Low Blood Pressure

[East_TX_Spa]

Doc, will you write a Rx for my lost customer?

Terminator

[tanstaafl2]

I'd have called him on that lie in a heart beat.Hot water raises blood pressure, it is recommended for people with high blood pressure to use the spa a lower temperatures so as not to dangerously elevate their BP, so how low is your BP? If his doctor really did say this I can only refer to Georg Carlins observation that by process of elimination, there IS a WORST doctor in the world, the bad news is somebody's got an appointment with him tomorrow. Evidently Terms customer.

I believe I would have to call you on that one. Most studies focus on hypertension and hot tubs/saunas. Unless one had orthostatic hypotension, often a side effect of hypertensive therapy, they usually could tolerate hot tubs well if they were otherwise relatively asymptomatic.

Among many sources is this example:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=280579

The American Heart Association has this to say:
http://www.americanheart.org/presenter.jhtml?identifier=584

Studies addressing chronic HYPOtension or low blood pressureare not as readily available. But a  patient with chronic hypotension  likely would not be a good candidate for a spa as his physician pointed out. Wouldn't make much sense to compound their current condition and risk fainting in the tub, arrhythmias or sudden hyperthermic death (the last more associated with saunas and alcohol consumption).

But what the heck do I know, after all I don't play a doctor on TV. But in real life however...  

[Wisoki]

Great, then Terms customers doctor needs to go to continuing education courses. After reading both articles the first being extensive and very boring revealed that only one person suffered a reaction out of their hypertensive group and their normotensive (control) group 21 and 23 people respectivly. This paragraph caught my attention.....

How much can blood pressure be reduced acutely without causing symptoms? Studies done several decades ago in which normotensive subjects and subjects with treated and untreated hypertension were given sympathoplegic agents to acutely reduce blood pressure showed that cerebral blood flow was unchanged when mean arterial pressure was reduced by 25% (equivalent to a reduction of 35% in systolic blood pressure).11,12 Furthermore, no symptoms were reported until systolic blood pressure was reduced by 50%. Accordingly, a reduction of 20%–25% in mean arterial pressure within “minutes to hours” is recommended for hypertensive emergencies.13 We observed reductions in mean arterial pressure of 26% (from 99 to 73 mm Hg) in the normotensive group and of 23% (from 110 to 85 mm Hg) in the hypertensive group. Only 3 normotensive subjects and 1 hypertensive subject showed reductions greater than 30%, and none showed reductions greater than 35%; none complained of hypotensive symptoms.


Playing doctor since I was ohhhh 5?

I believe I would have to call you on that one. Most studies focus on hypertension and hot tubs/saunas. Unless one had orthostatic hypotension, often a side effect of hypertensive therapy, they usually could tolerate hot tubs well if they were otherwise relatively asymptomatic.

Among many sources is this example:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=280579

The American Heart Association has this to say:
http://www.americanheart.org/presenter.jhtml?identifier=584

Studies addressing chronic HYPOtension or low blood pressureare not as readily available. But a  patient with chronic hypotension  likely would not be a good candidate for a spa as his physician pointed out. Wouldn't make much sense to compound their current condition and risk fainting in the tub, arrhythmias or sudden hyperthermic death (the last more associated with saunas and alcohol consumption).

But what the heck do I know, after all I don't play a doctor on TV. But in real life however...  

[tanstaafl2]

Can't speak to what the patients doctor needs to do or not do. But based on the extremely limited information available in the initial post the person in question was neither normotensive or hypertensive. Instead he was hypotensive. As I pointed out there is no study that suggests the impact of a hot tub on a hypotensive person. But if low blood pressure is, at some point, a potential problem (and I can tell you with certainty that it is) then it seems not unreasonable to conclude that someone with low blood pressure, low enough that their physician actually makes note of it, might not be the best candidate for something that will make it even lower. A lot easier to reach that critical 50% reduction in normal pressure that could affect cerebral blood flow in a person who already has a head start so to speak...

Which of course brings me back to the original point I was trying to illustrate and that is that hot tubs tend to lower pressure with use not raise it.

"Immersion in a hot tub for 10 minutes lowers blood pressure in subjects with treated hypertension, but no more than in normotensive control subjects."

And yes, after perusing it and even writing a little of it for the last 20 some years, I can say without hesitation that medical literature is frequently both extensive and boring!

Great, then Terms customers doctor needs to go to continuing education courses. After reading both articles the first being extensive and very boring revealed that only one person suffered a reaction out of their hypertensive group and their normotensive (control) group 21 and 23 people respectivly. This paragraph caught my attention.....

How much can blood pressure be reduced acutely without causing symptoms? Studies done several decades ago in which normotensive subjects and subjects with treated and untreated hypertension were given sympathoplegic agents to acutely reduce blood pressure showed that cerebral blood flow was unchanged when mean arterial pressure was reduced by 25% (equivalent to a reduction of 35% in systolic blood pressure).11,12 Furthermore, no symptoms were reported until systolic blood pressure was reduced by 50%. Accordingly, a reduction of 20%–25% in mean arterial pressure within “minutes to hours” is recommended for hypertensive emergencies.13 We observed reductions in mean arterial pressure of 26% (from 99 to 73 mm Hg) in the normotensive group and of 23% (from 110 to 85 mm Hg) in the hypertensive group. Only 3 normotensive subjects and 1 hypertensive subject showed reductions greater than 30%, and none showed reductions greater than 35%; none complained of hypotensive symptoms.


Playing doctor since I was ohhhh 5?

[East_TX_Spa]

The nice lady said her husband was hypotensive so I suggested she give him Ritalin.  She said "No, no, hypo means 'down'" so I suggested Viagra.  She said he sometimes faints when he stands up too fast in front of her so I told her to wear make-up and fix her hair.  Then she left.

Terminator

[anne]

Hot water definitely lowers, not raises BP.

As far as the study about what degree of systolic BP drecrease is needed to affect cerebral blood flow, you have to take into account that arterial and venous pressures will change differently. The most dramatic effect the tub (heat) will have is, I'm mostly certain, on venous not arterial dilation. You can pool a tremendous amount of blood in your veins, even with compensatory arterial constriction, and still have symptoms of hypotension.

Bummer for the guy who doesn not get his tub, but it is probably for the best.  

[sharonbaker]

Hi all,

Actually recently i came across this forum site. And this is my first visit over here. I am new to here. First i would like to say hi to every member of this forum site. Thanks.....

Regards
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