Michael Rotman, MD, FRCPC, PhD | Medically reviewed by Robin Backlund, BHSc
Last update: October 3, 2024

Hypotension, frequently referred to as low blood pressure, is characterized by blood pressure levels dropping below the typical range, with variations depending on a person’s age.

It’s typically measured in millimeters of mercury (mmHg) and categorized into two primary types: systolic, the top number representing pressure when the heart beats, and diastolic, the bottom number indicating pressure between beats.

While the specific threshold for hypotension can differ by age, according to the American Heart Association (AHA), it is technically hypotension when your readings drop below 90/60 mmHg.

This condition, though not as highlighted as hypertension, is relatively common. According to the Mayo Clinic, this condition can manifest in various types, as mentioned below.

Orthostatic hypotension
Postprandial hypotension
Neurally mediated hypotension
Multiple system atrophy with orthostatic hypotension (MSA)
Vasovagal syncope
Hypovolemic hypotension
Medication-induced hypotension
Shock
Secondary hypotension

While lightheadedness, vertigo, etc., are some common symptoms, resident physician Dr. Tatianna Pizzutto says:

“Regardless of age, if a patient is experiencing symptoms related to low blood pressure like dizziness, feeling lightheaded, or seeing spots, that’s when doctors say it’s important to determine why.”

She added:

“If they are getting up from a seated position and standing or lying down and trying to sit up on the edge of the bed and starting to feel really lightheaded, that’s when your low blood pressure might become a problem.”

According to the Australian Government’s Better Health Channel, the causes can include underlying diseases and internal bleeding, but the most common causes include dehydration, blood donation, medications, and even stress.

Diagnosis primarily involves blood pressure monitoring and assessing medical history. The doctor might assess the ECG and imaging of the heart in order to rule out any complications.

Treatment strategies vary, with emphasis on addressing the underlying cause, while natural remedies and lifestyle changes like increased salt and fluid intake are often recommended.

Preventative measures include regular monitoring, a foolproof routine, and diet. For those at risk, at-home blood pressure monitoring is a vital tool.

For this purpose, selecting the best blood pressure monitor tailored to your needs is crucial in managing and preventing hypotension effectively.

Some of the top-of-the-line smart blood pressure monitors, like CheckMe BP2, Oxiline Pressure X Pro, etc., are discussed in this article.

You can listen the review of this article on TheEMTSpot’s PODCAST (Episode 04) hosted by Samuel Harrison and Olivia Harper – check out the video below.

Watch this video on YouTube

Contents

What are the types of low blood pressure (hypotension)?

As mentioned above, hypotension can exist in different forms and types based on its causes.

Hypotension manifests in various forms, including orthostatic, postprandial, and neurally mediated hypotension, among others.

In a clinical scenario, each type presents unique challenges and symptoms, ranging from dizziness in orthostatic hypotension to severe shock in cases of severe hypotension.

In a 2017 study published by Sabine Eschlböck et al. in the Journal of Neural Transmission, several variations of hypotension, like orthostatic and postprandial, were linked to cardiovascular failure.

Understanding these types is crucial for effective diagnosis and management, highlighting the importance of awareness and regular monitoring, especially among vulnerable populations.

In the upcoming sections, you will explore more about three major types of hypotension prevalent among people with low blood pressure.

Orthostatic hypotension (postural hypotension)

Orthostatic hypotension, also known as postural hypotension, is a type of low blood pressure that occurs when getting up quickly from a seated or lying position. This condition often leads to a sudden drop in blood pressure.

A 2018 study published in The Journals of Gerontology reports that this hypotension is very prevalent, ranging from 13 to 36% among older people.

The primary causes of orthostatic hypotension are described below.

Dehydration decreases blood volume and impairs the body’s ability to maintain blood pressure.
Long-term bed rest leads to a decline in blood pressure regulation.
Changes in the circulatory system during pregnancy.
Certain medications, particularly those that lower blood pressure or act as diuretics.
Medical conditions like heart problems, diabetes, or nervous system disorders such as Parkinson’s disease.

The most common symptoms are dizziness, lightheadedness, and fainting or near-fainting, especially when standing up rapidly.

Diagnosis typically involves a physical examination and a review of the patient’s medical history. A critical diagnostic step is measuring blood pressure while the patient is seated and then again after standing for several minutes to note any significant changes.

Treatment focuses on lifestyle modifications, such as staying adequately hydrated, rising slowly from seated or lying positions, and using compression stockings.

In some cases, medications might be prescribed to help maintain blood pressure.

Additionally, treating any underlying health issues or adjusting medications that may be contributing to the condition is crucial.

Postprandial hypotension

Postprandial hypotension is a type of low blood pressure that happens after eating food, usually within one to two hours following a meal.

