Hypotension or low blood pressure in children can be due to various reasons. This is when the systolic or top reading pressure goes below 90mmHg, and the diastolic pressure or the bottom reading is below 60mmHg(1). According to most pediatric care guidelines, these blood pressure measures are less than the 5th percentile for children aged ten years or more. However, the normal measurements may vary in younger children. So you may seek pediatricians’ help to determine hypotension in children.
Read on to know more about the causes, symptoms, and management of low blood pressure in children.
Types Of Low Blood Pressure (Hypotension) In Children
The threshold of blood pressure in adults is usually static. However, it differs in children based on their age, height, and gender percentile(2). Hypotension can be classified into four categories:
- Orthostatic hypotension:当一个孩子的血压下降when they are in a standing posture for a long time. They may have symptomssuch as headache, weakness, and difficulty in vision(3).
- Neurally mediated hypotension: Also known as syncope, or more commonly vasovagal syncope, it is caused when the brain and heart have an abnormal reflex interaction due to a glitch in the autonomousnervous system. It could occur when the child is in a warm surrounding, has been standing for long, after exercise, or after eating(4)(5). Also, neurological disorders like spinal cord injury, or multiple sclerosis can lead to hypotension(6).
- 严重低血压:提单大幅下降ood pressure due to severe infection, loss of excess blood, severe allergy, injury, or trauma(7).
Low blood pressure in children could be caused due to various factors or could be the result of a condition or an event.
Causes Of Low Blood Pressure In Children
Some of the common causes that affect children are mentioned below.
- Dehydration:When there is an excess loss of water from the body, it causesdehydration. Low blood pressure can be one of the several symptoms of mild to severe dehydration in children(8).
- Allergies:An allergy occurs when the immune system mounts an attack on a usually harmless allergen. A severe allergic reaction is called anaphylaxis. This condition could lead to low blood pressure(9).
- Infections:Hypotension may happen in cases of severe infection. Sepsis or septic shock caused by a severe infection can also result in hypotension (10).
- Iron deficiency anemia:低血压可能是几个之一symptoms ofiron deficiency anemiaamong children(11). Hypotension is likely to be among the symptoms that occur when the anemia becomes severe.
- Heart problem: A fall in blood pressure could be a symptom of heart failure, congenital heart defects, or other heart-related issues among children. Some other symptoms include trouble breathing,excessive sweating, and poor development (12). Orthostatic hypotension can also be caused due to arrhythmias or irregular heartbeat (13).
- Injury or trauma:An injury can lead to external or internal blood loss, which may cause a drop in blood pressure. Low blood pressure is often among the many symptoms of a severe abdominal injury, which causes internal bleeding(14).
- Nutritional deficiencies and metabolic problems: A deficiency in nutrients, like folic acid and vitamin B12, which may have been caused by malnutrition, could also lead to hypotension. Problems in the endocrine system (glands that secrete hormones) may also be a reason (15) (1).
- Physical stress: Standing or sitting for too long, prolonged exposure to the sun during summer, intense exercise, and emotionally stressful events might also trigger low blood pressure.
- Addison’s Disease: Addison’s disease is caused due to damage of the adrenal glands which results in reduced secretion of the hormone cortisol. With adrenal insufficiency, the body is not able to increase the amount of cortisol which leads to an Addisonian crisis that results in low blood pressure (16).
- Hypovolemia: This is a condition that causes a reduction in blood circulation and in extreme cases, arterial hypotension (17).
- Pulmonary Embolism: This is a condition in which a blood clot originates in a large vein, mostly in the legs, and moves to the lungs, causing difficulty in breathing and low blood pressure (18).
- Hypoglycemia: This condition occurs when the body experiences abnormally low levels of blood sugar or glucose, often resulting from diabetes. This can trigger an elevated heart rate and a decrease in central blood pressure (19).
- Hyperthyroidism: The regulation of blood pressure may be impacted by an overabundance of thyroid hormone, leading to the relaxation of blood vessels and a decrease in diastolic blood pressure (20).
- Cancer: It is seen that cancer treatments like chemotherapy or certain biological drugs can cause low blood pressure (21).
Some research has suggested that low blood pressure might also be caused by certain genetic disorders too. However, sometimes it is difficult to figure out that the blood pressure of the child is low. But knowing the symptoms may help.
Certain prescription medications, alcohol, recreational drugs, and extreme temperatures can also trigger hypotension in kids(23).
Signs And Symptoms Of Low Blood Pressure In Children
A child with low blood pressure is likely to show the following symptoms (1).
- Dizziness or fainting
- Difficulty to focus
- Blurred vision
- Feeling sick
- Breathing difficulties
Some children show mild symptoms, like headaches and chronic fatigue, which may or may not indicate a fall in blood pressure.
Diagnosis Of Low Blood Pressure In Children
A doctor will use the following steps to diagnose low blood pressure(24).
- Assessment of symptoms:The doctor will check symptoms related to low blood pressure and may ask parents about any existing medical problems in the child.
- Auscultatory blood pressure measurement:The doctor uses a manual or digital sphygmomanometer, which is a blood pressure measurement machine, to check the blood pressure of the child.
- Pulse determination:Fingers are placed on an artery to feel the pulse. It helps in knowing the number of heartbeats per second.
- ECG:If some anomalies are detected, then the doctor might suggest further checkup of the heart with an ECG machine.
Treatment For Low Blood Pressure In Children
- If the blood pressure has dropped due to any medical condition such as heart disease or infections or allergies, then the doctor may prescribe medications for it(25)(26).
- If medication side effects like a drop in blood pressure is observed, then the medications may be changed as per the symptoms and health condition of the child.
