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Symptomatic arterial hypotension
Last reviewed: 04.07.2025
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Symptoms of symptomatic arterial hypotension depend on the underlying disease. A persistent decrease in arterial pressure in various somatic diseases is accompanied by the occurrence of similar subjective and objective symptoms, similar to those in primary arterial hypotension. This similarity extends to the features of changes in hemodynamics and the course of reflex reactions.
Etiology of symptomatic arterial hypotension
- Cardiovascular diseases:
- congenital or acquired aortic valve insufficiency;
- dilated cardiomyopathy;
- hypertrophic cardiomyopathy;
- exudative pericarditis;
- myocarditis.
- Diseases of the gastrointestinal tract:
- gastric ulcer and duodenal ulcer.
- Respiratory diseases:
- tuberculosis;
- chronic pneumonia;
- bronchial asthma.
- Diseases of the endocrine system:
- hypothyroidism;
- pituitary-adrenal insufficiency;
- OSD.
- Kidney diseases:
- nephritis with loss of salt;
- diabetes insipidus;
- econephropathy;
- chronic hemodialysis condition.
- Diseases of the central nervous system:
- mental illness;
- post-coma hypotension;
- cerebral infarctions;
- encephalopathy;
- Parkinson's disease;
- hydrocephalus.
- Medicines:
- antidepressant overdose;
- beta-blocker overdose;
- ACE inhibitor overdose;
- calcium channel blocker overdose;
- overdose of atropine-like drugs;
- overdose of antihistamines.
Aortic valve insufficiency, congenital or acquired as a result of acute rheumatic fever or infective endocarditis, is accompanied by a decrease in diastolic blood pressure, while systolic blood pressure is within normal values or increased. A decrease in blood pressure is associated with regurgitation of blood from the aorta into the left ventricular cavity.
Arterial hypotension in cardiomyopathy, myocarditis, exudative pericarditis is caused by low output syndrome, and a violation of baroreflex regulation of arterial pressure is also possible, with both systolic and diastolic arterial pressure reduced.
Secondary disturbances of the afferent link of hemodynamic reflexes, leading to arterial hypotension, occur in diabetes mellitus, tabes dorsalis.
Secondary disorders of the central link of hemodynamic reflexes that regulate arterial pressure occur in brain tumors, cerebral infarctions, encephalopathy, Parkinson's disease, and hydrocephalus.
Secondary disorders of the efferent link of hemodynamic reflexes that ensure the regulation of arterial pressure occur in polyneuropathies in patients with diabetes mellitus, amyloidosis, neuritis, and porphyria.
Arterial hypotension often occurs in endocrine diseases (hypothyroidism and adrenal cortex hypofunction).
The signs that unite primary and secondary arterial hypotension against the background of these conditions include pronounced asthenic syndrome, decreased mental and physical performance, changes in the cardiovascular system (bradycardia, dilation of the heart cavities, hypotonic crises).
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