This condition tends to be more common among elderly individuals, especially those who have high blood pressure or suffer from disorders of the autonomic nervous system, such as Parkinson’s disease.

According to a study published by Prof. Aelee Jang in the Journal of Clinical Medicine, the presence of postprandial hypotension is also an indicator of an impending cardiovascular disease.

The major causes of this hypotension are highlighted below.

Increased blood flow to the digestive tract after eating
Declining autonomic nervous system to regulate blood pressure after meals
Aging, which can weaken the body’s ability to maintain blood pressure stability
Preexisting conditions like high blood pressure or autonomic nervous system disorders such as Parkinson’s disease

In people with this condition, the body’s response to this shift in blood flow is inadequate, leading to a significant drop in overall blood pressure.

Dizziness, lightheadedness, weakness, fainting, or falls are some of the most common symptoms evident after meals.

Diagnosis often involves monitoring blood pressure before and after meals to observe any notable changes. A detailed medical history is also essential to identify symptoms correlating with meal times.

Treatment typically includes lifestyle adjustments such as eating smaller, more frequent meals, reducing carbohydrate intake, increasing water consumption, and avoiding alcohol with meals.

In some instances, medications may be prescribed to regulate blood pressure. Effectively managing underlying conditions, such as diabetes or Parkinson’s disease, is also crucial in treating postprandial hypotension.

Neurally mediated hypotension

Neurally mediated hypotension (NMH) is a type of low blood pressure that occurs after an extended period of standing.

This condition is particularly common among young adults and children. NMH results from a miscommunication between the heart and the brain.

When an individual remains standing for an extended period, the body typically adapts by slightly elevating the heart rate and narrowing blood vessels to maintain blood pressure and sufficient blood circulation.

However, in NMH, this regulatory mechanism is disrupted, leading to decreased blood pressure.

One of the major triggering factors for NMH is chronic fatigue syndrome (CFS), characterized by severe tiredness.

A study published by Dr. Peter C. Rowe from Johns Hopkins University School of Medicine found that people with CFS are at risk of NMH. Other key factors that can cause NMH are provided below.

Prolonged standing
Stressful or emotional events
Heat exposure
Pain
Fatigue and overexertion
Dehydration
Certain medications

Symptoms of NMH can include dizziness, lightheadedness, nausea, and fainting, especially after standing for prolonged periods. These symptoms occur because there is a decrease in blood pressure, leading to reduced blood flow to the brain.

Diagnosing NMH often involves a tilt table test, where the patient’s blood pressure and heart rate are monitored while they are tilted at different angles on a table.

This test is designed to replicate the physiological alterations that occur when an individual transitions from lying to upright.

Treatment for NMH focuses on lifestyle changes and, in some cases, medication.

Lifestyle changes can include increasing water and salt intake to boost blood volume, wearing compression stockings to improve blood flow, and avoiding standing still for prolonged periods.

Medications may be prescribed to increase blood volume or regulate blood pressure and heart rate. In some cases, counseling or biofeedback therapy is recommended to help patients manage symptoms related to NMH.

Multiple system atrophy with orthostatic hypotension (MSA)

Multiple system atrophy with orthostatic hypotension (MSA) is a rare, progressive neurodegenerative disorder characterized by a combination of symptoms affecting the autonomic nervous system and movement.

According to Fred Kahn, M.D. FRCS(C), one of the hallmark features of MSA, is orthostatic hypotension, which is a significant and often rapid drop in blood pressure upon standing, leading to symptoms like dizziness or fainting.

MSA encompasses a range of symptoms as highlighted below.

Symptoms similar to Parkinson’s disease, such as rigidity, tremors, and problems with movement and balance.
Problems with coordination and balance.
Autonomic dysfunction
Motor impairments
Speech and swallowing difficulties
Breathing problems

The cause of MSA is unknown, but it involves the degeneration of nerve cells in specific areas of the brain, which affects both autonomic functions and movement.

There is no known remedy for MSA, and the emphasis of treatment lies in symptom management and enhancing the individual’s quality of life.

This can include medications to manage blood pressure and motor symptoms, physical therapy, and lifestyle changes to cope with autonomic dysfunction.

The progression of MSA varies among individuals, but it is a life-limiting condition, often leading to severe disability and reduced life expectancy.

What is considered dangerously low blood pressure (hypotension)?

According to the American Heart Association (AHA), blood pressure readings lower than 90 millimeters of mercury (mm Hg) for the top number (systolic) or 60 mm Hg for the bottom number (diastolic) are generally considered low.

However, it’s important to note that what is considered dangerously low can vary depending on the individual and the context.

