[Common Diseases] Hypotension
A complete guide to low blood pressure treatment for Hong Kong residents
In Hong Kong, people are very aware of high blood pressure, but relatively little is known about low blood pressure. Many people believe that lower blood pressure is better, but this is not the case. Excessively low blood pressure can cause dizziness, fatigue, and even fainting. In severe cases, it can affect blood supply to vital organs, posing a dangerous risk.
As someone who has long been concerned about health issues, I've noticed that many people in Hong Kong overlook the dangers of low blood pressure, especially young women, those who diet or over-exert themselves, and those with chronic illnesses. Low blood pressure isn't necessarily safer than high blood pressure; it also requires proper management.
1. What is hypotension?
The Hong Kong Department of Health and the World Health Organization (WHO) do not have a unified definition of "low blood pressure", but the medical community generally uses the following values as a reference:
- Systolic blood pressure (SBP) below 90 mmHg
- or diastolic blood pressure (DBP) below 60 mmHg
It's important to note that the dangers of low blood pressure depend on the symptoms and duration . Some athletes or healthy individuals may have naturally low blood pressure but experience no discomfort and may not require treatment. However, if accompanied by dizziness, blurred vision, palpitations, shortness of breath, or even fainting, it's cause for concern.
2. Causes of low blood pressure
Hypotension can be divided into two categories: acute and chronic. Common causes include:
- Dehydration – Hong Kong’s summers are hot, and insufficient water intake due to exercise or excessive sweating can lead to a decrease in blood volume.
- Malnutrition – Long-term dieting, vitamin B12, folic acid or iron deficiency can affect blood production.
- Side effects of medications – diuretics, blood pressure medications, some antidepressants, etc.
- Endocrine problems – hypothyroidism, adrenal insufficiency, etc.
- Heart problems – irregular heartbeats, heart failure, heart valve disease.
- Standing for a long time or changing posture too quickly – commonly known as "orthostatic hypotension". This is the reason why some people suddenly feel dizzy when they stand up on the Hong Kong subway or bus.
3. Why should low blood pressure be treated?
Chronic low blood pressure can deprive vital organs like the brain, heart, and kidneys of adequate blood supply, potentially leading to organ damage. Acute, severe low blood pressure (e.g., due to massive bleeding or sepsis) can cause shock and be life-threatening.
In Hong Kong's emergency departments, many cases of fainting and hospitalization are related to low blood pressure, especially in hot weather or during the flu season.
4. Treatment of hypotension
Treatment for low blood pressure depends on the cause . Below are some common treatment options found in medical literature, which I'll explain in a practical way.
4.1 Lifestyle and Diet Adjustment
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Increase water intake
- Adults should drink at least 1.5–2 liters of water per day, and more in the summer or when exercising.
- The air-conditioned and dry environment in Hong Kong offices can easily lead to mild dehydration.
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Increase salt appropriately
- In contrast to high blood pressure, patients with low blood pressure can slightly increase their sodium intake under the guidance of a doctor, such as soups and saltine crackers.
- But if you already have heart disease or kidney disease, you should be especially careful.
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a balanced diet
- Eat enough protein (fish, eggs, lean meat), iron (red meat, spinach), and B vitamins (whole grains, nuts, dairy products).
- Avoid being fasting for long periods of time and add snacks between meals.
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Avoid excessive alcohol consumption
- Alcohol dilates blood vessels, accelerates dehydration, and lowers blood pressure.
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Small meals
- Especially for people with postprandial hypotension (a drop in blood pressure after eating a large meal), eating smaller, more frequent meals can reduce blood pressure fluctuations.
4.2 Adjustment of lifestyle habits
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Get up slowly
- When changing from a sitting or sleeping position to a standing position, first move your legs, take a deep breath, and then stand up slowly to reduce the occurrence of orthostatic hypotension.
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Wearing elastic stockings (compression stockings)
- Helps blood return to the lower limbs and reduces blood stagnation in the legs.
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Maintain moderate exercise
- Exercise can promote blood circulation and muscle tension, helping to maintain stable blood pressure.
- Light exercise in Hong Kong, such as morning exercises and hiking, are good choices.
4.3 Drug treatment
- If low blood pressure is caused by a chronic disease or a side effect of medication, your doctor may adjust your medication or prescribe a blood pressure-raising drug (such as midodrine or fludrocortisone).
- In Hong Kong's public hospitals, drug treatment is mostly used for patients with severe symptoms, ineffective lifestyle adjustments or with clear causes.
4.4 Management of Acute Hypotension
- If the condition is caused by massive bleeding, severe dehydration, anaphylactic shock, etc., the patient must be sent to the hospital immediately and the medical team will provide intravenous infusion, blood transfusion or use pressor drugs.
- Editor's reminder: If you see someone fainting on the street, call an ambulance as soon as possible and lift their legs to help blood flow back to the brain.
5. Hong Kong’s medical resources
- General outpatient clinics and specialist clinics : can provide preliminary assessments and examine the causes of blood pressure fluctuations.
- Private clinics : Short waiting times, suitable for those who need quick check-ups.
- Community health centres and elderly centres : Some provide free blood pressure testing and health consultation services.
Editor's summary
While low blood pressure isn't as often considered a major threat as high blood pressure, it's important to take it seriously if it's accompanied by symptoms or caused by a medical condition. Urban dwellers in Hong Kong are prone to low blood pressure due to busy schedules, irregular diets, stress, and weather. To improve low blood pressure, the first step is to identify the cause, then adjust your diet and lifestyle, combine medication if necessary, and monitor your blood pressure regularly.
Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.
