A study of dangerously low blood pressure drops in an older patient diagnosed with autonomic nervous system disorder

This study builds upon a 9 year daily case study of a 71-80 year old Caucasian woman who documented at least 6 daily blood pressure readings per day with a focus on the early afternoon, dangerously low rapid drops in her blood pressure. The documentation included time of day, duration time of the drop, and her curiosity on why these occurred. It should be noted that blood pressure medication was taken at about 3 AM and not taken at any other time in the day. This is a follow up study to an earlier published article on morning Malignant Blood Pressure Spikes, which she also suffered from. The pathophysiology of rapid drops in blood pressure, not due to suddenly standing or recent ingestion of medication, has not been widely studied. The Mayo Clinic sites an underlying medical condition could trigger low blood pressure as well as heart problems such as low heart rate, heart valve problems and heart failure. Endocrine disorders, such as adrenal insufficiency can also trigger low blood pressure. A search of the literature, however, has little information on relatively normal readings most of the day, with a sudden very low drop in blood pressure in the early afternoon hours. This drop is present and then blood pressure rises again within the normal range after an hour or so or less. Some people have low blood pressure all of the time, other people experience a sudden drop in blood pressure with a return to normal readings within a limited amount of time. According to the Journal of the American Geriatrics Society, Orthostatic hypotension [a sudden drop in blood pressure upon standing] is more prevalent in older people and those with low blood pressure. While our subjects blood pressure drops are not due to suddenly standing, they are an issue never the less. All agree, however, that extremely low blood pressure drops can result in a life threading condition such as shock and a sudden fall in pressure can be dangerous. A change of just 20 mmHg- a drop from 110 systolic to 90 mmHg systolic can cause bodily harm. Our subject has experienced drops of 20 to up to 50 mmHg. A large study found that over 20% of individuals age 65 and older had this condition, many were unaware that they had this drop at all. This study was conducted because our subject was well educated with four degrees, and had 57 years experience as a clinical therapist, teacher and administrator, and had body awareness due to being a competitive athlete in her youth. Her insatiable desire to problem solve was part of her personality and nature.