According to Dr. Gary Kerkvliet from Mercy Medical Center:

“The typical ideal blood pressure is around 120/70 or lower, but we prefer it to be under 135/85. However, I have had patients with readings as low as 70/40 who were perfectly fine.”

He added:

“If there is low blood pressure, it could be as simple as dehydration, or it could indicate an underlying problem. For the most part, it becomes a concern only when signs and symptoms are exhibited or when it is linked to a serious medical condition.”

For some individuals, slightly lower blood pressure measurements may not cause any problems and could be normal for them.

In other cases, especially if low blood pressure is accompanied by symptoms such as dizziness, fainting, or an inability to function normally, it can be considered dangerous.

The AHA emphasizes that the significance of low blood pressure is often less about the numbers and more about how it affects an individual’s body and daily functioning.

People with underlying health conditions should closely monitor their blood pressure readings because it could develop into a medical emergency without warning.

Below, you will learn more about the symptoms associated with low blood pressure so that you can keep a close watch for these.

What are the symptoms of low blood pressure (hypotension)?

Symptoms of hypotension, as highlighted by the AHA, are provided below. While additional individual-specific symptoms could manifest, the ones mentioned below are more commonly reported.

Dizziness or lightheadedness: Feeling unsteady or as if you might faint, especially when standing up quickly.
Fainting (Syncope): Temporary loss of consciousness due to insufficient blood flow to the brain.
Blurred vision: Visual disturbances or temporary loss of vision, indicating decreased blood flow to the eyes.
Nausea: A sensation of queasiness or unease in the abdomen, often associated with decreased blood circulation to the digestive system.
Fatigue: Generalized weakness or extreme tiredness, which can result from inadequate blood flow to various body tissues.
Lack of concentration: Challenges in concentration or mental confusion, potentially arising from diminished blood flow to the brain.
Cold, clammy, pale skin: Caused by the body’s response to maintain blood flow to vital organs.
Rapid, shallow breathing: As a response to reduced blood oxygen levels.
Depression: Long-term low blood pressure can sometimes lead to feelings of depression.

The seriousness of these symptoms can vary, and they may not consistently signify a significant issue.

Hypotension symptoms, including dizziness, fainting, and fatigue, are similar in men and women.

However, women may experience more fluctuations due to menstrual cycles, pregnancy, and menopause, affecting blood pressure regulation.

Sometimes, a completely unrelated symptom could occur, such as feeling cold. You will read more about it below.

Nevertheless, when symptoms persist or become severe, it is advisable to seek a medical assessment to ascertain the root cause and receive suitable treatment.

Does low blood pressure make you feel cold?

Yes, low blood pressure can cause you to feel cold, especially in your extremities, like your hands and feet.

In a 1983 study conducted by a group of researchers from Sweden, 40% of patients taking antihypertensive drugs reported experiencing coldness in their extremities, particularly those on diuretics.

This occurs when the blood pressure in hypertensive patients falls below the ideal limit and approaches the hypotension threshold.

This sensation of coldness is often a result of reduced blood flow to these areas.

When blood pressure is low, the body tends to prioritize sending blood to vital organs such as the heart and brain, which can lead to decreased blood flow in peripheral parts of the body.

This reduced circulation can make your skin feel cool to the touch and a general sense of being cold.

Additionally, the body’s response to low blood pressure may involve constricting blood vessels, further reducing blood flow to the extremities and contributing to the sensation of coldness.

While cold extremities are one of the symptoms, there is a long list of causes that, if you are aware of, can help you proactively manage hypotension.

What are the causes of low blood pressure (hypotension)?

There are several causes of blood pressure changes that could occur without any underlying reasons; while some could be manifestations of a comorbidity, others could be natural reasons.

According to the AHA, as long as these causes don’t lead to hypoxia, they are benign. Below, you will find the most common causes.

Prolonged bed rest: This leads to a decrease in the body’s ability to regulate blood pressure due to reduced physical activity.
Poor diet: Inadequate or unhealthy eating habits lacking essential nutrients can contribute to various health issues.
Temperature: Extreme hot or cold temperatures can affect the body’s physiological processes and impact health.
Anxiety: Excessive worry or stress can lead to physical and emotional symptoms, affecting overall well-being.
Certain medications: Drugs like diuretics, alpha-blockers, beta-blockers, and some antidepressants can lower blood pressure.
Neurally mediated syncope: A reflex condition where prolonged standing or emotional stress leads to a sudden blood pressure drop.
Dehydration: Reduces blood volume, leading to a drop in blood pressure, especially when standing up (orthostatic hypotension).

While some factors are environmental, some are related to diet, and some causes are due to your lifestyle. But what are the medical conditions that could lead to hypertension?

