Overview

Low blood pressure, also known as hypotension, occurs when your blood pressure is lower than normal. It’s generally considered to be a reading of 90/60 mm Hg or lower. However, what’s considered low blood pressure for you may be normal for someone else, as blood pressure varies from person to person.Symptoms of low blood pressure include dizziness and fainting, but many people don’t have symptoms. The cause also affects your prognosis.

The causes of low blood pressure range from dehydration to serious medical conditions. It’s important to find out what’s causing low blood pressure so that it can be treated, if necessary.

What is low blood pressure?

Hypotension, or low blood pressure, is when your blood pressure is much lower than expected. It can happen either as a condition on its own or as a symptom of a wide range of conditions. It may not cause symptoms. But when it does, you may need medical attention.

Types of low blood pressure

Types of low blood pressure include:

  • Orthostatic hypotension(Postural hypotension). This is a sudden drop in blood pressure when standing from a sitting position or after lying down. Causes include dehydration, long-term bed rest, pregnancy, certain medical conditions and some medications. This type of low blood pressure is common in older adults.
  • Postprandial hypotension. This drop in blood pressure occurs 1 to 2 hours after eating. It’s most likely to affect older adults, especially those with high blood pressure or autonomic nervous system diseases such as Parkinson’s disease. Eating small, low-carbohydrate meals, drinking more water, and avoiding alcohol might help reduce symptoms.
  • Neurally mediated hypotension. This is a blood pressure drop that happens after standing for long periods. This type of low blood pressure mostly affects young adults and children. It might result from miscommunication between the heart and the brain.
  • Multiple system atrophy with orthostatic hypotension. Also called Shy-Drager syndrome, this rare disorder affects the nervous system that controls involuntary functions such as blood pressure, heart rate, breathing and digestion. It’s associated with having very high blood pressure while lying down.

What is considered low blood pressure?

Low blood pressure is below 90/60 mm Hg. Normal blood pressure is above that, up to 120/80 mm Hg.

How common is low blood pressure?

Because low blood pressure is common without any symptoms, it’s impossible to know how many people it affects. However, orthostatic hypotension seems to be more and more common as you get older. An estimated 5% of people have it at age 50.

Who does low blood pressure affect?

Hypotension can affect people of any age and background, depending on why it happens. However, it’s more likely to cause symptoms in people over 50 (especially orthostatic hypotension). It can also happen (with no symptoms) to people who are very physically active, which is more common in younger people.

Symptoms of low blood pressure

Low blood pressure (hypotension) symptoms may include:

  • Blurred or fading vision
  • Dizziness or lightheadedness
  • Fainting
  • Fatigue
  • Trouble concentrating
  • Nausea

Usually, your body can automatically control your blood pressure and keep it from dropping too much. If it starts to drop, your body tries to make up for that, either by speeding up your heart rate or constricting blood vessels to make them narrower. Symptoms of hypotension happen when your body can’t offset the drop in blood pressure.

Extreme low blood pressure can lead to a condition known as shock. Symptoms of shock include:

  • Confusion, especially in older people
  • Cold, clammy skin
  • Decrease in skin coloration (pallor)
  • Rapid, shallow breathing
  • Weak and rapid pulse

What are the possible signs of low blood pressure?

Your healthcare provider may observe these signs of low blood pressure:

  • A heart rate that’s too slow or too fast.
  • A skin color that looks lighter than it usually does.
  • Cool kneecaps.
  • Low cardiac output (how much blood your heart pumps).
  • Low urine (pee) output.

What causes low blood pressure?

Hypotension can happen for a wide range of reasons. Causes of low blood pressure include:

