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This blog is a sequel to the August 2023 asymptomatic hypertension topic because after my 

diagnosis of stage two hypertension diagnosis and being prescribed medication which lowered my blood 

pressure to the normal range. I systematically take the measurement of my blood pressure daily and 

one morning the reading was 88/58 (mm Hg.) which appeared to be low to me and I checked google to 

determine what was considered low blood pressure. When blood pressure is 90/60 or lower one is 

considered to have hypotension. This term was unfamiliar to me and I thought if it was foreign to me 

that many others probably were unknowledgeable. My purpose is to inform my community about 

healthcare concerns.

Hypotension, or low blood pressure, is when your blood pressure is much lower than expected. 

It can happen either as a condition on its own or as a symptom of a wide range of conditions. It may 

cause symptoms. But when it does, you may need medical attention.

Types of low blood pressure

Hypotension has two definitions:

• Absolute hypotension: Your resting blood pressure is below 90/60 millimeters of mercury (mm Hg).
  
• Orthostatic hypotension: Your blood pressure stays low for longer than three minutes after you stand up from a sitting position. (It’s normal for your blood pressure to drop briefly when you change positions, but not for that long.) The drop must be 20 mm Hg or more for your systolic (top) pressure and 10 mm Hg or more for your diastolic (bottom) pressure. Another name for this is postural hypotension because it happens with changes in posture.

Measuring blood pressure involves two numbers: 

• Systolic (top number): This is the pressure on your arteries each time your heart beats.
• Diastolic (bottom number): This is how much pressure your arteries are under between heartbeats.

What is considered low blood pressure?

Low blood pressure is below 90/60 mm Hg. Normal blood pressure is about that, up to 120/80 mm Hg.

How common is low blood pressure?

Because low blood pressure is common without any symptoms, it’s impossible to know how many people it affects. However, orthostatic hypotension seems to be more and more common as you get older. An estimated 5% of people have it at age 50, while that figure climbs to more than 30% in people over 70.

Who does low blood pressure affect?

Hypotension can affect people of any age and background, depending on why it happens. However, it’s more likely to cause symptoms in people over 50 (especially orthostatic hypotension). It can also happen (with no symptoms) to people who are very physically active, which is more common in younger people.

What are the symptoms of low blood pressure?

Low blood pressure symptoms include: 

• Dizziness or feeling lightheaded.
• Fainting or passing out (syncope). 
• Nausea or vomiting. 
• Distorted or blurred vision.
• Fast, shallow breathing. 
• Fatigue or weakness. 
• Feeling tired, sluggish or lethargic. 
• Confusion or trouble concentrating 
• Agitation or other unusual changes in behavior (a person not acting like themselves)

For people with symptoms, the effects depend on why hypotension is happening, how fast it develops and what caused it. Slow decreases in blood pressure happen normally, so hypotension becomes more common as people get older. Fast decreases in blood pressure can mean certain parts of your body aren’t getting enough blood flow. That can have effects that are unpleasant, disruptive or even dangerous.

Usually, your body can automatically control your blood pressure and keep from dropping too much. If it starts to drop, your body tries to make up for that, either by speeding up your heart rate or constricting blood vessels to make them narrower. Symptoms of hypotension happen when your body can’t offset the drop in blood pressure.

For many people, hypotension doesn’t cause any symptoms. Many people don’t even know their blood pressure is low unless they measure their blood pressure.

What are the possible signs of low blood pressure?

Your healthcare provider may observe these signs of low blood pressure: 

• Cool kneecaps. 
• Low cardiac output (how much blood your heart pumps). 
• Low urine (pee) output.

What causes low blood pressure?

Hypotension can happen for a wide range of reasons. Causes of low blood pressure include:

• Orthostatic hypotension: This happens when you stand up too quickly and your body can’t compensate with more blood flow to your brain.
• Central nervous system diseases: Conditions like Parkinson’s disease can affect how your nervous system controls your blood pressure. People with these conditions may feel the effects of low blood pressure after eating because their digestive systems use more blood as they digest food.
• Life-threatening conditions: These conditions include irregular heart rhythms (arrhythmias), pulmonary embolism (PE), heart attacks and collapsed lung. Life-threatening allergic, reactions (anaphylaxis) or immune reactions to severe infections (sepsis) can also cause hypotension.
• Heart and lung conditions: You can get hypotension when your heart beats too quickly or too slowly, or if your lungs aren’t working as they should. Advanced heart failure (weak heart muscle) is another cause.
• Prescription medications: Hypotension can happen with medications that treat high blood pressure, heart failure, erectile dysfunction, neurological problems, depression and more. Don’t stop taking any prescribed medicine unless your provider tells you to stop.
• Alcohol or recreational drugs: Recreational drugs can lower your blood pressure, as can alcohol (for a short time). Certain herbal supplements, vitamins or home remedies can lower blood pressure. This why you should always include these when you tell your healthcare provider what medications you’re taking.
• Extreme temperatures: Being too hot or too cold can affect hypotension and its effects worse.

What are the complications of low blood pressure?

• Falls and fall-related injuries: These are the biggest risks with hypotension because it can cause dizziness and fainting. Balls can lead to broken bones, concussions and other serious or even life-threatening injuries.. If you have hypotension, preventing falls should be one of your biggest priorities.
• Shock: When your blood pressure is low, that can affect your organs by reducing the amount of blood they get. That can cause organ damage or even shock (where your body starts to shut down because of limited blood flow and oxygen).
• Heart problems or stroke: Low blood pressure can cause your heart to try to compensate by pumping faster or harder. Over time, that can cause permanent heart damage and even heart failure. It can also cause problems like deep vein thrombosis (DVT) and stroke because blood isn’t flowing like it should causing clots to form.

How is low blood pressure diagnosed?

Low blood pressure treatment usually starts with finding out why it’s happening. If a provider can treat that cause directly, hypotension will usually get better on its own. For example, hypotension can happen because of any injury and blood loss. Repairing that injury and replacing the lost blood with a blood transfusion will stop hypotension as long as the repair to the injury holds.

If you take medications that affect your blood pressure, your healthcare provider may change your dosage or have you stop that medication entirely.

Monitoring your blood pressure is essential to your well-being.

Your body keeps score.

RESOURCES: HEALTH DIRECT: MAYO CLINIC