Blood pressure: high blood pressure and low blood pressure

What are high blood pressure and low blood pressure?

The heart pumps blood into the blood vessels by contracting and relaxing at every heartbeat. This produces a certain amount of pressure in the blood vessels: blood pressure. Blood pressure is measured with a blood pressure device and is stated as two figures. The first number is the upper pressure: the pressure in the blood vessels when the heart contracts. The second number is the lower pressure: the pressure when the heart relaxes.


People are considered to have high blood pressure (hypertension) when the upper pressure is 140 or higher or when the lower pressure is 90 or higher. Low blood pressure (hypotension) is when the blood pressure is less than about 90/60.


The cause of high blood pressure is not known in most cases (95%). The following risk factors are known: kidney disease, alcohol consumption, food consumption, excessive salt use, smoking, overweight, little physical activity. The most common causes of low blood pressure are dehydration, an allergic reaction, infection, fainting (vasovagal reaction), blood loss, heart attack or cardiac arrhythmia, alcohol and certain medications. Low blood pressure can also occur without any apparent reason.

 

What are the complaints associated with high blood pressure and low blood pressure?

High blood pressure rarely causes complaints.


People with low blood pressure may suffer from 'orthostatic hypotension', in other words low blood pressure when they change position, for example when getting up out of a chair. Low blood pressure results in an inadequate supply of blood to various organs. The brain is affected the most because it needs most blood. This temporary deficiency of blood in the brain results in a feeling of lightheadedness (see also ''dizziness''), fainting or unconsciousness.


People with intellectual disabilities sometimes find it impossible to communicate these symptoms. The people around them may then notice only a change in behaviour.

 

How common are high blood pressure and low blood pressure in the general population?

In the age category of 30 to 59 years, 20.1% of Dutch people have high blood pressure. 233


Prevalence increases with age. In the age category of 50 to 70, 49.4% have high blood pressure.  529


Only 0.15% of GP visits in a year are for orthostatic hypotension. 234

 

How common are high blood pressure and low blood pressure in people with intellectual disabilities?

In Dutch adults with intellectual disabilities, the prevalence of hypertension is 17.4%, which is comparable with the general population.  236


In older people between the ages of 50 and 70, the prevalence of high blood pressure is exactly the same as in the general population (49.3%). According to the Dutch GOUD study, the prevalence rate is 53.0% for the group of elderly people with intellectual disabilities as a whole. 530


High blood pressure is more common in the group with intellectual disabilities in older people, people with obesity, people with a milder intellectual disability, and people who can do their own shopping. People with Down syndrome are less likely to have high blood pressure. 530


High blood pressure is more common in people with Williams syndrome, Bardet-Biedl syndrome, Turner syndrome and Prader Willi syndrome (as a result of being overweight). 236


No data have been found about the prevalence of low blood pressure in people with intellectual disabilities. It is known that people with Down syndrome are more likely to have low blood pressure 239  and that low blood pressure can be a side-effect of certain medication that affects behaviour.

0.28% General population (high blood pressure)
17.40% People with intellectual disabilities (high blood pressure)

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Louw van de J, Vorstenbosch R, Vinck L, Penning C, Evenhuis H. Prevalence of hypertension in adults with intellectual disability in the Netherlands. J Intellect Disabil Res. 2009 Jan;53(1):78-84.

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De Winter CF, Bastiaanse LP, Hilgenkamp TI, Evenhuis HM, Echteld MA. Cardiovascular risk factors (diabetes, hypertension, hypercholesterolemia and metabolic syndrome) in older people with intellectual disability: results of the HA-ID study. Res Dev Disabil. 2012 Nov-Dec;33(6):1722-31

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