What To Do When Blood Pressure Gets Too Low - Raising Hypotension

What to Do When Your Blood Pressure Gets Too Low

Blood pressure is the force exerted on blood vessel walls as blood flows through the circulatory system. It normally rises and falls over the course of a day. But some people experience chronically low blood pressure or sudden drops that lead to symptoms.

In this article, we’ll discuss what’s considered too low, causes and risks of very low blood pressure, and what you can do to raise it when needed.

Normal Blood Pressure Range

Normal blood pressure is less than 120/80 mmHg. The top number (systolic) is pressure when the heart beats. The bottom (diastolic) is pressure between beats when the heart refills.

Any blood pressure reading consistently under 90/60 mmHg is considered low. How low is too low depends on the underlying cause and your symptoms.

What is Hypotension?

The medical term for low blood pressure is hypotension. While a reading under 90/60 qualifies as hypotension, doctors use this term when pressure gets so low it causes problems.

Exact thresholds vary by age, health status, and cause. But generally hypotension is:

• Below 90/60 mmHg in healthy young adults
• Below 100/60 mmHg in otherwise healthy middle-aged or elderly adults
• 20-30 mmHg or more below your normal baseline
• Low enough to cause concerning symptoms

With very low blood pressure, vital organs may not get sufficient blood flow. Extended hypotension can lead to dangerous complications.

Causes of Low Blood Pressure

There are many possible underlying causes of low blood pressure:

Normal Variation

Some healthy people naturally have lower readings around 90/50 mmHg. Elite athletes may also have low blood pressure. For them, hypotension is normal if they have no symptoms.

Pregnancy

Blood pressure typically falls during the second trimester as circulation expands. This physiological drop is normal and not concerning if the pregnant person feels well.

Dehydration

Fluid loss from diarrhea, vomiting, sweating or inadequate water intake can substantially lower pressure. Blood volume drops, reducing flow.

Blood Loss

Acute bleeding from injury or internal bleeding like a ruptured ulcer depletes circulating blood volume. Less fluid means less pressure.

Medications

Many drugs can cause hypotension including diuretics, beta blockers, ACE inhibitors, calcium channel blockers and drugs for Parkinson’s disease or erectile dysfunction.

Sepsis

Widespread infection disrupts blood flow and may progress to septic shock with life-threatening hypotension.

Anaphylaxis

Allergic anaphylaxis releases compounds that dilate blood vessels and cause rapid pressure drops.

Heart Conditions

Issues like arrhythmias, heart valve problems, heart failure, or heart attack can impair cardiac output and lower pressure.

Endocrine Disorders

Conditions like diabetes, adrenal insufficiency, thyroid disorders or hormonal dysregulation may disrupt blood pressure regulation.

Autonomic Dysfunction

Nervous system disorders impairing blood vessel control can cause orthostatic or postprandial hypotension.

Nutritional Deficiencies

Low vitamin B12, folate or iron deficiency may reduce red blood cells or cardiac output.

Symptoms of Very Low Blood Pressure

Many people with mild hypotension have no symptoms. But very low pressure can cause:

Lightheadedness

With insufficient blood flow to the brain, lightheadedness or sensations of dizziness may occur. This often happens upon standing up quickly.

Fainting (Syncope)

Extremely low pressure deprives the brain of oxygen, causing temporary loss of consciousness or fainting spells.

Fatigue

Hypotension reduces oxygen delivery to muscles, often causing weakness and exhaustion.

Nausea

Gastrointestinal blood flow may be impaired, leading to nausea, vomiting or abdominal discomfort.

Blurred Vision

Eyes depend on ample blood flow. Vision may dim or blur when pressure is very low.

Confusion

Mental confusion or altered consciousness can occur if blood flow to the brain drops critically.

Pay attention if low readings are accompanied by these warning signs. Notify your doctor promptly about bothersome symptoms.

Dangers and Complications of Hypotension

While not always a medical emergency, very low pressure can escalate to a life-threatening problem. Potential complications include:

Falls

Lightheadedness and weakness raise risks of falling and injury, especially in older adults.

Stroke

Low flow to the brain heightens stroke risk. Hypotension limits collateral blood supply if a blockage occurs.

Heart Attack

Chronically low pressure strains the heart over time. Reduced coronary perfusion can trigger heart attacks.

