Some people naturally have low blood pressure. However, when high blood pressure suddenly becomes low blood pressure, also known as hypotension, it could be cause for concern.
Medically reviewed by Lindsey Marcellin, MD, MPH
Mildly low blood pressure, or hypotension, may be a sign of good health and a decreased risk of heart disease, but in some people, hypotension can be a problem. At times, continually low blood pressure or a sudden drop in blood pressure can lead to worrisome symptoms and even serious health problems.
Understanding Hypotension
A blood pressure reading contains two numbers: systolic pressure and diastolic pressure. Systolic pressure is the top or first number in your blood pressure reading, indicating the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number and shows the pressure in your arteries while your heart is filling with blood.
If your blood pressure is 120/80 millimeters of mercury (mm Hg) or lower, your blood pressure is considered normal. If the blood pressure reading is under 90/60 mm Hg, it is called hypotension. Some adults regularly have a blood pressure in the hypotensive range, but have no symptoms at all and do not require treatment. But in serious cases, hypotension can result in a decreased supply of oxygen and nutrients to your brain, which can eventually lead to life-threatening shock.
Anyone can develop hypotension, but certain groups of people are more likely to experience it. For instance, up to 30 percent of older adults will get sudden drops in blood pressure while sitting or standing.
Symptoms of Hypotension
Most doctors do not consider hypotension a problem unless it leads to worrisome signs and symptoms, which may include:
- Dizziness
- Fainting
- Fatigue
- Problems concentrating
- Blurry vision
- Nausea
- Clammy, pale skin
- Shortness of breath
When Low Blood Pressure Can Strike
Some people have naturally low blood pressure and they do not experience any symptoms. But for those who are used to having high blood pressure, episodes of low blood pressure can signal a problem and can cause the above symptoms.
An onset of hypotension is more likely to occur when you:
- Are on bed rest for a long period of time, and then resume an upright posture
- Are in your first 24 weeks of pregnancy
- Have lost a lot of blood
- Are taking certain medications, such as blood pressure lowering medications, certain heart medications, certain Parkinson's disease medications, tricyclic antidepressants, or medications to treat erectile dysfunction
- Have a heart problem, such as a very slow heart beat, heart valve problems, heart attack, or heart failure
- Have an endocrine problem, such as hypothyroidism, parathyroid disease, Addison's disease, low blood sugar, or diabetes
- Have a severe infection that enters your blood stream
- Are experiencing anaphylaxis, a life-threatening allergic reaction
- Have a neural disorder that affects your blood pressure
- Have a nutrient deficiency, such as low vitamin B12 and folic acid levels
When Do You Need Medical Care for Hypotension?
If your blood pressure is always on the low side and you do not have any worrisome symptoms, there is usually no cause for concern. Similarly, if you have a single at-home blood pressure reading that is abnormally low without any symptoms, you probably do not need to see your doctor. It is normal for your blood pressure to rise and fall over time, but your body is usually able to get your blood pressure back to normal.
However, if your blood pressure drops suddenly and you are experiencing symptoms or problems, like dizziness, you should call your doctor. He or she can assess your situation and rule out underlying problems such as unrecognized internal bleeding, serious infection, and allergic reaction. Any treatment for hypotension will depend on the cause of the low blood pressure. Immediate steps might include:
- Lying with your feet above your heart
- Drinking fluids
- Avoiding hypotension triggers like prolonged standing
After evaluation by a doctor, recommendations may include:
- Avoiding alcohol
- Adjusting your diet
- Adjusting your medications, possibly lowering dosages
- Taking blood pressure raising medications, such as fludrocortisone (Florinef) and midodrine (ProAmatine)
- Wearing compression stockings if varicose veins or leg swelling is a contributing factor
People who experience shock related to hypotension will need emergency treatment to restore blood flow to their organs and raise their blood pressure back to normal.
Keep track of your blood pressure readings, even if you don’t have any health issues, so that you know what your personal “normal” reading is. And if your blood pressure is being monitored, talk to your doctor about the blood pressure target range that’s best for you.
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