Hypotension can also cause complications

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Hypotension can also cause complications

Lifestyle modifications and dietary changes can help in managing symptoms

New Delhi, 24 November 2017: Statistics indicate that the prevalence of hypotension or low blood pressure depends on age. It ranges from 5% in patients under 50 years of age to 30% in those over 70 years of age. In healthy people, low blood pressure without any symptoms means negligible health concerns. However, symptoms indicate inadequate blood flow to the heart, brain, and other vital organs, which needs to be treated as soon as possible.

Hypotension is a condition in which blood pressure in the arteries gets abnormally low. In some cases, the blood pressure becomes so low that it fails to reach all the body organs. The ideal reading level for blood pressure is more than 120 over 80 but less than 140 over 90 (120/80-140/90). When either number is below the ideal reading level, the blood pressure is considered lower than normal.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Our blood pressure varies throughout the day due to several factors. Some of them include body positions, the level of stress, physical condition, medications, eating and drinking habits. Blood pressure usually decreases when a person is asleep and rises when he/she wakes up. Some other causes include dehydration, some heart conditions, pregnancy, loss of blood, endocrine problems, infections, certain nutritional deficiencies, allergic reactions, and low salt intake. With age, the risk of low blood pressure normally increases. This is because the blood flow to the heart muscle and the brain declines with age, often due to a buildup of plaque in blood vessels.”

Some symptoms of hypotension include fainting in case of syncope, nausea, lack of concentration, fatigue, blurred vision, and dizziness or lightheadedness. In extreme cases, hypotension can also lead to rapid pulse rate, weakness, feeling of confusion, pale skin color, and rapid, shallow breathing.

Adding further, Dr Aggarwal, said, “Low blood pressure that either doesn’t cause signs or symptoms or causes only mild symptoms rarely requires treatment. However, it is best to seek help in case of consistently low blood pressure readings. It also helps to keep a record of such signs and symptoms.”

The following preventive measures can be taken to manage chronic low blood pressure.

  • Drink lots of fluids and avoid alcoholic beverages.
  • Do not take over-the-counter medications.
  • Indulge in regular physical activity to promote normal blood flow.
  • Be careful when you get up from your sleep. For those who have consistent low blood pressure, it is imperative to be careful while standing up.
  • To improve circulation, pump your feet and ankles a few times before standing up. Avoid heavy lifting.
  • Increase your salt consumption in consultation with a doctor.
  • Avoid prolonged exposure to hot water.
  • To avoid problems with low blood pressure and lessen episodes of dizziness after meals, try eating smaller, more frequent meals.
  • Cut back on carbohydrates and take some rest after eating.

Standardized definitions for outcome measures beyond A1c for patients with type 1 diabetes

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A new joint consensus statement from the American Association of Clinical Endocrinologists AACE American Association of Diabetes Educators AADE American Diabetes Association ADA Endocrine Society JDRF International Leona M and Harry B Helmsley Charitable Trust Pediatric Endocrine Society and T1D Exchange standardizes definitions for clinically meaningful outcome measures beyond HbA1c for patients with type 1 diabetes. Glycosylated hemoglobin or HbA1c is a commonly used parameter to evaluate glycemic control as it provides a measurement of the mean blood glucose levels over the past three months. A1c is also a surrogate measure for a person s risk of developing diabetes related complications. According to the statement there are limitations to what the HbA1C can tell patients and physicians about their diabetes such as it does not detect short term variations in blood glucose exposure to hypoglycemia and hyperglycemia or the impact of blood glucose variations on the quality of life of the patient. Recent advances technologies such as continuous glucose monitoring CGM have made it feasible to assess the ef 64257 cacy of therapies and technologies using a set of outcomes beyond HbA1c in type 1 diabetes. The statement says that while hypoglycemia has been defined in clinical care these definitions are not standardized. Published online November 21 2017 in the journal Diabetes Care the consensus statement has developed definitions for outcomes beyond HbA1c including hypoglycemia hyperglycemia time in range and diabetic ketoacidosis DKA in type 1 diabetes. Three levels of hypoglycemia have been defined Level 1 hypoglycemia Measurable glucose concentration 70 mg dL 3.9 mmol L but 8805 54 mg dL 3.0 mmol L that can alert a person to take action. Level 2 hypoglycemia Measurable glucose concentration 54 mg dL 3.0 mmol L that needs immediate action. Level 3 hypoglycemia Severe event characterized by altered mental and or physical status requiring assistance. Two levels of hyperglycemia have been defined Level 1 Eevated glucose glucose 180 mg dL 10 mmol L and glucose 8804 250 mg dL 13.9 mmol L Level 2 Very elevated glucose glucose 250 mg dL 13.9 mmol L Time in range has been defined as percentage of readings ranging from 70 180 mg dL 3.9 10.0 mmol L per unit of time. CGM is used to obtain data from which time in range can be derived. Diabetic ketoacidosis Elevated serum or urine ketones greater than the upper limit of the normal range and Serum bicarbonate 15 mmol L or blood pH 7.3 Source ADA Press Release Diabetes Care. 2017 Dec 40 12 1622 1630