What conditions can lead to low blood pressure?

According to MayoClinic, the following are some of the health conditions that could lead to hypotension, and sometimes, it could even become a medical emergency as well.

Heart and heart valve conditions: Issues like a very low heart rate, heart valve problems, or heart failure can impair the heart’s ability to circulate blood effectively, leading to lowered blood pressure.
Depression or Parkinson’s disease: These conditions can disrupt the autonomic nervous system, affecting blood pressure control.
Hormone-related diseases (endocrine disorders): Disorders of the thyroid, adrenal glands, or pituitary gland can disrupt the hormonal balance that regulates blood pressure.
Blood loss: Considerable blood loss resulting from either injury or internal bleeding decreases the body’s total blood volume, leading to a sudden drop in blood pressure.
Severe infection (septicemia): Infections can lead to septic shock, where an overwhelming infection causes a dangerous drop in blood pressure.
Severe allergic reaction (anaphylaxis): This intense allergic response can result in a sudden and significant decrease in blood pressure.
Lack of nutrients in the diet: Nutritional deficiencies, especially in vitamins and minerals essential for blood and blood cell production, like B12, iron, and folate, can lead to low blood pressure.

The good thing is that all the above medical conditions can be diagnosed before they even have a chance to create trouble, and therefore, the risk of hypotension can be managed.

While diseases are a cause, some of the medications used for their treatment could also lead to hypotension. You can learn more below.

What medications can result in low blood pressure?

Certain medications can reduce blood pressure to a dangerously low level. According to William J. Elliott, MD, PhD, from Rush University Medical Center, this is often caused by flawed interactions of antihypertensive drugs.

Below are some of the common drugs or medications that could trigger low blood pressure.

Diuretics (water pills): They are used to treat hypertension by removing excess fluid from the body, but they can also lower blood pressure too much.
Alpha-blockers: These medications reduce arterial resistance, improving blood flow but potentially causing a drop in blood pressure.
Beta-blockers: Used for high blood pressure and heart conditions, they can decrease the heart rate and reduce the force of the heart’s contractions, leading to lower blood pressure.
Drugs for Parkinson’s disease: Some medications used to treat Parkinson’s can lower blood pressure.
Certain types of antidepressants: Some antidepressant drugs can affect blood pressure control.
Erectile dysfunction drugs: This class of drugs will cause blood vessel walls to relax and dilate, leading to a decrease in blood pressure.
Angiotensin-converting enzyme (ACE) inhibitors: Another hypertension medication that is used to treat heart failure. They can sometimes reduce blood pressure too much.
Angiotensin II receptor blockers (ARBs): Like ACE inhibitors, ARBs are used to treat high blood pressure and can occasionally lower it excessively.
Calcium channel blockers: Another class of vasodilators that relaxes the walls of blood vessels such that it can lead to a drop in blood pressure.
Nitrates: Nitrates, employed in the management of angina (chest pain), have the effect of reducing blood pressure by expanding blood vessels.

Certain medications can definitely be avoided for this reason, and clinicians always find a workaround for this. However, there are other risk factors involved, which are discussed in the next section.

What are the risk factors for low blood pressure?

Several risk factors for hypotension could vary from individual to individual. While factors like your diet, disease state, lifestyle, etc., could be a risk, below are some of the factors that are least discussed.

Age: As people age, the risk of hypotension can increase. This is partly due to the natural weakening of the heart muscle, stiffening of the arteries, and a decrease in the body’s ability to regulate blood pressure quickly.
Medications: Many medications can cause hypotension as a side effect. These include diuretics, alpha-blockers, beta-blockers, certain types of antidepressants, and medicines for Parkinson’s disease.
Inherited factors: Genetic predispositions can influence one’s risk of developing hypotension. If there is a family history of low blood pressure or related cardiovascular conditions, the likelihood of experiencing hypotension may be higher.
Gender: Research suggests that the risk of orthostatic hypotension (a form of low blood pressure that happens when you stand up from sitting or lying down) may be higher in women, especially postmenopausal women.
Low oxygen environment: Low oxygen environments, like high altitudes or poorly ventilated spaces, can lead to hypotension. The body’s effort to compensate for low oxygen can involve vasodilation (widening of blood vessels), which can lower blood pressure.
Nature of job: Jobs that require prolonged standing or have a physically demanding nature can increase the risk of hypotension. Prolonged standing can cause blood pooling in the legs, while heavy physical labor can lead to dehydration and electrolyte imbalances.
Suicidal thoughts: In March 2018, a research paper published in BMC Public Health, which utilized information from the Korean National Health and Nutrition Examination Survey, discovered a noteworthy correlation between thoughts of suicide and decreased blood pressure.

