HYPOTENSION

Many patients leave the hospital or doctor’s office with a new prescription to treat high blood pressure, also known as hypertension. Unfortunately, due to increased demand for services and staffing shortages in today’s healthcare settings, there is constant pressure to move patients in and out of the system as quickly as possible. While staff do their best to educate patients about their new anti-hypertensive medications, we often neglect to warn them of the side effects.

Antihypertensives can cause low blood pressure, also known as hypotension. Hypotension is defined as a blood pressure lower than 90/60; however, any sudden blood pressure drop can cause life-threatening effects. Some blood pressure medications can also decrease heart rate. Normal heart rate is 60-100 beats per minute. Normal blood pressure is 90/60 to 120/80.

Symptoms of hypotension include dizziness, fatigue, fainting, confusion, weakness, visual disturbances, nausea and/or vomiting, headache, and occasionally chest pain, rapid heart rate, and shortness of breath.

Dizziness and fainting can cause falls, resulting in broken hips, legs, arms, and ribs, and severe trauma to the face and head. Consistent hypotension can also cause damage to the kidneys and other organs, as they will not get enough blood flow.

When you start a new medication that can affect blood pressure and/or heart rate, purchase a wrist blood pressure cuff so you can monitor it. Check your blood pressure every morning before getting up and every night before bed. This will warn you if your pressure is too low and tell you if your medication is working throughout the day.

Record your blood pressure and pulse in a book every day, including the date and time taken, and show it to your primary care provider (PCP) at your appointments. If your blood pressure is dropping below 90/60 and/or your heart rate is dropping consistently below 60 beats per minute, your PCP may want to adjust your dosage or even switch you to another medication. Do not stop taking your medication or change your dosage without consulting your PCP.

When you get up in the morning, sit on the edge of the bed for one to two minutes to allow your body to adjust to the change in position. Then, if you are not feeling dizzy or lightheaded, slowly stand up. If you are alone and feel unsafe getting up, call a neighbor, friend, or family member to come and be with you. You can always call 911, and the emergency personnel will come and evaluate and assist you. Be sure to keep an up-to-date list of your medications to show the emergency personnel when they arrive. On the refrigerator door is a great place to put your medication list and advance directive information, including a Physician Orders for Life-Sustaining Treatment Form (POLST), if you have one.

Stay safe, stay active, stay happy, stay healthy.

Dawn Audette, RN