Evidence for the existence of a hypotensive syndrome - Tips from Other Journals

Date: May, 1992

High blood pressure is recognized as a potentially life-threatening condition for which medical intervention is appropriate. Whether low blood pressure produces a syndrome is controversial. In many European countries, hypotension is frequently diagnosed and is treated with a variety of agents such as digoxin, ergotamine and amphetamine. Several recent studies have suggested that low blood pressure may be associated with nonspecific symptoms such as tiredness and feeling faint. Because these symptoms are often attributed to psychologic problems, some authorities believe that psychologic dysfunction may be associated with hypotension. To investigate the possible relationship between low blood pressure and psychologic dysfunction, Pilgrim and co-workers analyzed data from a large epidemiologic study of British civil servants.

The study included 6,829 men and 3,351 women between the ages of 35 and 55. All subjects underwent extensive medical screening and completed a detailed questionnaire concerning physical, social, psychologic and demographic factors.

Dizziness-giddiness in men and unexplained tiredness in both men and women were significantly related to low systolic blood pressure. For both sexes, the general health questionnaire score was inversely related to systolic blood pressure. This relationship persisted after controlling for potentially confounding variables. However, the association of low blood pressure and physical symptoms was not significant after controlling for the general health questionnaire score.

The authors conclude that there is a strong relationship between low systolic blood pressure and minor psychologic dysfunction. The physical symptoms reported are believed to be secondary to mental disturbance. This association appears to be with systolic blood pressure only, and the mechanism is not known. (BMJ, January 11, 1992, vol. 304, p. 75.)

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