines.”

More About Long COVID

Long COVID refers to symptoms that occur after a SARS-CoV-2 infection and cannot be explained by another diagnosis.

Symptoms may include brain fog, fatigue, cognitive difficulties, breathlessness, sleep disturbances and problems with everyday activities. These symptoms may last for months or even years.

Research has also suggested that brain inflammation may persist even after the virus is no longer detectable.

Some people improve over time, while others experience prolonged illness that affects their ability to lead routine lives.