Low Blood Pressure (Hypotension) In Children: Types, Causes, And Treatment

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 . 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 . Hypotension can be classified into four categories:

  1. Orthostatic hypotension: It happens when a child’s blood pressure falls when they are in a standing posture for a long time. They may have symptoms such as headache, weakness, and difficulty in vision .
  1. Neurally mediated hypotension: Also known as syncope, it is caused when the brain and heart have an abnormal reflex interaction due to a glitch in the autonomous nervous system. It could occur when the child is in a warm surrounding, has been standing for long, after exercise, or after eating .
  1. Severe hypotension: It is a substantial drop in blood pressure due to severe infection, loss of excess blood, severe allergy, injury, or trauma .

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.

  1. Dehydration: When there is an excess loss of water from the body, it causes dehydration. Low blood pressure can be one of the several symptoms of mild to severe dehydration in children .
  1. 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 .
  1. Infections: Hypotension may happen in cases of severe infection.
  1. Iron deficiency anemia: A low blood pressure could be one of the several symptoms of iron deficiency anemia among children . Hypotension is likely to be among the symptoms that occur when the anemia becomes severe.
  1. Heart problem: A fall in blood pressure could be a symptom of heart failure or other heart-related issues among children. Some other symptoms include trouble breathing, excessive sweating, and poor development .
  1. 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 .
  1. Nutritional deficiencies and metabolic problems: A deficiency in nutrients, like folic acid and vitamin B12, may cause hypotension. Problems in the endocrine system (glands that secrete hormones) may also be a reason .
  2. 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.

Sometimes, it is difficult to figure out that the blood pressure of the child is low. But knowing the symptoms may help.

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
  • Tiredness
  • Nausea
  • 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 .

  1. 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.
  1. 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.
  1. Pulse determination: Fingers are placed on an artery to feel the pulse. It helps in knowing the number of heartbeats per second.
  2. 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 issues or infections or allergies, then the doctor may prescribe medications for it .
  • If any medications are causing a drop in blood pressure, then the medications may be changed as per the symptoms and health condition of the child.
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Low blood pressure in children is often manageable at home when it is due to physical 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 sodium could help in maintaining the blood pressure. Savory snacks, cured meats, cheese, chicken, soups, and bread have sodium content . You may speak to a pediatrician or a pediatric dietician to know about the right quantity of sodium your child needs at their age.
  • A well-balanced diet is 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 water can help prevent dehydration, which is one of the causes for low blood pressure in children.
  • Tell your child to slow down the pace of any strenuous physical activity. The child must avoid standing or sitting for too long, especially in warm outdoors.
  • Compression stockings can 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.

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.


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