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HYPOTENSION ITS  TYPES CAUSES AND TREATMENT
  •   Dr. Sujata Singh |
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  •   12-Aug-2020

HYPOTENSION ITS TYPES CAUSES AND TREATMENT




Hypotension is diminished blood pressure. It is defined as when systolic pressure is less than 90 and diastolic pressure less than 60. This could be acute and chronic.

Low blood pressure is also a risk factor for dementia.

Blood pressure is the pressure or force of the blood exerted upon the wall of arteries as the heart pumps out of blood. Blood  pressure is measured as systolic and diastolic.

Normal volume of blood pressure in adult is 120/80.

Acute hypotension


Cause

  • Cardiovascular
  • Intravascular volume contraction
  • Anaphylaxis
  • Gram negative septicemia

Risk Factors

  • Stress
  • Medical conditions like anaemia
  • Consuming alcohol
  • Heat
  • Dehydration
  • Standing for a long time.
  • Medicines - some medicines can decrease the level of blood pressure.
  • Calcium channel blockers
  • Beta blockers
  • Digoxin

Clinical Feature

  • Tachycardia
  • Vomiting
  • Fainting
  • Headache
  • Giddiness
  • Sweating
  • Slow thinking
  • Weakness
  • Nausea
  • Light headedness
  • Irregular heartbeat
  • Decrease urine output
  • Depression
  • Blurry vision
  • Sleepiness
  • Confusion
  • Chest pain
  • Tiredness
  • Fatigue
  • Rapid heart rate

The condition is very much sever when blood pressure is decreased less than 60/45mm Hg. In this condition patient may get unconscious and develop shortness of breath, dyspnea, palpitation, swelling of face, tongue and lips. 

In postural hypotension, fall of blood pressure occurs on Suddenly on assuming an erect posture from supine posture.


Treatment

  • Patient should be in lying position with legs raised
  • Injection - Atropine 0.6 mg IV given in  vasovagal attack.
  • Hydrocortisone hemi - succinate 100 mg IV, repeated as required. (For anaphylaxis).
  • Advising to the patient to assume the erect posture slowly and to wear elastic stockings and abdominal binder in the case of postural hypotension.

Vasoconstriction

  • Dopamine
  • Nor - epinephrine
  • Ephedrine

Salt :-  Adequate account of salt (Nacl) in diet helps to expand the plasma volume.

Fludrocortisome acetate (0.1 - 0.2mg ) cause fluid retention and avoids postural fall of blood pressure.


Chronic hypotension

A number of healthy subjects have a systolic blood pressure of 80 -100 mm Hg, which is compatible with long life expectancy. Only some patients complaints of weakness, lethargy, easy fatigability, dizziness, and faint on assuming erect posture and standing inactive for long periods. This occurs due to interference with neural pathways between the vascular center and efferent sympathetic nerve endings in the blood vessels and heart, so that the normal rise in cardiac output and vasoconstriction on assuming erect posture are abolished.

Cause

  • Low cardiac output
  • Constrictive pericarditis
  • LV dysfunction
  • Supine hypertension of pregnancy
  • Addison's disease
  • Myxedema
  • Hypopituitarism
  • Diabetic neuropathy
  • Multiple sclerosis
  • Peripheral neuropathy
  • Chronic idiopathic orthostatic

Treatment

Elastic bandages over legs, head up position in bed High fluid Salt intake Fludrocortisone supplement (0.1mg/day).

Atrial pacing

Drugs

  • Midodrine
  • Erythropoietin
  • Partial beta agonist (pindolol).
  • Alpha 2 receptor agonists
  • Indomethacin
  • Ephedrine
  • Amphetamine
  • L-dopa


Homoeopathic medicine for hypotension

  1. Gelsimium
  2. Natrum mur
  3. Camphor
  4. Carvo veg
  5. China


Note :- Homoeopathic remedy  gives to the patients based on symptom similarities and a minute dose is sufficient to treat the patient. The selection of potency is dependents upon susceptibility of patient.


Gelsemium

It is a very great remedy for low blood pressure. There is headache with passive congestion due to reduction in blood pressure. Dullness, dizziness, drowsiness and trembling are the marking feature of gelsemium.


Vertigo due to low blood pressure with blurred vision, dilated pupils, double sight, sense of intoxication. Gradual onset of all symptoms. Pain begins in the nape of the neck and settled down over the eyes. The patient can not think and he is listless and stupid. Trembling of hand or lower extremities on attempting to move. Dullness of mental faculties with listlessness and prostration. Hypotension due to excessive mental exertion. All complaints are aggravated by mental exertion, smoking, heat, head lying low.


Patient is better by head heald high, profuse urination. gelsimium is a remedy for warm climate. Heaviness of limbs with intense prostration, patient avoid all motion. There is slow, soft and comprehensible pulse. Susceptibility and mental disturbance such as a sudden excitement or emotion, bad news or fright, anticipation of an unusual ordeal brings on headache. Fear that unless constant motion is kept up, the heart would stop beating. Pulse is slow when quite but greatly accelerated on motion. In slow pulse of old age gelsimium is very useful remedy. There is delirium with flushed face.


Determination of blood to head with cold extremities. Heaviness of limbs, painful and unable to move.

Disturbance of sensation. Patient is very much confused and a sluggish stage of mind in case of low blood pressure. There is extreme prostration and weakness. Tremor is the key note symptom of gelsimium. 


Natrum Mur

Natrum mur is very useful remedy for low blood pressure when headache is aggravated by sunrise and better by perspiration.  Hearts pulsating shakes the whole body.  The blood circulation becomes readily excited so that every little excertion produces throbbing. There is palpation of heart is excited by every motion and noise. There is intense craving for salt may be due to low blood pressure. Marked emaciation is the keynote symptom of this remedy. There is throbbing type of headache that feels like thousands of hammer constantly hitting on head. Confusion and  vision problem like letters running together and a zigzag appearance in case of low blood pressure because of diminished blood circulation. 


Excessive irritability

Lachrymal disposition

Mapped tongue

Heart fluttering with palpitations

Left sided headache.

Hot patient

Losing flesh when living well

Consolation aggravated her troubles

Impoverished blood

Chronic long standing headache

Insatiable thirst

Worse by sunlight, sunrise (10 - 11 AM) and overuse of mind.

Better by sleep, sweating

Patient being perfectly quite.


Camphor

Pulse small and weak

Sudden sinking of the strength

Icy coldness of the body.


China

Hypotension is due to loss of vital fluids, in case of dehydration, diarrhoea and vomiting. Best suited to the person who have broken down constitution.

Oversensitive to external impressions like noises, bright light.

Sweat with great thirst

Debility

Aneamia


Intense prostration due to loss of vital fluids. Headache because of low blood pressure. During headache there is a great tendency to congestion of head with flushing of face and throbbing of carotids. Extremities became cold and covered with cold sweat, ringing and rearing in ears.


Headache is aggravated by exposure of  sun, touch and draft of air & the patient is better by hard pressure, on painful side .

Pale and hippocratic face in the case of hypotension. 

It is chilly patient.


The selection of homoeopathic remedies based on symptom similarities and doses according to the Susceptibility of patient.

Don't take homoeopathic medicine without any prescription / without any advise of physician


Comments

client

Manjit Singh

13-Aug-2020 04:24 PM

I like your blog very much.

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