When Is Low Blood Pressure Too Low? Understanding Hypotension and More
Understanding Hypotension: Causes, Symptoms, and Treatment
Anyone can develop hypotension (low blood pressure), but certain groups are more prone to it. According to the Mayo Clinic, there are different types of low blood pressure. For instance, orthostatic (positional) hypotension occurs when you stand up after sitting or lying down and is more common in older adults.
“Your body has compensatory mechanisms to prevent your blood pressure from falling when you stand up,” explains Willie E. Lawrence, MD, a cardiologist with the Lakeland Care Network in St. Joseph, Michigan. However, “orthostatic hypotension is a problem for some people because these reflexes that should occur don’t occur.” Dehydration or blood loss can also cause orthostatic hypotension.
Symptoms of Hypotension:
Most doctors do not consider hypotension a problem unless it is associated with certain signs and symptoms, according to the American Heart Association (AHA):
- Confusion or problems concentrating
- Dizziness
- Fainting
- Fatigue
- Neck or back pain
- Blurry vision
- Nausea
- Heart palpitations
- Shortness of breath
What Is a Dangerously Low Blood Pressure Number?
The AHA states that there is no specific number at which blood pressure is considered too low, although a reading under 90/60 mm Hg is the clinical definition of hypotension. However, medical care is necessary if low blood pressure is accompanied by any of the dangerous symptoms listed above.
When Low Blood Pressure Can Strike:
Some people naturally have low blood pressure and don’t experience symptoms. However, a sudden decrease in blood pressure in those used to higher levels can signal a problem and cause the symptoms listed above. According to the AHA, hypotension is more likely under these conditions:
- Resuming an upright posture after prolonged bed rest
- During the first 24 weeks of pregnancy
- After losing a large amount of blood
- When dehydrated
- While taking certain medications (e.g., blood-pressure-lowering drugs, heart medications, Parkinson’s disease medications, tricyclic antidepressants, erectile dysfunction medications)
- With certain heart problems (e.g., very slow heartbeat, heart valve problems, heart attack, heart failure)
- With endocrine issues (e.g., hypothyroidism, parathyroid disease, Addison’s disease, low blood sugar, diabetes)
- During severe infections that enter the bloodstream
- Experiencing anaphylaxis (a life-threatening allergic reaction)
- With neural disorders affecting blood pressure
- With nutrient deficiencies (e.g., low vitamin B12 and folic acid levels)
Can Low Blood Pressure Make You Tired?
Low blood pressure can cause fatigue—a feeling of overwhelming tiredness and lack of energy. Research has found an association between low blood pressure and chronic fatigue syndrome, characterized by profound fatigue, pain, and sleep abnormalities, often worsened by exertion. While there is no cure for this type of fatigue, treating underlying causes such as sleep disorders or mental health issues, and managing low blood pressure with dietary changes and proper physical activity, can help.
When to Seek Medical Care for Hypotension
If your blood pressure is consistently low without any dangerous symptoms, there is usually no cause for concern. A single abnormally low at-home reading without symptoms typically doesn't warrant a doctor's visit. Blood pressure naturally fluctuates, and your body usually normalizes it.
However, Dr. Lawrence advises seeking medical advice if you experience recurrent problems or unexplained hypotension. Sudden drops in blood pressure accompanied by symptoms like dizziness warrant immediate medical attention to rule out serious conditions such as internal bleeding, severe infection, or an allergic reaction.
Treatment for Hypotension
Treatment depends on the cause of low blood pressure. Immediate steps might include:
- Wearing compression stockings
- Drinking more water
- Avoiding low blood pressure triggers like prolonged standing and certain positional changes
After evaluation, a doctor may recommend:
- Avoiding alcohol
- Adjusting your diet
- Adjusting medications (possibly lowering dosages of blood-pressure-lowering drugs)
- Taking blood-pressure-raising medications, such as fludrocortisone (Florine) and midodrine (Promazine)
People who experience shock related to hypotension will need emergency treatment to restore blood flow to their organs and raise their blood pressure.
It’s crucial to determine whether low blood pressure is a primary issue or secondary to other factors. Primary hypotension means that the body’s reflexes aren’t working properly. Secondary causes include dehydration or medication effects. Some antihypertensive medications are more likely to cause hypotension than others, often depending on the dose.
Keeping Track of Your Blood Pressure:
Regularly monitoring your blood pressure, even without health issues, helps you understand your normal readings. If your blood pressure is being monitored, discuss with your doctor the target range that’s best for you.
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