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.

Blood cancers are among the most challenging, but advances in treatments, such as targeted therapies, advanced transplantation techniques, and increasingly customized approaches, are offering a new ray of hope for patients. Among these innovations, Chimeric Antigen Receptor T-cell therapy, commonly known as CAR-T cell therapy, represents one of the most important breakthroughs in modern cancer care in recent times.

Unlike conventional treatments that directly target cancer cells, CAR-T cell therapy harnesses the patient's immune system to identify and attack cancer. It is a powerful example of how medicine is moving towards personalized treatment strategies that are designed around an individual's disease biology.

How CAR-T Cell Therapy Works

To understand CAR-T therapy, it is important to understand the role of T-cells. These are specialized immune cells responsible for recognizing and eliminating abnormal cells in the body. In some blood cancers, cancer cells develop mechanisms that allow them to evade immune surveillance. CAR-T therapy addresses this challenge by genetically modifying a patient's T-cells in a laboratory to recognize specific proteins present on cancer cells.

The process begins with the collection of T-cells from the patient's blood through leukapheresis. These cells are then engineered to express specialized receptors, called chimeric antigen receptors (CARs), which enable them to recognize cancer cells more effectively. Once modified and multiplied, the cells are infused back into the patient's bloodstream, where they seek out and destroy cancer cells.

Potential of CAR-T

Currently, CAR-T cell therapy has shown encouraging results in several blood cancers, including certain forms of acute lymphoblastic leukemia, diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, follicular lymphoma, and multiple myeloma. For some patients whose disease has relapsed after multiple lines of treatment or failed to respond to conventional therapies, CAR-T therapy has offered a valuable new treatment option.

One of the most promising aspects of CAR-T therapy is its potential for durable responses. In selected patients, the engineered immune cells can continue to remain active within the body, providing ongoing surveillance against cancer recurrence. While every patient may not experience the same outcome, the ability to achieve long-lasting remission in heavily pre-treated cancers has generated significant optimism within the oncology community.

CAR-T therapy: The Challenges And Side Effects

All that being said, CAR-T therapy is a highly specialized treatment that requires careful patient selection and close monitoring. Some patients may also experience side effects such as cytokine release syndrome (CRS), neurological complications, or temporary suppression of normal blood cell production. Fortunately, advances in supportive care and growing clinical experience have substantially improved the management of these complications.

The Future of Blood Cancer Care

Researchers across the world are working on next-generation CAR-T platforms designed to improve effectiveness, reduce toxicity and expand treatment eligibility. Investigational approaches include "off-the-shelf" CAR-T products derived from healthy donors, dual-target CAR-T cells capable of recognizing multiple cancer markers, and therapies aimed at overcoming treatment resistance.

Scientists have also been exploring the potential of CAR-T therapy in other blood cancers and even selected solid tumors. While significant challenges remain, ongoing research continues to push the boundaries of what immune-based therapies can achieve. As research advances and access continues to improve, CAR-T cell therapy is expected to play a very important role in the future of blood cancer care. For patients, families, and clinicians alike, it represents a powerful reminder that innovation continues to redefine what is possible in the fight against cancer.

(By Dr. Dinesh Bhurani, Director – Hemato-Oncology & Bone Marrow Transplant, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC))

Keeping your cholesterol levels in a healthy range is one of the best things you can do for your heart. High cholesterol is a major risk factor for heart disease, but the good news is that what you eat can make a significant difference. While some people may need medication, research shows that certain foods can naturally help lower LDL cholesterol and support overall cardiovascular health.

One of the easiest places to start is with oats. Oats are packed with a soluble fiber called beta-glucan, which helps reduce the amount of cholesterol absorbed into your bloodstream. A review published in Nutrients found that regularly eating oat beta-glucan can lead to meaningful reductions in LDL cholesterol, especially when combined with an overall heart-healthy diet.

Legumes such as beans, lentils, and chickpeas are another powerful addition to your plate. They're rich in fiber and plant-based protein, making them an excellent alternative to processed meats and other foods high in saturated fat. Research has consistently linked regular legume consumption with lower LDL cholesterol levels and better heart health.

Nuts also deserve a place in a cholesterol-friendly diet. Almonds, walnuts, and other tree nuts provide healthy unsaturated fats, fiber, and antioxidants. According to studies published in the American Journal of Clinical Nutrition, moderate nut consumption can help improve cholesterol levels and support cardiovascular health.

