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.

The National Medical Commission (NMC) has issued an advisory mandating strict adherence to safe injection practices. The directive aims to curb preventable outbreaks of HIV, Hepatitis B (HBV), and Hepatitis C (HCV) caused by the unsafe reuse of syringes, needles, and other single-use medical devices.

Despite decades of evidence and repeated warnings from the World Health Organization (WHO), unsafe injection practices continue in India, often under the guise of cost-saving. This has led to avoidable infections, lifelong treatment costs, and a loss of public trust in healthcare systems.

What the NMC Advisory Says

The advisory mandates:

• Single-use devices must never be reused:Reuse of syringes, dialyzers, or vials is a direct breach of patient safety.
• Progressive adoption of safety-engineered auto-disable syringes: These devices prevent reuse and help protect healthcare workers from needle-stick injuries.
• Strict enforcement of the Biomedical Waste Management Rules, 2016: Proper segregation and disposal of sharps is mandatory.
• Mandatory training and audits: Healthcare workers must undergo regular competency assessments, and institutions must conduct strict monitoring.

Why Action Is Important

“India has the manufacturing capacity to supply safety-engineered syringes at scale. The barrier is not technology, it is willpower. Procurement administrators must prioritize patient safety over short-term cost-cutting,” said Rajiv Nath, Forum Coordinator of the Association of Indian Medical Device Industry.

“Single-use devices like syringes, dialyzers, and AV (Arteriovenous) fistula needles must not be reused. Unsafe injection practices are entirely preventable, and continuing them is indefensible,” he added.

The expert urged policymakers to act now because it is affecting

• Public Health : Treating HIV, HBV, and HCV infections acquired through unsafe injections costs far more than investing in safe injection devices.

• Global Credibility: As one of the world’s largest users of injectable medicines and vaccines, India’s leadership in safe injection, drug delivery, and blood management practices is critical to global health security.

• Patient Trust: Every reused syringe erodes confidence in healthcare institutions and undermines national health programs.

Read More: Ebola Alert In India: Rajasthan, Hyderabad Report Suspected Cases of Deadly Virus

Call to Action

The AiMeD stated that the NMC's advisory must be treated as a binding mandate, not a suggestion. Procurement administrators, hospital authorities, and policymakers should:

• Enforce zero tolerance for device reuse across all healthcare facilities.
• Allocate budgets for safety-engineered syringes, including auto-disable syringes and sharps injury-prevention devices, as a public health investment rather than a discretionary expense.
• Establish accountability mechanisms through accreditation schemes, including audits, reporting of needle-stick injuries, and penalties for non-compliance.
• Launch patient awareness campaigns to empower communities to demand safe injection practices.

"Unsafe injection practices are not a matter of affordability but of accountability. India has the capacity, technology, and cost-effectiveness evidence through Health Technology Assessment (HTA). What is needed now is decisive action to protect patients and healthcare workers alike," the AiMeD said.

Survival rates among patients with high-grade gliomas — one of the most aggressive forms of brain cancer — have improved by up to 50 per cent in India, according to leading oncologists ahead of World Brain Tumour Day 2026.

Doctors say a growing number of patients are now living significantly longer after diagnosis, with some surviving for more than a decade.

Advances Boost Survival Outcomes

Dr. Tejinder Kataria, Chairperson of Radiation Oncology at Medanta, said median survival for many high-grade glioma patients has increased from around 9–12 months to 14–18 months.

She noted that some centers are "reporting nearly 40 per cent two-year survival rates among patients with Grade III and Grade IV gliomas. In addition, about 5 per cent of patients in certain high-grade glioma groups are now surviving for more than 10 years".

Experts attribute these improvements to advances in molecular diagnostics, comprehensive genomic profiling, neuronavigation-assisted surgery, precision radiation therapy, and targeted treatments.

“Radiation oncology has evolved from open beams in the cobalt era to highly precise beam configurations using modern technologies. We are now able to deliver tumoricidal doses more accurately while also preserving quality of life,” Dr. Kataria said.

Personalized Treatment Changing Care

Also read: Ebola Alert In India: Rajasthan, Hyderabad Report Suspected Cases of Deadly Virus

Dr. R. Ranga Rao, Chairman of Medical Oncology at Paras Health, said brain tumor treatment is no longer limited to surgery and radiation.

A deeper understanding of tumor biology is enabling doctors to tailor treatment according to the molecular profile of each patient’s cancer.

“Although high-grade gliomas remain challenging to treat, the combination of precision diagnostics, modern therapies, and multidisciplinary specialist care is helping more patients live longer and maintain a better quality of life than was possible even a few years ago,” Dr. Rao said.

He also highlighted the growing role of whole genomic sequencing, which helps clinicians understand a tumor’s genetic makeup and select more personalized treatment strategies that may improve survival.

