When Is Low Blood Pressure Too Low? Hypotension and More

Some people naturally have low blood pressure, known as hypotension. However, when high blood pressure suddenly becomes low blood pressure, it could be cause for concern.

senior man checking his blood pressure at home
Learn what to do to keep your heart healthy if you have low blood pressure.Alba Vitta/Stocksy

Low blood pressure, or hypotension, may be a sign of good health and of a decreased risk of heart disease. But not always.

At times, continually low blood pressure or a sudden drop in blood pressure can lead to worrisome symptoms and may occur due to serious health problems, including blood loss, dehydration, diabetes and several heart issues. Pregnancy can lead to hypotension, as well as certain medications for other conditions.

Understanding Hypotension (Low Blood Pressure)

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. This indicates the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number, showing 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, healthcare professionals consider this to be normal. Generally, if the blood pressure reading is under 90/60 mm Hg, it is abnormally low.

A doctor will refer to this as hypotension.
Some adults regularly have blood pressure in the hypotensive range but no symptoms. They may not require treatment. However, in serious cases, low blood pressure can result in a decreased supply of oxygen and nutrients to your brain and other essential organs, which can eventually lead to life-threatening shock.

Anyone can develop hypotension, but certain groups of people are more likely to experience it.

There are also different types of low blood pressure,?notes the Mayo Clinic.

For instance, orthostatic (positional) hypotension occurs when you stand up after sitting or lying down. It is more common in older adults.

Typically, “your body has certain 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. But, he adds, “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.

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Symptoms of Hypotension (Low Blood Pressure)

Most doctors do not consider hypotension to be a problem unless it occurs alongside certain signs and symptoms, per 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?

According to the AHA, no specific number suggests that day-to-day blood pressure is too low, although anything under 90/60 mm Hg reading noted fits the clinical definition of hypotension.

However, when any of the dangerous symptoms listed above accompany a blood pressure reading that suggests hypotension, it is time to seek medical care.

Can Low Blood Pressure Make You Tired?

Low blood pressure can cause weakness and fatigue — that feeling of overwhelming tiredness and lack of energy.

Research has found an association between low blood pressure and chronic fatigue syndrome, a condition that causes ongoing, profound fatigue that doesn’t get better with sleep, sleep abnormalities that physical exertion often makes worse, and pain.

Potential Causes of Hypotension (Low Blood Pressure)

Some people have naturally low blood pressure, and they don’t experience any symptoms. But for people who are used to having normal or high blood pressure, a sudden decrease in blood pressure can signal a problem and can cause symptoms.

Per the AHA, an episode of hypotension is more likely to occur under these conditions:

  • Resuming an upright posture after bed rest for a long period of time
  • Being in the first 24 weeks of pregnancy
  • Losing a large amount of blood
  • Dehydration
  • Taking certain medications, such as blood-pressure-lowering medications, heart medications, Parkinson’s disease medications, tricyclic antidepressants, or medications to treat erectile dysfunction
  • Having a heart problem, such as a very slow heartbeat, heart valve problems, heart attack, or heart failure
  • Having an endocrine problem, such as hypothyroidism, parathyroid disease, Addison’s disease (an adrenal gland disorder), low blood sugar, or diabetes
  • Having a severe infection that enters your bloodstream
  • Experiencing anaphylaxis, a life-threatening allergic reaction
  • Having a neural disorder that affects your blood pressure
  • Having a nutrient deficiency, such as low vitamin B12 and folic acid levels

When to See a Doctor

If your blood pressure is always on the low side and you do not have any of the dangerous 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, and your body is usually able to get your blood pressure back to normal.

But, Dr. Lawrence advises that, “when you sense there’s a recurrent problem or there’s no clear explanation for what’s happened, you need to seek medical advice."

If your blood pressure drops suddenly and you are experiencing symptoms like dizziness, you should call your healthcare provider. They can assess your situation and rule out underlying problems, such as internal bleeding, serious infection, or an allergic reaction.

Treatment for hypotension will depend on the cause of the low blood pressure. Immediate steps might include the following, according to the Mayo Clinic:

  • Wear compression stockings
  • Drink more water
  • Avoid low blood pressure triggers like prolonged standing?and other positional changes

After evaluation, a doctor may make these recommendations:

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.

Determining whether your low blood pressure is a primary problem or secondary problem is crucial, notes Lawrence. A primary problem means that the body’s reflexes are not working as they should. Secondary causes mean that the low blood pressure is a result of other health problems like dehydration or the effects of certain medications.

“Some antihypertensive [medications] are more likely to cause hypotension than others, and a lot of it is dose-dependent,” says Lawrence. “In most people, there will be some easily identifiable secondary cause or some easy solution to what may even be a chronic problem that has no secondary cause. And that’s why it’s important to see your doctor, so they can make an appropriate assessment.”

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 you have medical reasons to monitor your blood pressure, talk to your doctor about the blood pressure target range that’s best for you.

Takeaway

While low blood pressure, also known as hypotension, can sometimes indicate good health, it may also cause serious symptoms like dizziness, fatigue, or fainting. Hypotension can occur due to sudden blood loss, dehydration, and the effects of certain medications or pregnancy.

While blood pressure can fluctuate high or low, understanding your personal normal blood pressure range is crucial for managing potential health risks. Stay hydrated and keep track of your blood pressure readings to prevent the complications of ongoing low blood pressure.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. Low Blood Pressure. National Heart, Lung, and Blood Institute. March 24, 2022.
  2. About High Blood Pressure. Centers for Disease Control and Prevention. May 15, 2024.
  3. Low Blood Pressure (Hypotension). Mayo Clinic. June 13, 2024.
  4. Low Blood Pressure - When Blood Pressure Is Too Low. American Heart Association. May 6, 2024.
  5. Bozzini S et al. Cardiovascular characteristics of chronic fatigue syndrome. Biomedical Reports. November 28, 2017.
  6. Low blood pressure (hypotension). Mayo Ciinic. June 13, 2024.

Resources

  • Low Blood Pressure (Hypotension): Symptoms and Causes. Mayo Clinic. May 14, 2022.
  • Low Blood Pressure — When Blood Pressure Is Too Low. American Heart Association. May 25, 2023.
  • Bozzini S, Albergati A, Capelli E, et al. Cardiovascular Characteristics of Chronic Fatigue Syndrome. Biomedical Reports. January 2018.
  • Low Blood Pressure (Hypotension): Diagnosis and Treatment. Mayo Clinic. May 14, 2022.
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