A Hypotension, or low blood pressure, is not as common as hypertension – nor is it of as much concern to doctors. That’s probably why you hear so little about it. Hypertension is common because it is exacerbated by a sedentary lifestyle and obesity and, so, is increasing in prevalence, given our modern Western lifestyles. It is also a potentially life-threatening condition, being a risk factor for stroke and heart disease.

In contrast, low blood pressure has no long-term adverse effects and is, in fact, associated with a longer life expectancy. No wonder insurance companies like clients with low blood pressure – they continue paying into life insurance policies for longer.

However, hypotension can be an impediment as its main symptoms are fatigue, feeling faint and intermittent headaches. These are all the result of oxygen-carrying haemoglobin not being transported quickly enough around the body. It is dangerous only because sufferers could fall and injure themselves on fainting.

Feeling faint and dizzy is particularly noticeable when standing up quickly, which should be avoided. The effect is worsened by a hot bath, as the heat causes blood to migrate away from the organs and towards the periphery of the body.

One solution, according to panellist Dr Harald Gaier, is to supplement with organic iron. The liquid iron formula Floradix doesn’t come with the usual side-effects of standard iron tablets. If taken as indicated, it should provide your friend with enough iron to transport the required oxygen via her blood circulation more efficiently.

The headaches should cease too, as these familiar low-grade throbbings are simply the brain complaining that it isn’t getting enough oxygen.

A common cause of fainting is a sudden reduction of blood flow to the brain which results from a temporary drop in blood pressure and pulse rate. These lead to a brief loss of consciousness. A fainting victim may pass out for several seconds or up to ½ hour.

There are many reasons why women faint. Medical reasons include:

• Low blood sugar (hypoglycemia) which is common in early pregnancy.
  
• Anemia.
  
• Any condition in which there is a rapid loss of blood. This can be from internal bleeding such as with a peptic ulcer, a tubal pregnancy or a ruptured cyst.
  
• Heart and circulatory problems such as abnormal heart rhythm, heart attack or stroke.
  
• Eating disorders such as anorexia, bulimia.
  
• Toxic shock syndrome.

Other things that can lead to feeling faint or fainting include:

• Any procedure that stretches the cervix such as having an IUD inserted, especially in women who have never been pregnant.
  
• Extreme pain.
  
• A sudden change in body position like standing up too quickly (postural hypotension).
  
• Sudden emotional stress or fright.
  
• Taking some prescription drugs. Examples are: Some that lower high blood pressure, tranquilizers, antidepressants, or even some over-the-counter drugs such as antihistamines, when taken in excessive amounts.
  
• Know, also, that the risk for fainting increases if you are in hot, humid weather, are in a stuffy room or have consumed excessive amounts of alcohol.

Here are some dos and don’ts to remember if someone faints:

Dos:

• Catch the person before he or she falls.
  
• Place the person in a horizontal position with the head below the level of the heart and the legs raised to promote blood flow to the brain. If a potential fainting victim can lie down right away, he or she may not lose consciousness.
  
• Turn the victim’s head to the side so the tongue doesn’t fall back into the throat.
  
• Loosen any tight clothing.
  
• Apply moist towels to the person’s face and neck.
  
• Keep the victim warm, especially if the surroundings are chilly.

Don’ts:

• Don’t slap or shake anyone who’s just fainted.
  
• Don’t try to give the person anything to eat or drink, not even water, until they are fully conscious.
  
• Don’t allow the person who’s fainted to get up until the sense of physical weakness passes and then be watchful for a few minutes to be sure he or she doesn’t faint again.

Is the person who fainted not breathing and does he/she not have a pulse?
Are signs of a heart attack also present with the fainting? Chest pain or pressure. Pain that spreads to the arm, neck or jaw. Shortness of breath or difficulty breathing. Nausea and/or vomiting. Sweating. Rapid, slow or irregular heartbeat. Anxiety.
Are signs of a stroke also present with the fainting? Numbness or weakness in the face, arm or leg. Temporary loss of vision or speech, double vision. Sudden, severe headache.
Did the fainting come after an injury to the head.
Do you have any of these with the fainting? Pelvic pain? Black stools?
Have you fainted more than once?
Are you taking high blood pressure drugs or have you recently taken a new or increased dose of prescription medicine?

