HEALTH MATTERS: Causes, treatments of low blood pressureI have been feeling dizzy, and my doctor found low blood pressure. What is the cause, and what can be done?
By: Dr. Joshua Wynne, Grand Forks Herald
Q. I have been feeling dizzy, and my doctor found low blood pressure. What is the cause, and what can be done?
A. Blood pressure forces blood to all parts of the body. Especially when we stand up, we need blood pressure to get blood to the brain; otherwise, gravity would pool the blood in our legs, and we would feel dizzy. The body normally regulates the pressure to keep it in the normal range.
But changes in two factors can alter the blood pressure and cause it to be too low or two high — the amount of blood we have circulating and the degree of constriction of the blood vessels. Low blood pressure is relatively uncommon, while high blood pressure is all too common. Too little blood — such as seen with anemia — can cause low blood pressure (see answer below). So one of the first things we check for in patients with low blood pressure is anemia. The other major problem that can lead to low blood pressure is that the body’s arteries do not constrict enough.
There are a variety of problems that can cause this on a chronic basis, including hormone deficiency and problems with the nervous system. But the first step in treating low blood pressure is to determine its cause. You need to ask your doctor about the cause, because treatment varies — for anemia, we usually give iron or other supplements to build up the red blood cells in the blood. Treatment varies for other causes, but medication usually can enable people with chronic low blood pressure to function normally.
Q. I am a 34-year-old woman, and I’ve been fatigued. My nurse practitioner found anemia and put me on iron. Please explain.
A. In addition to the liquid part of blood, blood also contains circulating cells that consist of red blood cells that carry oxygen, white blood cells that fight infection, and platelets that help stop bleeding by clotting the blood.
Anemia means that the red blood cell count is too low. We determine this by doing a test called a CBC, which stands for complete blood count. In this test, the red blood cells in a small sample of blood are counted; anemia is when there are too few red blood cells.
Anemia is caused by one of three problems — blood loss (either internally or externally such as with a serious cut); inadequate production of red blood cells in the bone marrow; or destruction of them in the body. In a young woman like you, by far the most common cause of anemia is heavy menstrual periods with loss of blood. But in men and nonmenstruating women, it is important to look for other causes of anemia. In these cases, we worry about bleeding into the intestinal tract. Looking for the bleeding source is important — precancerous polys can bleed as can tumors.
When there is bleeding — caused by intestinal blood loss or heavy menstrual cycles — the lost red blood cells carry their contained iron with them, depleting the body’s stores of iron. Since iron is needed to make new red blood cells, not enough such cells are produced. Thus, we give iron orally, and the body then can make new red cells and the anemia resolves.
Wynne is vice president for health affairs at the University of North Dakota, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.
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