I’m feeling a little dizzy lately, especially when I stand up quickly. I’ve also noticed I’m more tired than usual. I’m thinking it might be related to my blood pressure. I know high blood pressure is a concern for many people, but I’m wondering about the opposite. Given these symptoms (dizziness, fatigue, particularly upon standing), and focusing on the range generally considered problematic, what is considered low blood pressure, and at what point should I consult a doctor about potentially low blood pressure readings, taking into account that occasional, slightly lower readings might be normal for some individuals? Are there different levels of concern within the "low blood pressure" range?

Answer

Low blood pressure, or hypotension, is generally considered a blood pressure reading lower than 90 mmHg systolic or 60 mmHg diastolic.

Further Details:

• Systolic Blood Pressure: This is the top number in a blood pressure reading and represents the pressure in your arteries when your heart beats.
• Diastolic Blood Pressure: This is the bottom number and represents the pressure in your arteries when your heart rests between beats.
• Measurement: Blood pressure is measured in millimeters of mercury (mmHg).

Important Considerations:

• Individual Variability: What is considered "low" can vary from person to person. Some individuals naturally have lower blood pressure without experiencing any symptoms or health problems. For others, a reading below 90/60 mmHg could cause noticeable symptoms.

• Symptoms: The significance of low blood pressure often depends on whether it causes symptoms. Some common symptoms associated with low blood pressure include:

  • Dizziness or lightheadedness
  • Fainting (syncope)
  • Blurred vision
  • Nausea
  • Fatigue
  • Difficulty concentrating
  • Cold, clammy, pale skin
  • Rapid, shallow breathing
  • Dehydration and unusual thirst
• Causes: Low blood pressure can be caused by a variety of factors, including:
  • Dehydration: Reduced blood volume can lead to lower blood pressure.
  • Heart problems: Certain heart conditions, such as heart failure, heart valve problems, and arrhythmias, can lower blood pressure.
  • Endocrine problems: Thyroid disorders, adrenal insufficiency (Addison’s disease), and low blood sugar (hypoglycemia) can contribute to low blood pressure.
  • Nervous system disorders: Conditions like Parkinson’s disease can affect blood pressure regulation.
  • Severe infection (septicemia): Septic shock can cause a dramatic drop in blood pressure.
  • Severe allergic reaction (anaphylaxis): Anaphylactic shock can also lead to a dangerous drop in blood pressure.
  • Nutritional deficiencies: Lack of vitamin B12 and folate can cause anemia, which can lower blood pressure.
  • Medications: Many medications can lower blood pressure as a side effect, including diuretics, alpha-blockers, beta-blockers, some antidepressants, and medications for Parkinson’s disease and erectile dysfunction.
  • Pregnancy: Blood pressure often decreases during pregnancy due to circulatory changes.
  • Prolonged bed rest: Can weaken the cardiovascular system.
  • Blood loss: Significant blood loss, whether from injury or internal bleeding, can reduce blood volume and lower blood pressure.
• Types of Hypotension: There are different types of low blood pressure, including:
  • Orthostatic hypotension (postural hypotension): This occurs when blood pressure drops suddenly upon standing up from a sitting or lying position.
  • Postprandial hypotension: This occurs after eating, particularly in older adults.
  • Neurally mediated hypotension (NMH): This occurs after standing for long periods, leading to blood pooling in the legs and feet.
  • Severe Hypotension Related to Shock: Can occur from decreased blood volume (hypovolemic), heart problems (cardiogenic), allergic reaction (anaphylactic) or severe infection (septic shock).
• Diagnosis: A doctor can diagnose low blood pressure by measuring your blood pressure and evaluating your symptoms and medical history. Further tests, such as blood tests, an electrocardiogram (ECG), or an echocardiogram, may be needed to determine the underlying cause. A tilt table test may be ordered if neurally mediated or orthostatic hypotension is suspected.
• Treatment: Treatment for low blood pressure depends on the cause. If low blood pressure is due to dehydration, drinking more fluids may be sufficient. If it is due to a medical condition, treating the underlying condition is essential. Other treatments may include:
  • Lifestyle modifications: These include increasing salt intake, drinking more fluids, wearing compression stockings, and avoiding prolonged standing or sitting.
  • Medications: Certain medications, such as fludrocortisone and midodrine, can help raise blood pressure.
• When to Seek Medical Attention: It’s essential to see a doctor if you experience persistent symptoms of low blood pressure, especially if you have a history of heart problems or other medical conditions. Seek immediate medical attention if you experience:
  • Severe dizziness or lightheadedness
  • Fainting
  • Chest pain
  • Shortness of breath
  • Severe abdominal pain
  • Bleeding