Do these things when you feel faint:

• Lie down and elevate both legs.
  
• Sit down, bend forward and put your head between your knees.
  

  If you faint easily:
  

• Get up slowly from bed or from a sitting position.
  
• Follow your doctor’s advice to treat any medical condition which may lead to fainting. Take medicines as prescribed but let your doctor know about any side effects, so he/she can monitor your condition.
  
• Don’t wear tight-fitting clothing around your neck.
  
• Avoid turning your head suddenly.
  
• Stay out of stuffy rooms and hot, humid places. If you can’t, use a fan.
  
• Avoid activities that can put your life in danger if you have frequent fainting spells, such as driving a motor vehicle and climbing to high places.
  
• Drink alcoholic beverages in moderation.
  

  When pregnant:
  

• Get out of bed slowly.
  
• Keep crackers at your bedside and eat a few before getting out of bed. Try other foods such as dry toast, graham crackers, bananas, etc.
  
• Eat small, frequent meals instead of a few large. Have a good food source of protein, such as lean meat, low-fat cheese, milk, etc., with each meal. Avoid sweets. Don’t skip meals or go for a long time without eating.
  
• Don’t sit for long periods of time.
  
• Keep your legs elevated when you sit.
  
• When you stand, as in a line, don’t stand still. Move your legs to pump blood up to your heart.
  
• Take vitamin and mineral supplements as your doctor prescribes.
  
• Never lay on your back during the 3rd trimester. It is best to lay on your left side. If you can’t, lay on your right side

Symptoms


Symptoms of anxiety are both physical and psychological. They include:

• Rapid pulse and/or breathing rate
  
• Racing or pounding heart
  
• Dry mouth
  
• Sweating
  
• Trembling
  
• Shortness of breath
  
• Faintness
  
• Numbness/tingling of the hands, feet, or other body part
  
• Feeling a “lump in the throat”
  
• Stomach problems
  
• Insomnia
  

Causes


Anxiety can be a symptom of medical conditions such as:

• A heart attack
  
• An overactive thyroid gland (hyperthyroidism)
  
• Low blood sugar (hypoglycemia)
  
• An excess of hormones made by the glands located above the kidneys called the adrenal glands (Cushing’s syndrome)
  
• A side effect of some medications
  
• A withdrawal reaction from nicotine, alcohol, drugs, or medicines, such as sleeping pills
  

• Phobias (see page 203)
  
• Panic attacks and panic disorder (see page 200)
  
• Obsessive-Compulsive Disorder An anxiety disorder where the sufferer has persistent, involuntary thoughts or images (obsessions) and engages in ritualistic acts such as washing their hands according to certain self-imposed rules (compulsions).
  
• Post-Traumatic Stress Disorder A condition where a person reexperiences a traumatic past event like a wartime situation, hostage taking, or rape. Symptoms include nightmares, flashbacks of the event, excessive alertness, and emotional numbness to people and activities.
  

Treatment


When anxiety is mild and/or does not interfere with daily living, it can be dealt with using self-help. (See Self-Care Tips in this section on page 183.)

Treatment for anxiety includes:

• Treating any medical condition which causes the anxiety
  
• Medication. Examples include antianxiety medicines such as Xanax, and antidepressants such as Tofranil and Prozac. Another medicine, Tenormin, which is usually used for high blood pressure, has been shown to help persons with the anxiety that comes with stage fright.
  
• Psychological counseling
  
• Changing jobs or other life situations
  
• Self-help groups such as Agoraphobics in Motion (AIM). (See “Places to Get Information & Help” under “Anxiety/Phobias” on page 375.)
  

