Just after having started my job at the university, I was shocked by some sad news. One of my professors, who was only in his fifties, had died; when the cause of death was revealed, we learned that due to hypotension he had become dizzy and fainted, hitting his head against the bathroom sink and suffering cerebral bleeding.

When we have been sitting or lying for a long time we can suffer from orthostatic hypotension due to an insufficient operation of the sympathetic nerves.

When we are lying down, the blood pressure in our arteries is pretty much equal throughout the body. When we stand up, the blood pressure is affected by the gravity and increases in the vessels under the heart, while decreasing in the brain. If we lie down again, the blood pressure in the arteries balances once again. If these changes cannot be naturally controlled, then we may suffer an increase or decrease in blood pressure, which could result in a fatal injury.

There are baroreceptors in the walls of main arteries whose tasks are to measure constantly the blood pressure and to send data (electrical signals) to the brain, informing it about the blood pressure in the body. These baroreceptors are located in the aorta as it leaves the heart and in the carotid artery as it enters the brain. With the onset of hypertension, the frequency of the signals that are sent to the brain increases and this drops in case of hypotension. The center of vessel movement in the brain, with regard to the frequency of electrical signals it receives, perceives a low or high blood pressure.

In the brain is a vasomotor center; this continuously controls the blood pressure and regulates it. This center constantly receives data about blood pressure. If the pressure decreases, the signals of the sympathetic nerve increase. If the pressure increases, the signals to the parasympathetic nerves are suppressed. As a result of sympathetic irritability, the heart begins to beat faster and stronger. It pumps much more blood in a unit of time, and thus the blood pressure increases. The arteries and veins also constrict and owing to this constriction in the arteries, the blood pressure increases further. As a consequence of constriction in the veins, the extra blood that is stored inside the veins is pumped into the heart. Now, as the heart is receiving greater volumes of blood, it works faster and contributes to the increase in the pressure. In the meantime, as a result of the suppression of parasympathetic nerve signals, the heart contracts faster and stronger, thus pumping much more blood.

As the blood pressure rises, the mechanism which is in charge of reducing the pressure via vasomotor center is triggered. While pressure is applied to the sympathetic nerves, the signals that are being sent to the heart and vessels decrease. Thus, the rate of systole and the amount of blood which is being pumped decreases. As the arteries receive less blood the volume of blood in the system falls off and as the arteries and veins expand, the blood pressure falls. Due to the dilatation in the veins, the volume of blood which is sent to the heart also decreases and as a result the heart pumps less blood and the blood pressure drops.

However, by triggering the parasympathetic nerves, the signals that are sent to the heart increase. This helps to slow the heart down and ensures that there is less blood pumping through the system. As a result, the blood pressure which has been reduced via the sympathetic system is reduced even further with the parasympathetic system. At this point, it is necessary for there to be a rapid drop in blood pressure, which is provided by the simultaneous functioning of different mechanisms.

We cannot control this system and it acts extremely rapidly and with great elegance. Even in the systole period, when the heart is pumping the blood and there is a short and sudden increase in pressure and in the diastole period, when the heart relaxes and there is a short and sudden decrease in pressure, the system is in charge and functioning at every second, operating to increase the hypotension and to decrease the hypertension. The average healthy human heart beats 70 times per minute. Consequently, there are 70 systole and 70 diastole stages every minute; thus a normal balance can be maintained by decreasing the pressure, which increases 70 times every minute, and by increasing the pressure, which decreases 70 times every minute; this is how the body maintains a normal balance. In other words, this system functions 140 times every minute. Is it possible that this system, which operates throughout our life, a system that we are not aware of, a system that is so sensitive and vital to our lives, a system the details of which have only recently been understood after centuries of observation could be nothing more than a coincidence?

The pressure regulating system mentioned above carries out other important tasks while we are sitting and standing as well. The amount of blood going to the brain is related to the maintenance of a difference in blood pressure between the arteries and veins and to the recirculation of blood. In connection with hypotension, the pressure in the veins to the brain decreases, in order to partially compensate for the decrease in the arteries. By preventing a decrease in the difference of pressure (perfusion pressure) between the two systems, the continuity of blood going to the brain can be maintained.

In addition, a small decrease in the blood going to the brain can lead to an increase in acidity and carbondioxide in the brain tissues and to a decrease in oxygen; this results in the dilatation of the blood vessels in the brain. When these systems go into action anyone who is not suffering from orthostatic hypotension will have a stable amount of oxygen consumption in the brain when they stand up, and thus not experience dizziness.

In fact, scenes from karate movies are wonderful displays of the perfect functioning of this system. In such scenes, the fighter will jump up, and then suddenly fall to the ground; he will then suddenly spring up and performs different moves. Certainly with every movement, the blood pressure changes suddenly, but as a sign of the Creator’s mercy and grace, the body is able to maintain a balance. Should not the person watching these scenes stand in amazement, thinking: “Oh my God, what an incredible order! How great is Your knowledge, power, wisdom and art!”

As mentioned at the beginning of the article with reference to an actual sad incident, when a person whose sympathetic system is not functioning normally suddenly stands up, they can suffer from dizziness and perhaps even faint due to irregular blood pressure.

For patients suffering from orthostatic hypotension patients, it is important that they do not stand up rapidly. In addition, exercises that encourage the use of leg muscles before standing up will help pump blood towards the brain.

Pause for a minute… What would happen if this miraculous system did not exist? Consider how much time it would take you to merely get out of bed every day!