Hypotension could sometimes result from a particular condition or a psychological state.

As mentioned above, while it is not a significant risk in some instances, hypotension might become a medical emergency.

Below are some of the causes that could lead to a sudden drop in blood pressure and what to do about it.

What causes a sudden drop in blood pressure?

Hypotensive shock, characterized by a sudden loss of blood pressure, can arise from various causes, all of which lead to a decrease in the volume or effectiveness of blood circulation in the body.

In the 2014 study ‘The Epidemiology of Adult Rapid Response Team Patients in Australia’ by Jones et al., the researchers examined the characteristics and outcomes of patients receiving Rapid Response Team interventions and identified sudden blood pressure drops as a significant category of patients.

Hemorrhagic shock, one of the primary causes, results from significant blood loss due to factors like trauma, surgery, or internal bleeding, thereby hindering the body’s ability to maintain sufficient blood pressure and circulate essential oxygen and nutrients.

Similarly, cardiogenic shock arises when the heart fails to pump adequately, often due to severe heart conditions such as a heart attack, heart failure, or arrhythmias.

In the case of septic shock, a severe infection triggers an inflammatory response, causing vasodilation and a drop in blood pressure.

Anaphylactic shock, a severe allergic reaction, also leads to vasodilation and increased capillary permeability, rapidly lowering blood pressure.

Neurogenic shock, resulting from spinal cord or central nervous system damage, disrupts blood vessel tone and heart function.

Lastly, distributive shock, which includes septic, anaphylactic, and neurogenic shock, involves a loss of blood vessel tone, culminating in a blood pressure drop.

All these conditions share a common thread—a reduction in effective blood circulation, whether due to diminished blood volume, compromised heart pumping, or weakened blood vessel tone.

An effective way to prevent this is through a proper diagnosis, preferably during a routine checkup, to assess the risk of sudden blood pressure drops. The following section will provide further education on this topic.

How is low blood pressure (hypotension) diagnosed?

Diagnosing low blood pressure involves a combination of medical evaluation, clinical tests, and patient history analysis. The various diagnostics approaches are provided below.

Blood pressure measurement

The first and most fundamental step is measuring blood pressure using a sphygmomanometer.
Blood pressure readings lower than 90 millimeters of mercury (mm Hg) for the top number (systolic) or 60 mm Hg for the bottom number (diastolic) are generally considered low.

Medical history review

Doctors review the patient’s medical history, including any existing health conditions, medications, and any history of similar symptoms.
This helps identify any underlying causes of hypotension, such as heart problems, dehydration, or endocrine disorders.

Physical examination

A thorough physical exam, including checking heart rate and temperature and looking for signs of underlying conditions that might be causing the low blood pressure.
Examination of the heart, lungs, and neurological systems to assess overall health and detect any abnormalities.

Blood tests

These can reveal valuable information about the overall health of the patient, such as blood sugar levels, electrolyte and mineral balance, and kidney function.
Blood tests may also help identify conditions like anemia, which can cause low blood pressure.

Electrocardiogram (ECG or EKG)

This test records the electrical activity of the heart and can identify irregularities in heart rhythm, structural problems, or evidence of a heart attack.
It’s a non-invasive test and can provide quick insights into heart-related causes of hypotension.

Echocardiogram

An ultrasound of the heart to check for structural heart diseases or problems with the heart’s chambers and valves.
This test helps in visualizing the heart in motion and can detect conditions that might not be evident in an ECG.

Tilt table test

Used if blood pressure drops when standing up (orthostatic hypotension).
It involves lying on a table that is tilted to raise the upper part of your body, simulating a change from lying down to standing up.

Stress test

This test is to see how the heart performs under physical stress.
It can include walking on a treadmill or using medication to stimulate the heart if the patient is unable to exercise.

Holter monitoring

A continuous recording of heart rate and rhythm over 24 to 72 hours.
Useful for detecting intermittent episodes of abnormal heart rhythms that might be causing low blood pressure.

Each of these diagnostic steps contributes to a comprehensive understanding of the patient’s condition, allowing for an effective treatment planning for hypotension.

What are the treatment methods for low blood pressure (hypotension)?

Treating low blood pressure (hypotension) involves various strategies aimed at addressing the underlying cause and alleviating symptoms.

The treatment approach can be diverse, ranging from lifestyle adjustments to medical interventions.

A StatPearl book chapter titled ‘Hypotension’ in the NIH library clearly highlights common treatment methods that align with the AHA recommendations, as provided below.

Lifestyle changes

Increasing water and salt intake to boost blood volume.
Avoiding alcohol and staying hydrated.
Eating small, low-carbohydrate meals to prevent post-meal hypotension.