Questions to Ask

Are any of these symptoms of a heart attack present with the anxiety? Chest pressure or pain (may spread to the arm, neck, or jaw) Chest discomfort with any of these problems: Shortness of breath or trouble breathing; nausea or vomiting; sweating; uneven heartbeat or pulse; or sense of doom
Are these symptoms present with the anxiety? Excessive hair growth Round face and puffy eyes Skin changes reddening, thinning, and stretch marks High blood pressure
Do you have these symptoms with the anxiety? Rapid heartbeat Hyperactivity Weight loss Muscle weakness, tremors Bulging eyes Feeling hot or warm all the time
If you have been through or seen a traumatic event, do you suffer from any of these problems? Nightmares, night terrors, and/or flashbacks of the event Lack of concentration, poor memory, sleep problems Feelings of guilt for surviving the event Startled easily by loud noises or anything that reminds you of the event Lack of interest in the activities and people you once enjoyed	Or
Do you have anxiety only under the following conditions? When you don’t eat or when you do too much physically, especially if you are diabetic During the 2 weeks before your menstrual period if you are a woman
Does the anxiety come only after 1 or both of the following? Taking an over-the-counter (OTC) or prescription medicine Withdrawing from medication, nicotine, alcohol, or drugs
Have you had any of these problems? Panic attacks followed for 1 month by fears of getting another one Worry about what would happen with another panic attack, or A change in what you do related to panic attacks such as avoiding places, not being able to leave the house or be left alone	Or
Do any of the following keep you from doing your daily activities? Checking something over and over again, such as seeing if you’ve locked the door, even though it is locked Repeated, unwanted thoughts such as worrying you could harm someone Repeated, senseless acts such as washing your hands over and over again	Or
Is anxiety keeping you from doing the things you need to do every day?	Or

Self-Care Tips

• Look for the cause of the stress that results in anxiety and deal with it through the use of stress management techniques, such as deep breathing exercises and meditation. (See “Self-Care Tips” under “Stress” on pages 212 and 213.)
  
• Lessen your exposure to things that cause you distress.
  
• Talk about your fears and anxieties with someone you trust such as a friend, spouse, teacher, etc.
  
• Eat healthy and at regular times. Don’t skip meals.
  
• If you are prone to low blood sugar episodes, eat 56 small meals per day instead of 3 larger ones. Avoid sweets on a regular basis, but carry a quick source of sugar with you at all times, such as a small can of orange juice. This will give you a quick source of sugar in the event that you do get a low blood sugar reaction.
  
• Exercise regularly.
  
• Limit or avoid caffeine intake after noon. Caffeine can worsen anxiety and lead to poor sleeping patterns. If you must drink coffee, switch to decaffeinated. Also use decaffeinated teas, colas, and other sodas. Limit your intake of chocolate.
  
• Avoid nicotine and alcohol.
  
• Avoid medicines that have a stimulating effect, which can cause anxietylike symptoms. Examples are over-the-counter diet pills and pills to keep you awake.
  
• Do some form of relaxation exercise daily. Examples include biofeedback, deep muscle relaxation, meditation, and deep breathing exercises.
  
• Don’t “bite off more than you can chew.” Plan your schedule for what you can handle both physically and mentally.
  
• Rehearse for events that are coming up about which you have felt anxious in the past or think will cause anxiety. Imagine yourself feeling calm and in control during the event several times before it really occurs.
  
• Be prepared to deal with symptoms of anxiety if you think they will happen. For example, if you have hyperventilated in the past, carry a paper bag with you. If you do hyperventilate, cover your mouth and nose with the paper bag. Breathe into the paper bag slowly and rebreathe the air. Do this in and out at least 10 times. Remove the bag and breathe normally a few minutes. Repeat breathing in and out of the paper bag as needed.
  
• Help others. The positive feelings from this can help you overcome or forget about your anxiety.
  

Symptoms come on fast and are often severe. They include:

• High sudden fever.
  
• Muscle aches.
  
• Vomiting.
  
• Diarrhea.
  
• Sunburn-like rash, including peeling skin on hands and feet.
  
• Rapid pulse.
  
• Extreme fatigue and weakness.
  
• Sore throat.
  
• Dizziness.
  
• Fainting.
  
• Drop in blood pressure.

Are symptoms of toxic shock syndrome present? These could occur during your menstrual period or any other time of month.

• Never use tampons if you’ve experienced TSS in the past.
  
• Use sanitary napkins instead of tampons whenever possible.
  
• Alternate tampons with sanitary pads or mini-pads during a menstrual period.
  
• Don’t use superabsorbent tampons.
  
• Don’t use tampons with plastic applicators.
  
• Lubricate the tampon applicator with a water-soluble (nongreasy) lubricant like K-Y Jelly before insertion.
  
• Change tampons and sanitary pads every 4 to 6 hours, or more frequently.