Low blood pressure equally dangerousBy Charles E. Buban
Philippine Daily Inquirer
With all the dangers associated with high blood pressure, it is easy to believe that having low blood pressure—hypotension—is a much better thing to suffer from.
“However, most people never realize that low blood pressure is equally as dangerous as high blood pressure,” warned Dr. Adolfo Bellosillo who heads the Makati Medical Center’s Cardiac Rehabilitation and Preventive Cardiology Unit.
He explained that while frequent fainting spells, palpitations, lightheadedness, blurred vision, dizziness, cold and clammy skin, and rapid breathing may be some of the common manifestations of this condition (and which could be easily remedied through medications), hypotension could indicate the presence of internal bleeding, alarming amount of resistance encountered by the blood as it flows through blood vessels (peripheral resistance), allergic reaction or an overwhelming infection.
“Doctors should watch out for signs of hypotension since if allowed to linger, this will eventually lead to multiple organ failure and may result in stroke, heart attack, kidney failure and bowel ischemia (decreased blood supply to the small and large intestine). The patient could be dead within days or weeks,” he said.
The first to fail, according to Bellosillo, is the kidney, then the pancreas and the respiratory system in about two days. In five days, the effect on the liver starts to manifest, while changes in the brain function may start to appear (agitation, metal confusion and even coma).
“Heart function may start to exhibit irregularities (as a result of hypotension) in about a week while gastrointestinal hemorrhage in about two weeks along with problems in the body’s ability to form blood or blood cells. The number of organs involved—rather than than a particular one—determines how fatal the outcome,” Bellosillo said.
If only one organ is affected, the chances of death is 30 percent; with two organs, 60 percent. The chances of death worsen to 85 percent if three organs are involved. Death is almost always assured if four or more organs are severely impaired by hypotension.
Recognizing the common misjudgment that a number of doctors make with regard to hypotension and its relation to multiple organ failure, Bellosillo, who is president and founder of the Foundation for Lay Education on Heart Diseases, has chosen the theme: “Multiple Organ Failure, Prevention through Phato-physiologically based Management of Hypotension” for the upcoming 13th national annual convention on preventive cardiology for physicians.
The two-day free lecture happening from Jan. 25 to 26, is organized by FLEHD in cooperation with the Makati Medical Center’s Preventive Cardiology and Cardiac Rehabilitation Unit.
“The 18 topics that we have prepared will impress upon our doctors the importance of managing hypotension. All they have to do is reserve these two dates and proceed to the Makati Medical Center Auditorium in Makati City,” he said.
Reduce number of deaths
Bellosillo hopes that the event would help deal with reducing the number of deaths of patients through early detection of oxygen deficits, utilizing hemodynamic monitoring (study of blood flow or the circulation), as well as early intervention and treatment.
“Unless the actual cause or causes of hypotension is determined and each one managed adequately, elevating the blood pressure with the use of vasopressors (medicines that cause blood vessels to constrict and blood pressure to rise) may only serve as a temporary remedy. They should realize that repeated administration or giving higher doses of vasopressors could already mean something is wrong in the blood system or that there may already be organs malfunctioning,” Bellosillo reminded doctors.
The FLEHD, a nonprofit, nongovernmental organization, is primarily focused on educating the Filipino community with regards to heart and related diseases.