Fatty fish like salmon, sardines, and mackerel are well known for their heart-protective benefits. These fish are rich in omega-3 fatty acids, which can help lower triglycerides and support healthy blood vessels. The American Heart Association recommends eating fatty fish at least twice a week as part of a balanced diet.

Fruits and vegetables remain some of the most important foods for maintaining healthy cholesterol levels. Apples, berries, oranges, leafy greens, and broccoli provide fiber, vitamins, antioxidants, and plant compounds that help protect the heart. Numerous studies have shown that diets rich in fruits and vegetables are associated with a lower risk of cardiovascular disease.

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Avocados are another heart-smart choice. They contain monounsaturated fats and fiber, both of which can help improve cholesterol levels when used in place of foods high in saturated fat. A clinical study published in the Journal of the American Heart Association found that people who ate one avocado daily experienced greater reductions in LDL cholesterol than those following similar diets without avocado.

The bottom line is that controlling cholesterol doesn't require a drastic diet overhaul. Small, consistent changes—such as eating more whole grains, legumes, nuts, fruits, vegetables, fatty fish, and healthy fats—can have a lasting impact on heart health. Combined with regular exercise and other healthy lifestyle habits, these foods can help keep your cholesterol in check and support long-term well-being.

Sleep is one of the most important factors for overall health and well-being, influencing both physical and mental health. Yet, how much sleep a person actually needs remains a common topic of debate.

Dr Sudhir Kumar, a neurologist at Apollo Hospitals, addressed several misconceptions and shared evidence-based insights about sleep that everyone should know.

In a detailed post on social media platform X, Dr Sudhir said that most adults need 7–9 hours of sleep per night.

While some may function well with slightly less or more sleep, he noted that "regularly sleeping less than six hours or more than 9–10 hours is associated with adverse health outcomes."

Sleep Consistency Matters Too

While sleep duration is important, sleep consistency is equally important.

"Going to bed and waking up at roughly the same time every day helps regulate your circadian rhythm," he said.

Irregular sleep schedules, on the other hand, are associated with poorer metabolic health, mood disturbances, and daytime sleepiness.

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Monophasic vs Biphasic Sleep

Dr Sudhir said that most modern adults follow a monophasic pattern, with one main sleep period at night.

However, "a biphasic pattern (night sleep plus a short afternoon nap) can also be healthy if total sleep duration is adequate and the nap does not interfere with nighttime sleep."

Does Everyone Need an Afternoon Nap?

Not necessarily, said Dr Sudhir, popularly known as Hyderabaddoc on X, adding that many healthy adults do perfectly well without naps.

However, naps may be particularly useful for:

• Shift workers

• People with sleep debt

• Older adults with increased daytime sleepiness

• Those performing safety-critical tasks requiring sustained alertness

Further, he said that a 10–30-minute nap, also known as a power nap, is usually best, and may help:

• Improve alertness

• Improve concentration

• Reduce fatigue

• Enhance performance

However, naps lasting more than an hour may cause "sleep inertia" (grogginess) and disrupt nighttime sleep in some individuals.

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Night Shift Work And Health Impacts

"Night shift work is not biologically normal," Dr Sudhir said.

Humans are programmed to be awake during the day and asleep at night. Long-term night shift work has been associated with increased risks of:

• Obesity

• Type 2 diabetes

• Cardiovascular disease

• Mood disorders

• Workplace accidents

Sleep During Weekends

Dr Sudhir also addressed the common belief that people can make up for lost sleep during weekends.

While "partial recovery is possible," he said weekend catch-up sleep does not fully reverse the effects of chronic sleep deprivation.

Large shifts in sleep timing during weekends, often referred to as "social jet lag," can disrupt circadian rhythms.

He advised keeping wake-up and bedtime within about one to two hours of the weekday schedule.

He also warned against relying on multiple alarms every morning, which according to him "suggests insufficient sleep, poor sleep quality, and circadian misalignment."

How Inadequate Sleep Can Affect You

Dr Sudhir said regularly sleeping more than 9–10 hours may be associated with higher risks of cardiovascular disease, depression, frailty, and mortality.

At the same time, the neurologist noted that "even one night of inadequate sleep can impair performance".

Short-term sleep deprivation can lead to:

• Reduced attention

• Slower reaction time

• Poor decision-making

• Mood changes

• Increased accident risk

Chronic insufficient sleep is associated with:

• Hypertension

• Type 2 diabetes

• Obesity

• Cardiovascular disease

• Depression and anxiety

• Cognitive decline

• Reduced quality of life

"Sleep is a fundamental biological requirement, just like nutrition and exercise," Dr Sudhir said.