During vital signs assessment of a patient with anorexia nervosa, which pattern is most consistent with the condition?

• A. Hypertension and tachycardia.
• B. Hypertension and bradycardia.
• C. Hypotension and tachycardia.
• D. Hypotension and bradycardia.

Answer: (D)

In anorexia nervosa, the body slows down to conserve energy, so the heart and circulation operate at a reduced level. The heart rate tends to drop (bradycardia) because of increased vagal tone and a lower metabolic demand, while blood pressure often falls (hypotension) due to decreased circulating volume from poor intake and dehydration, along with reduced cardiac output. This combination—low heart rate with low blood pressure—is the pattern most consistent with the condition. Hypertension or a fast heart rate would point to other states (such as anxiety, stimulant use, or acute dehydration with compensation), not the typical nutritional starvation pattern. Orthostatic changes can also occur as volume status fluctuates.