  1. Dehydration: Not having enough fluid in your body can cause a drop in blood pressure.When the body doesn’t have enough water, the amount of blood in the body (blood volume) decreases. This can cause blood pressure to drop. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can lead to dehydration.
  2. Medications: Certain medications, such as diuretics, alpha blockers, beta blockers, and some antidepressants, can lower blood pressure.
  3. Heart problems: Conditions such as extremely low heart rate (bradycardia), heart valve problems, heart attack, and heart failure can lead to low blood pressure.A heart attack, heart failure, heart valve disease and an extremely low heart rate (bradycardia) can cause low blood pressure.
  4. Endocrine problems: Disorders such as adrenal insufficiency, hypothyroidism, and low blood sugar (hypoglycemia) can cause low blood pressure.Conditions affecting the parathyroid or adrenal glands, such as Addison’s disease, may cause blood pressure to drop. Low blood sugar (hypoglycemia) and, sometimes, diabetes also may lower blood pressure.
  5. Pregnancy: Hormonal changes during pregnancy can cause blood pressure to drop.Changes during pregnancy cause blood vessels to expand rapidly. The changes may cause blood pressure to drop. Low blood pressure is common in the first 24 weeks of pregnancy. Blood pressure usually returns to pre-pregnancy levels after giving birth.
  6. Nutritional deficiencies: Lack of nutrients like vitamin B12 and folic acid can lead to anemia, which can result in low blood pressure.Low levels of vitamin B-12, folate and iron can keep the body from producing enough red blood cells (anemia), which can lead to low blood pressure.
  7. Blood loss: Losing a significant amount of blood due to injury or internal bleeding can cause a sudden drop in blood pressure.Losing a lot of blood, such as from an injury or internal bleeding, also reduces blood volume, leading to a severe drop in blood pressure.
  8. Infection: Septicemia, a severe blood infection, can cause a rapid decrease in blood pressure (septic shock).When an infection in the body enters the bloodstream, it can lead to a life-threatening drop in blood pressure called septic shock.
  9. Postural hypotension: Also known as orthostatic hypotension, this occurs when you stand up from a sitting or lying position, causing a sudden drop in blood pressure.
  10. Neurological conditions: Conditions such as Parkinson’s disease, multiple system atrophy, and autonomic neuropathy can affect the nerves that regulate blood pressure.
  11. Severe allergic reaction (anaphylaxis): Symptoms of a severe allergic reaction include a sudden and dramatic drop in blood pressure.
  12. Lack of nutrients in the diet: Low levels of vitamin B-12, folate and iron can keep the body from producing enough red blood cells (anemia), which can lead to low blood pressure.

The American Heart Association categorizes ideal blood pressure as normal. An ideal blood pressure is usually lower than 120/80 mm Hg.

Blood pressure varies throughout the day, depending on:

  • Body position
  • Breathing
  • Food and drink
  • Medications
  • Physical condition
  • Stress
  • Time of day

Blood pressure is usually lowest at night and rises sharply on waking. Certain health conditions and use of medications may cause low blood pressure.

Medications that can cause low blood pressure

Some medications can cause low blood pressure, including:

  • Water pills (diuretics), such as furosemide (Lasix) and hydrochlorothiazide (Microzide)
  • Alpha blockers, such as prazosin (Minipress)
  • Beta blockers, such as atenolol (Tenormin) and propranolol (Inderal, Innopran XL, Hemangeol)
  • Drugs for Parkinson’s disease, such as pramipexole (Mirapex) or those containing levodopa
  • Certain types of antidepressants (tricyclic antidepressants), including doxepin (Silenor) and imipra

Treatment for low blood pressure

Treatment for low blood pressure depends on the underlying cause and the severity of symptoms. Here are some general approaches to managing low blood pressure:

  1. Increase Fluid Intake: Dehydration is a common cause of low blood pressure. Drinking plenty of fluids, especially water, can help increase blood volume and raise blood pressure.
  2. Increase Salt Intake: Salt helps retain water in the body, which can increase blood volume and raise blood pressure. However, this should be done in moderation, especially for individuals with certain health conditions like hypertension (high blood pressure) or kidney disease.
  3. Compression Stockings: Compression stockings can help prevent blood from pooling in the legs and feet, which can improve circulation and raise blood pressure.
  4. Avoid Alcohol: Alcohol can lower blood pressure, so it’s essential to limit or avoid alcohol consumption, especially if you have low blood pressure.
  5. Eat Small, Frequent Meals: Eating small, frequent meals throughout the day can help prevent a drop in blood pressure after meals, especially in individuals prone to postprandial hypotension (low blood pressure after eating).
  6. Avoid Prolonged Standing: If you experience symptoms of low blood pressure when standing for long periods, try to avoid prolonged standing or take breaks to sit down and rest.
  7. Wear Supportive Clothing: Wearing compression garments or abdominal binders can help improve blood flow and prevent blood from pooling in the legs.
  8. Medications: In some cases, medications may be prescribed to raise blood pressure. These may include fludrocortisone (a mineralocorticoid) to help retain sodium and water, or medications to increase heart rate or constrict blood vessels.
  9. Address Underlying Conditions: Treating underlying medical conditions such as heart problems, endocrine disorders, or neurological conditions can help improve low blood pressure.
  10. Lifestyle Changes: Adopting a healthy lifestyle, including regular exercise, maintaining a healthy weight, managing stress, and getting enough sleep, can help regulate blood pressure.