Low blood pressure in children is often manageable at home when it is due tophysical stress, dehydration, or poor diet.
Home Care Tips For Children With Low Blood Pressure
A home care routine can help make low blood pressure manageable and may even help restore normal blood pressure.
- Food that contains sodiumcould help in maintaining the blood pressure. Savory snacks, cured meats, cheese, chicken, soups, and bread have sodium content(27). You may speak to a pediatrician or a pediatric dietician to know about the right quantity of sodium your child needs at their age.
- Awell-balanced dietis also essential to maintain blood pressure. Having vegetables, fruits, and nuts as part of your daily diet helps. Foods rich in folic acid and vitamin B12 should be included in the regular meals.
- Drinking adequate watercan help prevent dehydration, which is one of the causes for low blood pressure in children.
- Tell your child toslow down the paceof any strenuousphysical activity.The child must avoid standing or sitting for too long, especially in warm outdoors.
- Compression stockingscan help maintain optimum blood pressure in the upper body and prevent blood from pooling in the legs. Speak to the child’s doctor about the use of stockings for your child.
Infographic: Measuring Blood Pressure At Home
While trying to manage your child’s blood pressure (BP), the first thing to do is study their numbers. Fortunately, this doesn’t require you to visit a clinic frequently. A one-time investment in a reliable BP apparatus and some training regarding its operation will do.
Let us help you study your child’s BP number. Here is a handy infographic discussing the steps of measuring blood pressure at home.
Frequently Asked Questions
1 Can a lack of sleep in children cause low blood pressure?
Studies show that a lack of sleep due to insomnia and poor sleep quality may be linked to increased blood pressure. Therefore, it is important to ensure your children are sleeping adequately every day (29).
2 Is milk a good option for lowering blood pressure among children?
Milk is rich in potassium and is associated with lowering blood pressure. Studies show that high intake of potassium may also prevent hypertension (30).
3. What should be done in case of a sudden drop in blood pressure in a child?
Pediatrician and neonatologistDr. Neema Shresthasuggests, “Take the child to a safe place, lay them down, and lift their legs above the head for a few minutes. This will help all the pooled blood to return to the heart, increasing the blood pressure. Once the child has regained consciousness and can sit up, fluids may be given to the child. The child should then be taken to the hospital for further assessment of the cause of hypotension.”
Fainting, fatigue, nausea, or blurred vision may indicate low blood pressure in children. Various infections, allergies, stress, dehydration, injuries, or nutritional deficiencies may cause a drop in blood pressure. Hypotension may occur due to prolonged standing posture or as a result of an autonomic malfunction in the body. The condition is manageable at home by making dietary changes and reducing physical stress on the child. However, consult a pediatrician if the condition persists and speak to a pediatric dietician to ensure you include the right ingredients in your child’s diet.
- Low blood pressure in children is defined as having a systolic pressure less than 90 mmHg and a diastolic pressure less than 60 mmHg.
- There are different types of low blood pressure in children, including orthostatic, neurally-mediated, and severe hypotension.
- Allergies, infections, anemia, and dehydration are some of the common causes of low blood pressure in children.
- 低血压的治疗方法可能包括de staying hydrated, increasing salt intake, and maintaining an active lifestyle.
2. A. Banker, C. Bell, and J. Samuels;Blood pressure percentile charts to identify high or low blood pressure in children;BMC Pediatrics (2016)
3. J. M. Stewart et al.;Pediatric Disorders of Orthostatic Intolerance;儿科官方杂志的美国私立高中emy Of Pediatrics (2017)
4.Patient Information Brochure On Neurally Mediated Hypotension And Its Treatment;Johns Hopkins Hospital (1995)
5. M. Zaqqa and A. Massumi;Neurally Mediated Syncope;Texas Heart Institute Journal (2000)
6.Low Blood Pressure Syndromes;News Medical
7.Low blood pressure;University of Florida Health
8.Why is Dehydration so Dangerous?;Rehydration Project
9.Food Allergies in Children;University of Rochester Medical Center
10.Low blood pressure (Hypotension);Cleveland Clinic
11. J. Roganović and K. Starinac;Iron Deficiency Anemia in Children;Intech Open (2016)
12.Heart Failure in Children and Adolescents;American Heart Association
13.Low Blood Pressure;Penn Medicine
14.Recognizing Internal Injuries in Young Athletes;Stanford Children’s Health
15.Low Blood Pressure – When Blood Pressure Is Too Low;American Heart Association
17.Pathophysiology of fluid imbalance;National Library of Medicine
18.Difficulty breathing? It may be due to a blood clot, or pulmonary embolism;UChicago Medicine
19.Hypoglycemia and Cardiovascular risks;Diabetes Journals
20.Hypothyroidism and your heart;Harvard Health Publishing
21.Low Blood Pressure (Hypotension);Breast Cancer
22.Blood pressure modifies outcomes in patients with stage 3 to 5 chronic kidney disease;National Library of Medicine
23. C. Corrado;Blood pressure measurement in children;Italian Journal of Pediatrics (2015)
24.Low Blood Pressure: Your guide to symptoms, risk factors, treatment, recovery; Narayana Health
25.Low Blood Pressure (Hypotension);Michigan Medicine
26.Salt and Sodium;Harvard T. H. Chan
27.Low blood pressure (Hypotension);Cleveland Clinic
28.BEST HOME REMEDIES FOR LOW BLOOD PRESSURE;Narayana Health
29.How Does Sleep Affect Your Heart Health? CDC
30. Mary M. McGrane et al.;Dairy Consumption, Blood Pressure, and Risk of Hypertension;National Library of Medicine; (2011)