Medications

Fludrocortisone, which helps boost blood volume.
Midodrine, which increases blood pressure by raising blood vessel tone.

Wearing compression stockings

These garments help reduce the pooling of blood in the legs, thus minimizing the symptoms of orthostatic hypotension.

Physical maneuvers and exercises

Simple physical movements or exercises to improve circulation.
Avoiding sudden position changes that can cause dizziness.

Managing underlying conditions

Addressing heart conditions, dehydration, or other medical issues that may be causing low blood pressure.

Every treatment approach is customized to suit the individual’s unique requirements and the root cause of their low blood pressure.

Following these treatments, the next logical step in managing hypotension is exploring the medications used specifically for this condition.

This includes understanding the types of drugs available, their mechanisms of action, and how they fit into the overall treatment plan for low blood pressure.

What medications are typically used to treat low blood pressure?

In the treatment of low blood pressure (hypotension), certain medications are commonly prescribed to help raise blood pressure to normal levels.

These medications work by various mechanisms, such as increasing blood volume or constricting blood vessels.

A publication in the journal Cardiovascular by Manouchehr Saljoughian, PharmD, Ph.D., from Alta Bates Summit Medical Center elaborates on some of the common medications used to treat hypotension, and they are listed below.

Fludrocortisone

Primarily used to increase the volume of blood in the body.
It enhances the retention of sodium, which leads to water retention and an increase in blood pressure.

Midodrine

Works by shrinking blood vessels, thereby raising blood pressure.
Particularly useful for treating orthostatic hypotension.

Pyridostigmine

Used in some cases to manage orthostatic hypotension.
It works by enhancing nerve signals to blood vessels, increasing blood pressure.

Erythropoietin

Occasionally used if hypotension is linked with anemia.
Stimulates the secretion of red blood cells, increasing blood volume and pressure.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

It can be used to increase blood pressure in certain situations.
They work by reducing the production of substances that dilate blood vessels.

Each of these medications has specific indications and is chosen based on the individual’s underlying cause of hypotension and overall health profile.

As with any medication, these treatments for low blood pressure can have side effects.

Understanding these side effects is essential for managing and monitoring the overall treatment plan, which will be discussed in the following section.

What are the side effects of these medications?

Medications used to treat low blood pressure, while effective, can come with a range of side effects.

For instance, Fludrocortisone, which boosts blood volume, may lead to fluid retention and swelling, potential electrolyte imbalances, and an increase in blood pressure that’s too high.

Midodrine, used to constrict blood vessels, can cause scalp tingling, urinary urgency, and, in some cases, supine hypertension, where blood pressure rises excessively when lying down.

Pyridostigmine, which enhances nerve signals to blood vessels, might lead to gastrointestinal discomfort, sweating, and muscle cramps.

Erythropoietin, used in cases linked with anemia, carries risks like hypertension and increased thrombotic events (blood clots).

Lastly, NSAIDs occasionally used for increasing blood pressure, can result in gastrointestinal issues, kidney function impairment, and increased risk of cardiovascular events in some individuals.

While these medications are important for managing hypotension, understanding and managing their side effects is crucial for patient safety and comfort.

In addition to medical treatments, there are also natural methods to raise blood pressure.

These methods, which will be explored in the next section, offer alternative or complementary approaches for individuals looking to manage their blood pressure without or in addition to medication.

How can you naturally raise blood pressure?

There are various natural methods that can help you increase your blood pressure back to normal limits.

According to an interview with Dr. Allan Stewart, a cardiothoracic surgeon and the cardiovascular surgery medical director for HCA Florida Mercy Hospital, below are some of the natural ways to increase blood pressure.

Stay hydrated: Dr. Stewart emphasizes the importance of hydration, stating, “Be sure to drink plenty of water throughout the day, and opt for beverages with electrolytes if you’ve been sweating a lot.” This advice is very relevant in the context of preventing dehydration, which can lead to a reduction in blood volume and a consequent drop in blood pressure.
Increase salt intake: While reducing salt is often advised for high blood pressure, increasing salt intake can help raise blood pressure in those with hypotension. However, it’s important to consult with a healthcare provider before making significant changes to salt consumption, as it can have other health implications.
Eat small, frequent meals: Regarding meal consumption, Dr. Stewart advises, “Avoid consuming large amounts of carbohydrates at once,” as this can lead to a significant drop in blood pressure.
Avoid alcohol: Alcohol can lower blood pressure further, so it’s advisable to limit or avoid it. This recommendation is supported by numerous studies linking alcohol consumption to blood pressure changes.
Wear compression stockings: These stockings, typically employed to alleviate discomfort and swelling caused by varicose veins, can also assist in diminishing blood accumulation in the legs, thus contributing to the alleviation of symptoms associated with low blood pressure.
Medication review: Sometimes, medications can contribute to low blood pressure. It’s important to review all medications with a healthcare provider to see if any could be causing a drop in blood pressure.
Physical maneuvers: Certain physical maneuvers can increase blood pressure temporarily. These include crossing the legs while sitting, clenching fists, or tensing leg muscles. These techniques can be particularly useful when feeling dizzy or lightheaded.
Regular exercise: Engaging in consistent physical activity supports the maintenance of favorable blood pressure. Nevertheless, seeking guidance from a medical professional before commencing a fresh exercise routine is crucial, particularly for individuals with low blood pressure.
Monitor blood pressure regularly: Keeping track of blood pressure readings can help identify patterns and triggers for low blood pressure. This can be crucial in managing and preventing severe drops in blood pressure.