Patients Should Not Lose Hope

Dr. Shyam Agarwal, Senior Consultant in Medical Oncology at Sir Ganga Ram Hospital, said many patients fear the worst when diagnosed with a brain tumor.

“People often feel that nothing can be done once they hear the word tumor in the brain. But brain tumors are of many different types — benign and malignant — and even malignant tumors vary widely in behavior,” he said.

According to Dr. Agarwal, modern treatment options, including surgery, radiation, targeted therapies, and newer drugs, can control many brain cancers for extended periods and may even offer a cure in selected cases.

He also stressed the importance of molecular testing and comprehensive genomic profiling to identify patients who may benefit from precision medicines.

Late Diagnosis Remains a Major Challenge

Despite advances in treatment, experts say delayed diagnosis remains a significant problem in India.

“The biggest blind spot in our country is that many patients reach specialists at a late stage. Symptoms may masquerade as routine headaches, hearing deficits, or visual disturbances. We need greater awareness,” Dr. Kataria said.

Dr. Agarwal added that delayed diagnosis is due to symptoms such as persistent headaches, hearing problems, or vision disturbances which are often mistaken for stress, migraine, or other common conditions, leading to late referrals.

What Is Glioma?

As per the Johns Hopkins Medicine, glioma is a common type of tumor originating in the brain. About 33 per cent of all brain tumors are gliomas, which originate n the glial cells that surround and support neurons in the brains, including astrocytes, oligodendrocytes and ependymal cells.

Gliomas are called intra-axial brain tumors because they grow within the substance of the brain and often mix with normal brain tissue. Symptoms include

• Headaches
• Seizures
• Personality changes
• Weakness in the arms, face or legs
• Numbness
• Problems with speech
• Nausea and vomiting
• Vision loss
• Dizziness.

With advancements in medical technology, hip replacement surgery has evolved significantly over the years. One of the most promising innovations in this field is the Direct Anterior Approach (DAA) Total Hip Replacement, a modern technique that offers patients a safer procedure, reduced pain, and faster recovery.

Unlike traditional hip replacement surgeries, the DAA technique allows surgeons to access the hip joint from the front through a small incision. The biggest advantage of this approach is that muscles are not cut during the surgery. Instead, they are gently separated, which helps minimize tissue damage and reduces post-operative pain considerably.

This muscle-sparing approach has transformed patient recovery experiences. Most patients are able to stand and walk on the same day of surgery, and hospital stays are generally shorter. Recovery is smoother, allowing individuals to return to their normal routine within three to four weeks in most cases.

The DAA technique is especially beneficial for patients suffering from chronic hip pain, restricted movement, or severe joint damage. Common conditions that may require hip replacement include osteoarthritis, avascular necrosis (AVN), rheumatoid arthritis, old hip fractures, and long-standing degenerative joint conditions. When medications, physiotherapy, and injections fail to provide lasting relief, hip replacement surgery can significantly improve mobility and quality of life.

Compared to conventional hip replacement procedures, DAA offers several advantages. The surgery involves a smaller incision, less blood loss, minimal muscle damage, and lower post-surgical discomfort. Patients are able to regain movement faster and often experience greater confidence during rehabilitation.

One of the most common concerns among patients is the fear of severe pain after surgery. However, with modern pain management techniques and advanced surgical methods, discomfort after DAA hip replacement is usually minimal and manageable. Patients today recover much more comfortably than they did in the past.

Another important factor is the durability of modern implants. Advances in implant technology have significantly improved their lifespan, with many implants lasting more than 25 years. Maintaining a healthy body weight, staying physically active, and following medical advice can further improve the longevity and effectiveness of the implant.

After successful recovery, patients are generally able to resume a normal and active lifestyle. They can return to work, perform household activities independently, and participate in light exercises such as yoga, swimming, and stationary cycling. The primary goal of hip replacement surgery is not just pain relief, but restoring confidence, mobility, and independence.

Preparation before surgery also plays an important role in achieving better outcomes. Patients are advised to maintain controlled blood sugar levels, blood pressure, and overall heart health. Informing doctors about ongoing medications, performing basic physiotherapy exercises before surgery, and preparing a comfortable recovery environment at home can contribute to a smoother rehabilitation process.

Hip pain should never be ignored, especially when it begins affecting daily life and mobility. Timely treatment and the right surgical approach can make a remarkable difference. The Direct Anterior Approach has made hip replacement surgery simpler, safer, and more patient-friendly, helping individuals return to an active and pain-free life much faster than before.

Dr. Ishwar Bohra is Senior Director and Senior Joint Replacement Surgeon at BLK-Max Super Speciality Hospital, New Delhi.