How Is Hypotension Treated?

Treatment depends on the cause of the hypotension and how severe the signs and symptoms are.

Hypotension in a healthy person that does not cause signs or symptoms usually does not need to be treated. Hypotension that causes signs or symptoms often needs to be treated. Severe hypotension associated with shock is a medical emergency. It can cause death if it is not treated immediately.

A person's response to treatment depends on his or her age and overall health and strength. It also depends on how easily the person can stop, start, or change medicines.

Any person with blood pressure low enough to cause symptoms should immediately sit or lie down, with the feet up above the level of the heart. Low blood pressure symptoms that do not go away very quickly upon sitting or lying down can be a medical emergency, and immediate medical attention is needed.

Treating Orthostatic Hypotension

The goals of treatment are to relieve or improve signs and symptoms and to manage any underlying medical condition causing the hypotension.

Treatment can include:

• Making lifestyle changes, such as:
  • Drinking plenty of fluids, like water
  • Drinking little or no alcohol
  • Standing up slowly
  • Gradually sitting up for longer periods of time if you've had to stay in bed for a long time
• Using compression stockings that apply pressure to the lower body. These garments drive blood from the legs to the heart and brain and help blood circulate through the body.
• Stopping a medicine or changing the dose if the medicine is causing the hypotension.
• Taking medicine to raise blood pressure, reduce signs and symptoms, and treat related conditions. Medicines include ephedrine, phenylephrine, fludrocortisone, beta blockers, and nonsteroidal anti-inflammatory medicines.

Treating Neurally Mediated Hypotension

Treatment for neurally mediated hypotension (NMH) can include:

• Making lifestyle changes, such as:
  • Avoiding situations that trigger symptoms. For example, don't stand for long periods of time, and avoid frightening or upsetting situations.
  • Drinking plenty of fluids, like water.
  • Increasing salt intake.
  • Learning to recognize symptoms that occur before fainting, and taking action to raise blood pressure (crossing the legs and squeezing them together or lying down).
• Stopping a medicine or changing the dose if the medicine is causing the hypotension.
• Taking medicines, such as fludrocortisone, to treat the hypotension if symptoms are very bad.

Children with NHM often outgrow it.

Treating Severe Hypotension Associated With Shock

Shock is a life-threatening emergency that usually requires treatment in a hospital or by emergency medical personnel. The goals of treating shock are to restore blood flow to the organs as quickly as possible, to prevent organ damage, and to find and reverse the cause of the shock.

Restoring blood flow to the organs often requires that special fluids or blood be given directly into the bloodstream through a needle. Medicines can be given to raise the blood pressure or make the heartbeat stronger. Depending on the cause of the shock, other treatments such as antibiotics or surgery may be required.