While these natural methods are useful in managing low blood pressure, it’s important to understand the potential risks associated with hypotension.

The next section will delve into the possible complications and health risks arising from prolonged or severe low blood pressure.

This awareness is significant for individuals coping with hypotension, ensuring they thoroughly understand the importance of preserving an optimal blood pressure level.

What are the dangers associated with low blood pressure (hypotension)?

Low blood pressure can result in insufficient blood flow, reducing oxygen supply to vital organs, especially the brain, which can impair various bodily functions and overall well-being.

In fact, chronic low blood pressure may lead to heart damage due to inadequate oxygenation.

A study published in the British Medical Journal (February 2017) found that individuals with coronary heart disease and very low blood pressure had a heightened risk of cardiovascular events like heart attacks.

Additionally, another study in the Journal of the American College of Cardiology (September 2018) linked very low blood pressure with increased angina in people with chronic coronary artery disease.

Moreover, sudden drops in blood pressure can cause fainting, increasing the risk of injuries from falls, especially in the case of older people.

A certain degree of concern exists for patients with kidney failure since excessively low blood pressure can worsen kidney function.

Patients who have had strokes in the past may experience a recurrence of symptoms if their blood pressure drops too low.

As mentioned earlier, a Korean study found a significant association between low blood pressure and suicidal thoughts, indicating potential mental health implications of hypotension.

Given these potential dangers, it’s vital to monitor and manage low blood pressure effectively.

Considering these risks, you will now explore the scenarios in which medical consultation is essential for managing hypotension.

When should you call a doctor regarding low blood pressure?

Determining when to seek medical advice for low blood pressure is crucial.

According to Alexandra Lajoie, MD, a non-invasive cardiologist at Providence Saint John’s Health Center in Santa Monica, California:

“The number is variable and depends on a patient’s other medical conditions,” she says.

“Some people have symptoms if their systolic blood pressure is below 120, others below 70. However, it’s essential to consult a doctor if symptoms cause discomfort or affect daily life,” says Dr. Lajoie.

According to AHA official guidelines, the symptoms can include dizziness, fainting, nausea, chest pain, palpitations, blurred vision, and dehydration.

For occasional, non-critical symptoms like lightheadedness, or if home blood pressure readings consistently measure below the low blood pressure range, it’s advisable to contact a primary healthcare provider.

The doctor may request a physical exam to assess the situation more accurately.

Moreover, certain signs and symptoms, when occurring alongside low blood pressure, may indicate a medical emergency.

These include nausea, cold, clammy, pale skin, rapid, shallow breathing, heart palpitations, dehydration, thirst, headache, neck or back pain, and lack of concentration.

In such scenarios, immediate medical attention or calling an ambulance is necessary.

In cases where hypotension symptoms persist for extended periods, it’s imperative to consult a doctor to understand the severity of the condition and formulate an appropriate treatment plan.

With these considerations in mind, it’s also important to know how low blood pressure can be prevented.

In the next section, you will explore preventive measures and lifestyle modifications that can help maintain healthy blood pressure levels.

How can low blood pressure (hypotension) be prevented?

Preventing low blood pressure involves a combination of lifestyle changes and awareness of health conditions.

While not all cases of hypotension can be prevented, especially those due to underlying health issues, certain measures like the one given below can help you.

