Pediatric Low Blood Pressure (Hypotension)

Q: Are there home remedies I can use for my child’s low blood pressure?

In mild cases, home care may help. Encourage your child to: Drink plenty of water. Eat small, frequent meals. Stand up slowly. Avoid overheating or hot showers. Always check with your doctor before trying home remedies, especially if your child’s symptoms are frequent or severe.

Q: Is there any way to prevent hypotension in kids?

It’s not always possible to prevent some types of low blood pressure. But you can reduce the chances of symptoms by: Keeping your child well hydrated Helping them avoid long periods of standing still Making sure they eat a balanced diet Working with their provider to manage any underlying conditions

Low blood pressure (hypotension) happens when a child’s blood pressure drops below the normal range. It isn’t always a problem – some kids have low readings and feel fine. But in other children, it can cause symptoms such as dizziness or fainting. At Children’s Health℠, our pediatric heart experts find out what’s causing low blood pressure in your child. We’ll create a customized treatment plan to help your child feel better and stay active.

Overview

What is low blood pressure (hypotension) in children?

A child’s blood pressure is diagnosed as low when it drops below typical levels for their age. Blood pressure is the force of blood pushing against the walls of arteries (vessels that carry blood from the heart to the body).

Normal blood pressure for children and teens usually falls between 90/60 and 120/80, and the threshold for low blood pressure varies by age. With low blood pressure, doctors pay attention to the first number (called systolic pressure). Your child may have low blood pressure if the first number is less than:

60 for newborns up to age 28 days
70 for infants up to age 12 months
70 + (age in years x 2) for children from age 1 to 10 (example: 70 + (8 x 2) = 86 for an 8-year-old)
90 for children from age 10 to 15

Types

What are the different types of low blood pressure (hypotension) in children?

Several types of hypotension affect children and teens. They include:

Neurally mediated hypotension

This common type of low blood pressure usually affects school-aged children and teens. It can happen when your child has been standing for a long time, is in a warm environment or has just eaten or exercised. Their heart rate and blood vessels don’t respond quickly enough, causing blood pressure to drop. Many children outgrow this type over time.

Orthostatic (postural) hypotension

This type of low blood pressure happens when your child stands up quickly from a sitting or lying position. It can make them feel dizzy or lightheaded for a few seconds until their blood pressure adjusts

Severe hypotension

This type is a sudden and dangerous drop in blood pressure. It can result from a serious infection, allergic reaction, heart problem or injury. Severe hypotension can lead to shock and needs emergency care to protect the brain and other organs.

Signs and Symptoms

What are the signs and symptoms of pediatric low blood pressure (hypotension)?

Signs of hypotension in children and teens can vary depending on the cause. Symptoms may include:

Dizziness (vertigo) or lightheadedness
Fainting
Fatigue (tiredness)
Blurred vision
Nausea and vomiting
Confusion
Weakness

Severe hypotension can be life threatening. Some signs of dangerously low blood pressure and shock include:

Rapid, shallow breathing
Cold, pale or clammy skin
Weak, rapid pulse
Blue tint to the skin

If your child experiences any of these severe symptoms, they need emergency care right away.

Diagnosis

How is low blood pressure (hypotension) diagnosed in children?

Your child’s doctor or provider might notice low blood pressure in your child during a routine visit. We diagnose pediatric low blood pressure with a physical exam and a series of blood pressure checks over time. We’ll also ask about your child’s symptoms, medical history and any medications they’re taking.

If needed, your child may have additional tests, such as:

Electrocardiogram (EKG/ECG): This test measures the heart’s electrical activity and rhythm to check for problems with how the heart is beating.
Echocardiogram: This is an ultrasound of the heart that shows its structure and how well it’s pumping.
Blood tests: These tests can check for signs of dehydration, infection or other conditions that may affect blood pressure.
Tilt table test: During this test, we secure your child to a special bed that moves quickly from lying flat to an upright position. We monitor your child’s blood pressure and heart rate for changes between the two positions.

Causes

What causes low blood pressure (hypotension) in children?

Low blood pressure can happen for many reasons. Common causes include:

Dehydration from illness, heat or not drinking enough fluids
Sudden position changes, such as standing up quickly
Certain medications, such as those for anxiety, pain or heart conditions
Heart rhythm problems (arrhythmias)
Infections
Life-threatening allergic reactions (anaphylaxis)
Blood loss from an injury
Alcohol use, in teens
Nervous system conditions such as dysautonomia

Treatment

How is pediatric low blood pressure (hypotension) treated?

Treatment for low blood pressure in kids depends on the cause. Some children need only simple changes such as drinking more fluids. Others may need medication or care for an underlying condition.

At Children’s Health, our pediatric specialists and providers offer complete care for children who have low blood pressure. We may recommend these changes to improve your child’s blood pressure: