A Guide to Low Blood Pressure (Hypotension)

We’ve all heard of the risks associated with high blood pressure. But what if your blood pressure is too low? In this article, we’ll take a look at the symptoms and causes of low blood pressure, also known as hypotension, and list the measures you can take to keep your blood pressure under control.

What is low blood pressure?

Low blood pressure (hypotension) is a condition where the pressure of blood in the arteries is consistently lower than normal.

A blood pressure reading of <90/<60 is generally described as hypotension. When the condition is chronic, it can lead to a poor quality of life and other symptoms.

Types of low blood pressure

Orthostatic hypotension (also known as postural hypotension) occurs when there is a change in body position, such as standing up suddenly after a prolonged state of sitting or lying down. This form of hypotension is often momentary and normal blood flow returns fairly quickly.
Postprandial hypotension happens after eating substantial meals. This is due to increased blood flow towards the intestines to allow the food to digest.
Neurally mediated hypotension (NMH) occurs from a prolonged state of standing. It can cause dizziness, fainting, or nausea.

What causes low blood pressure?

Some of the causes of hypotension are temporary, and your body is able to take steps to regulate your blood pressure. Medical conditions, medication taken for another condition, and pregnancy can cause low blood pressure. Your physician should screen for these conditions first.

Medical conditions that can cause low blood pressure

Addison’s disease
Anaemia (low iron levels in the blood)
Anaphylaxis
Bradycardia (low heart rate)
Carcinoid syndrome
Dehydration
Diabetes
Diabetic dysautonomia
Excessive blood loss
Hypoglycemia (low blood sugar)
Malnutrition
Neurological conditions such as Shy-Drager syndrome
Parathyroid disease
Post-cardiac arrest syndrome
Septicemia, leading to septic shock
Vitamin deficiencies
Valvular heart disease

Medication that can cause low blood pressure

Any medication taken for high blood pressure
Erectile dysfunction medication
Opioids
Parkinson’s disease medication
Tricyclic antidepressants

Pregnancy

Pregnancy is a unique cause of hypotension. As the baby grows, a pregnant person’s circulatory system expands rapidly, which can lower their blood pressure. This usually occurs in the first two trimesters of pregnancy. After delivery, the blood pressure should return to normal.

Low blood pressure symptoms

Unlike hypertension, there are many signs of low blood pressure. The most common symptoms are lightheadedness and dizziness, but others include:

Blurry vision
Confusion
Cold, clammy skin
Extreme fatigue
Feeling weak
Lightheadedness, dizziness
Loss of consciousness
Nausea

If you’re experiencing any of these symptoms of low blood pressure, it’s worth taking a trip to your GP, who can measure your blood pressure, identify possible causes and advise on the best course of action.

Treatment usually means addressing an underlying condition or making a few simple lifestyle changes. It’s unlikely you’ll need medication to increase blood pressure.

How to manage low blood pressure

The first step is to book a doctor’s appointment so you can discuss your symptoms and have your blood pressure checked. They’ll also ask you whether there’s any known family history of low blood pressure, if you’re experiencing any significant stresses or recent life changes, and whether you’re currently taking any medications, vitamins or supplements.

If your medication is causing low blood pressure, your doctor or healthcare provider may recommend changing or stopping the medication or lowering the dose. It’s important that you don’t change or stop taking your medication without first talking to a physician.

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Your doctor may recommend one or more of the following lifestyle changes to bring low blood pressure under control and manage your symptoms:

Staying hydrated by drinking more water and cutting down on alcohol. Water increases the blood volume in the body, while alcohol is dehydrating and can contribute to lower blood pressure.
Get up slowly from a sitting, squatting or lying position. If you experience symptoms when standing up, cross your thighs like a pair of scissors and squeeze, or put one foot on a ledge or chair and lean as far forward as possible. Both moves encourage blood flow from the legs to the heart.
Avoid sitting or standing for long periods, and don’t sit with your legs crossed.
Get moving with at least 30 minutes of moderate physical activity every day. Exercise can be beneficial for hypotension as it helps to improve circulation. Remember to warm up and cool down properly, drink plenty of water and avoid exercising in hot, humid conditions.
To help prevent blood pressure from dropping sharply after eating, have small meals several times a day. Limit carb-heavy foods like potatoes, rice, pasta and bread.
Try compression stockings to improve circulation and encourage blood flow from the legs to the heart. A 2006 study showed that compression stockings were an effective way to reduce symptoms in older patients with progressive orthostatic hypotension.

A healthy lifestyle is extremely important to help your body to regulate your blood pressure, particularly if you are predisposed to having low blood pressure due to medical conditions or your family’s medical history. It’s important to note that lifestyle changes can vary in the time it takes to reduce hypotension, so always speak to a doctor about your particular circumstances.

Medication that can reduce low blood pressure

There are some medications that can raise the blood pressure purposely, but should only be used under the direction of a medical provider, after checking for all reversible causes of low blood pressure.

Consult your doctor on the different medications you can take to increase your blood pressure.

Monitoring your blood pressure

Your healthcare provider may recommend monitoring your blood pressure at home to understand your symptoms and potential causes.

You might be familiar with inflatable cuffs or finger monitors, but these devices require some extra preparation for the most accurate readings. For example, with an inflatable cuff, you’ll need to take multiple readings at the same time each day.

In comparison, Aktiia makes it easy to monitor your blood pressure without disrupting your daily routine. This lightweight bracelet uses a unique blood pressure monitoring technology that allows you to take around 20 to 30 measurements throughout the day. It’s completely automated and automatically logs your results in an app, and you can easily share your readings with your physician.

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Frequently asked questions

Is low blood pressure hereditary?

Low blood pressure is not usually a hereditary condition. According to NHS, some research suggests that some types of hypotension are genetic. One study by a research team in the US also found that people who inherited 2 defective copies of particular salt-regulating genes developed a rare disease-such as Gitelman or Bartter syndrome – which led to “dangerously low blood pressure.”

What impact does low blood pressure have on the kidneys?

Severely low blood pressure can lead to kidney problems such as kidney failure and Acute Kidney Injury (AKI).

The bottom line

While low blood pressure isn’t talked about as much as high blood pressure, it can be disruptive and, in some cases, dangerous. If you’re experiencing symptoms, it’s always worth talking to your doctor or healthcare provider to determine the cause and discuss the changes you can make to manage this condition.

Disclaimer: The information in this article is intended for educational purposes only. If you have symptoms of low blood pressure, speak to your doctor. They can advise on the best way to effectively manage your blood pressure.

Sources

NHS, Low blood pressure (Hypotension), 09 September 2020 – https://www.nhs.uk/conditions-low-blood-pressure-hypotension

Lower limb and abdominal compression bandages prevent progressive orthostatic hypotension in elderly persons, 14 September 2006 – https://pubmed.ncbi.nlm.nih.gov/17010806

NIH, Rare Mutations Can Keep Blood Pressure Low, 21 April 2008 – https://www.nih.gov/rare-mutations-can-keep-blood-pressure-low

NHS, Acute kidney injury, 08 September 2022 – https://www.nhs.uk/conditions-acute-kidney-injury