Manage stress: Chronic stress can affect blood pressure. Engage in stress-reduction techniques such as meditation, yoga, deep breathing exercises, or mindfulness to help maintain healthy blood pressure levels.
Get adequate sleep: Poor sleep patterns and inadequate sleep can contribute to low blood pressure. Aim for 7-9 hours of quality sleep per night to support cardiovascular health.
Avoid excessive heat: Prolonged exposure to hot environments, such as saunas or hot baths, can lead to dehydration and low blood pressure. Stay hydrated and limit time spent in extremely hot conditions.
Review your medication: If you are taking medications for other conditions, consult with your healthcare provider to ensure that none of them are contributing to low blood pressure as a side effect.
Stay active, but be cautious with intense exercise: While regular exercise is beneficial, extremely intense workouts, especially if you are not conditioned for them, can lead to drops in blood pressure.
Limit caffeine: Excessive caffeine consumption can lead to dehydration and potentially lower blood pressure. Consume caffeine in moderation and stay hydrated.
Avoid hot showers or baths: Extremely hot showers or baths can cause blood vessels to dilate and result in a drop in blood pressure. Consider lukewarm water instead.
Get regular checkups: Regularly monitor your blood pressure and consult with a healthcare provider for guidance on maintaining healthy blood pressure levels.
Manage underlying health conditions: If you have any underlying medical conditions contributing to low blood pressure, such as diabetes or hormonal disorders, work with your healthcare team to manage and treat these conditions effectively.

After understanding how to prevent low blood pressure, it’s also important to know how to monitor it. In the upcoming section, you will learn steps and considerations for accurately measuring blood pressure at home.

How do you check blood pressure with a home monitor?

Checking blood pressure at home with a monitor is a straightforward process that can be an important part of managing your health.

Dr. Michael Rakotz, a family physician and vice president of health outcomes at the American Medical Association (AMA), emphasizes the critical role of home blood pressure monitoring.

He states:

“It’s so important to partner with patients in improving their blood pressure. Having patients take their own BP measurements is a way to do that and engage patients in self-management of their blood pressure.”

He also advises on the proper use of home blood pressure devices, recommending those with upper arm cuffs that automatically inflate for ease of use and accuracy.

Some of the AHA guidelines for proper measurement are provided below.

Relax and prepare: Take a seat in a cozy chair with adequate back support and ensure your feet are flat on the ground. Allow yourself to relax for five minutes before proceeding with the measurement.
Position your arm: Place your arm on a table or other flat surface, with the upper arm at heart level. Roll up your sleeve so that the cuff can be placed on your bare skin.
Apply the cuff: Wrap the cuff around the upper part of your bare arm. The cuff should be snug but not too tight.
Start the measurement: Turn on the monitor and start the measurement. Stay motionless and silent while the device initiates the reading.
Read the results: After the measurement has finished, the monitor will show your blood pressure reading.
Record the reading: Write down your results, including the date and time of the reading. Keeping a record can help you and your healthcare provider monitor and manage your blood pressure.

If you’re wondering how to check blood pressure with clinical precision, the good news is that a few products with clinical-level accuracy are on the market.

Below, you will find the best options for home blood pressure monitors and how to choose one that provides the most accurate readings.

Which blood pressure monitors are the most accurate?

Oxiline Pressure X Pro and CheckMe BP2 are two of the blood pressure monitors which are most accurate.

Oxline LLC is an American brand with a decades-long market reputation and extensive experience.

Pressure X Pro is one of their top-of-the-line healthcare products. Pressure 7 Pro and Pressure 9 Pro are among their entry-level offerings. Some of the standout features of Oxiline Pressure X Pro are provided below.

Cuffed with tube
FDA 510(k) Granted
Mobile App Support
VIBRA™ TX Sensor for detecting arterial pressure
Bluetooth connectivity
Lifetime warranty

CheckMe, on the other hand, is a product from Viatom Innovation Technology Co., Ltd., based in Shenzhen, China, with a strong market presence in the West.

They excel with their technology and state-of-the-art features that facilitate seamless smartphone integration. Some of the remarkable features of this product are given below.

Tubeless cuff
Mobile App Support
ECG with AI analysis
Wi-Fi and Bluetooth connectivity
Rechargeable
OLED screen
Real-time Tracking

There are other models you may consider, including Withings BPM Connect, Omron Silver, and QardiArm.

How to interpret your reading according to latest AHA’s blood pressure chart?

The American Heart Association (AHA) and the American College of Cardiology (ACC) have updated their blood pressure chart, which is key for understanding both hypertension and hypotension.

Blood Pressure Category	Systolic BP (mmHg)	Diastolic BP (mmHg)
Normal	Below 120	Below 80
Elevated	120-129	Below 80
Hypertension Stage 1	130-139	80-89
Hypertension Stage 2	140+	90+
Hypertensive Crisis	180+	120+

Blood pressure readings are categorized based on systolic (top number) and diastolic (bottom number) values in mmHg.

The chart helps identify conditions ranging from normal to hypertensive crisis.

It’s important to note that this chart doesn’t cover low blood pressure (hypotension), which, though less common than hypertension, can be critical and typically presents warning signs before becoming severe.