It’s essential to work with a healthcare professional to determine the underlying cause of low blood pressure and develop an appropriate treatment plan. In some cases, low blood pressure may not require treatment if it’s not causing symptoms or complications. However, if you experience symptoms such as dizziness, fainting, or fatigue, it’s important to seek medical advice for proper evaluation and management.

Preventing Low blood pressure

Preventing low blood pressure often involves maintaining a healthy lifestyle and managing underlying conditions that may contribute to hypotension. Here are some preventive measures:

  1. Stay Hydrated: Dehydration can cause low blood pressure, so it’s essential to drink an adequate amount of fluids, especially water. Avoid excessive alcohol and caffeine consumption, as they can contribute to dehydration.
  2. Eat a Balanced Diet: Consuming a diet rich in fruits, vegetables, whole grains, and lean proteins can help maintain overall health and support cardiovascular function. Avoid large, heavy meals, which can cause a temporary drop in blood pressure.
  3. Limit Alcohol Intake: Alcohol can lower blood pressure, so it’s important to drink alcohol in moderation or avoid it altogether, especially if you’re prone to low blood pressure.
  4. Monitor Medications: Some medications can lower blood pressure as a side effect. If you’re taking medications that may cause hypotension, discuss potential alternatives with your healthcare provider.
  5. Use Compression Stockings: Compression stockings can help prevent blood from pooling in the legs and improve circulation, particularly if you’re prone to orthostatic hypotension (a drop in blood pressure upon standing).
  6. Avoid Prolonged Standing or Sitting: If you’re prone to orthostatic hypotension, try to avoid prolonged periods of standing or sitting. Change positions slowly, especially when transitioning from lying down to standing up.
  7. Exercise Regularly: Regular physical activity can help improve cardiovascular health and regulate blood pressure. Aim for at least 30 minutes of moderate-intensity exercise most days of the week, as long as it’s approved by your healthcare provider.
  8. Manage Stress: Chronic stress can affect blood pressure levels. Practice stress-reducing techniques such as deep breathing, meditation, yoga, or spending time on hobbies you enjoy.
  9. Monitor Blood Pressure: If you have a history of low blood pressure or are at risk, regularly monitor your blood pressure at home and discuss any significant changes with your healthcare provider.
  10. Treat Underlying Conditions: Manage any underlying medical conditions that may contribute to low blood pressure, such as heart problems, endocrine disorders, or neurological conditions.
  11. Stay Active: Avoid prolonged periods of inactivity, as this can contribute to low blood pressure. Get up and move around regularly, especially if you have a sedentary lifestyle.

By adopting these preventive measures, you can help maintain healthy blood pressure levels and reduce the risk of experiencing symptoms associated with low blood pressure. However, it’s important to consult with your healthcare provider for personalized recommendations based on your individual health status and risk factors.

Risk Factors

Anyone can have low blood pressure (hypotension). Risk factors for hypotension include:

  • Age. Drops in blood pressure on standing or after eating occur primarily in adults older than 65. Neurally mediated hypotension primarily affects children and younger adults.
  • Medications. Certain medications, including some blood pressure drugs, increase the risk of low blood pressure.
  • Certain diseases. Parkinson’s disease, diabetes and some heart conditions may increase risk of low blood pressure.

Complications

Potential complications of low blood pressure (hypotension) include:

  • Dizziness
  • Weakness
  • Fainting
  • Injury from falls

What can/can’t I eat/drink with low blood pressure?

  • If you have low blood pressure, you should:

    • Drink more water.
    • Drink alcohol in moderation.
    • Add salt to your diet.
    Be sure to talk with your provider before making these changes. They can give you more specific guidance.mine (Tofranil)
  • Drugs for erectile dysfunction, including sildenafil (Revatio, Viagra) or tadalafil (Adcirca, Alyq, Cialis), particularly when taken with the heart medication nitroglycerin (Nitrostat, Nitro-Dur, Nitromist)

Written by Satya