Presence of symptoms is very important as low blood pressure can also be normal. If the low blood pressure is not associated with any symptoms, and no cause of low blood pressure with potentially serious future complications is evident, then the low blood pressure requires no specific treatment.
Any low blood pressure requires proper medical evaluation as it may be the first or the only clue to an underlying serious disease condition. The treatment of low blood pressure is focused around the primary cause and therefore, is extremely variable. Also there is no fixed treatment that is always effective in all low blood pressure cases. A treatment helpful in one condition might worsen the symptoms in another. For e.g. increased salt and water intake is often effective in raising the blood pressure in many cases. However, if the low blood pressure is due to heart failure, increasing salt and water intake may worsen the symptoms and further lower the blood pressure. The general approach to treatment of the most important causes of hypotension is mentioned below.
Low blood pressure due to dehydration can be treated by intake of salt and water. Severe dehydration may require intravenous fluids. Replenishing the fluids and electrolytes often cures the hypotension due to dehydration.
Treatment of low blood pressure due to heart disease is dependent upon the exact cause. Hypotension caused by arrhythmias may require anti-arrhythmic drugs or pacemakers or an implantable cardioverter-defibrillator. Surgery might be needed to correct valvular dysfunction if medical treatment is not effective.
Low blood pressure due to endocrine dysfunction requires correcting the underlying hormonal abnormality. Thyroid dysfunctions like hypothyroidism and hyperthyroidism would require treatment with appropriate drugs. Similarly, in adrenal insufficiency (Addison’s Disease), replacement of adrenal hormones by exogenous glucocorticoids and mineralocorticoids is needed.
Any type of shock is a medical emergency and requires urgent medical care in a hospital. The treatment is variable, depending upon the exact cause of the shock. Hypovolemic shock due to acute blood loss would require blood transfusion and intravenous fluids. Septic shock would need intravenous antibiotics also along with fluids. Anaphylactic shock may need intravenous pressor agents like adrenaline. The goal is to maintain adequate perfusion of vital organs like heart, brain, kidney, etc. while the underlying cause of the shock is treated.
Low blood pressure if caused as a side effect of drug(s) may require alteration in the doses of the drug(s) or switching to another drug(s).
Treatment of orthostatic hypotension (postural hypotension) is usually supportive. Other than the routine measures like increasing salt and water intake, the affected persons are advised to wear a compressive stocking. Furthermore, they should be extra cautious while standing up from a lying down or sitting position and should rise slowly and preferably hold something for support while rising up. Some of the drugs that are effective in this condition are fludrocortisones, midorine and pyridostigmine.
Some of the drugs that are effective in raising the blood pressure are fludrocortisones, midorine, pyridostigmine, etc. These drugs should only be taken on physician’s recommendations.
Furthermore, there are few other non-pharmacological interventions that can help to raise the blood pressure to normal limits. These are increased salt and water intake, mild exercises, cutting down on alcohol, etc. They are described in more details here (Home Remidies for Low Blood Pressure).