Kidney Failure

When blood flow to the kidneys decreases, acute kidney injury or failure may develop.

Shock

Without fast treatment, progressively falling pressure leads to shock, organ damage, cardiac arrest and death.

Ischemic Damage

Tissue deprived of ample blood supply experiences cell death and ischemia. This damages vital organs.

While concerning, most hypotension is mild and reversible. But ignoring severe drops or prolonged low pressure is dangerous. Seek immediate care for serious symptoms like fainting, chest pain or mental changes.

When to See the Doctor

Consult your physician about low blood pressure if you experience:

• Readings below 90/60 mmHg plus any symptoms
• A significant drop from your normal baseline
• Lightheadedness, dizziness or fainting
• Confusion, weakness or rapid heartbeat
• Postural symptoms mainly upon standing
• Unexplained falls

Also seek care if you take pressure medications and readings incontinually dip too low. Your doctor can assess for underlying causes and adjust treatment if needed.

Raising Low Blood Pressure

Hypotension caused by dehydration, blood loss or medication effects often resolves by treating the underlying problem. But for symptomatic drops, you can try these measures to temporarily boost pressure:

Drink More Fluids

Increasing fluid intake expands blood volume to raise pressure. Drink 2-3 cups of water or electrolyte drinks.

Increase Salt Intake

Consuming more salt helps retain fluid. Have something salty like broth or salty snacks.

Sit or Lie Down

Getting horizontal stops gravity from pulling blood to your feet. This helps blood return to the chest and brain.

Leg Compressions

Special compression leggings squeeze the legs to propel blood back to the heart.

Caffeine

Drinking a cup of coffee or tea stimulates the heart. But avoid caffeine if heart racing or palpitations develop.

Raise Legs

If lying down, raise your legs above heart level. This improves venous blood return.

Combining fluid loading, salt intake, caffeine and leg elevation rapidly improves low pressure in most cases of mild hypotension.

Preventing Sudden Pressure Drops

You can take some proactive steps to avoid significant dips in blood pressure:

• Stay well hydrated by drinking adequate water and electrolytes.
• Increase salt and fluid before exercising on hot days.
• Wear compression stockings to prevent blood from pooling in the legs.
• Take pressure medication at night so the lowest levels occur during sleep.
• Move slowly when changing positions to avoid pressure drops.
• Eat frequent, smaller meals instead of a few large ones.

Monitoring pressure trends may reveal patterns, like pressure typically dropping after meals or in the evenings. Identifying these dips allows you to anticipate and treat them.

Medical Treatments for Hypotension

If self-care measures and lifestyle adjustments don’t improve low pressure, doctors have medication options:

Fludrocortisone

This steroid hormone increases blood volume and sensitizes blood vessels to salt and fluid retention.

Midodrine

Midodrine constricts blood vessels to raise pressure. But side effects include scalp tingling and goosebumps.

Vasoconstrictors

Medications like norepinephrine narrow blood vessels to increase resistance and blood pressure.

Erythropoietin

The hormone erythropoietin stimulates red blood cell production. More cells increase blood viscosity.

Treatment depends on the cause and may require adjusting other medications contributing to hypotension.

When to Call 911

Most low pressure is mild and easily raised with self-care. But call 911 or emergency services immediately if you experience:

• Fainting or prolonged dizziness
• Chest pain
• Severe shortness of breath
• Sudden, extreme weakness or confusion
• Symptoms of shock like pale, clammy skin
• Head injury after a fall

Rapid medical assistance is crucial for unstable patients with critical drops in blood pressure. Prompt IV fluids, oxygen and medications may be lifesaving.

Key Takeaways

• Hypotension under 90/60 mmHg may cause troubling symptoms.
• Dehydration, blood loss, medications or illness can trigger pressure drops.
• Drink fluids, elevate legs and add salt to temporarily raise low pressure.
• See a doctor for symptoms, significant drops or readings under 90/60 mmHg.
• Call 911 if you experience fainting, chest pain, confusion or sudden weakness.

Your blood pressure fluctuates during the day. But chronically low pressure or sudden decreases can be problematic. Monitoring your levels and developing simple response plans will help you safely manage periods when your blood pressure gets too low.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.