Hypotension or low blood pressure, when is it too low?

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Low blood pressure - Hypotension

Arterial hypontension or low blood pressure, when is it too low?

Low blood pressure, known as hypotension, can indicate both good health and a lower risk of heart disease, but this is not always the case. Sometimes, a consistently low blood pressure or a sudden drop in blood pressure levels can trigger worrying symptoms and even serious health problems.


Understanding hypotension (low blood pressure)

The blood pressure value is made up of two numbers: the systolic pressure and the diastolic pressure. The systolic pressure, which is the top or first figure in the blood pressure reading, reflects the force within the arteries when the heart pumps blood. On the other hand, the diastolic pressure, the lower number, indicates the pressure in the arteries when the heart is filling with blood.

A blood pressure reading of 120/80 millimetres of mercury (mm Hg) or lower is considered within normal parameters. Generally, if the blood pressure reading is less than 90/60 mm Hg, it is considered abnormally low and is referred to as hypotension. Some adults regularly maintain blood pressure levels in the hypotensive range without experiencing symptoms, and in such cases, no treatment is required. However, in severe situations, low blood pressure can result in a decreased supply of oxygen and nutrients to the brain and other vital organs, which may eventually lead to a potentially life-threatening state of shock.

Hypotension can affect anyone, but certain groups of individuals are more likely to suffer from it..

Types of hypotension

Various types of hypotension can be encountered. For example, orthostatic (positional) hypotension occurs when standing up after sitting or lying down, and is more common in older adults. Generally, our body has compensatory mechanisms to avoid the drop in blood pressure when standing up, but sometimes these reflexes do not occur, leading to orthostatic hypotension. Dehydration or blood loss can also be responsible for orthostatic hypotension.


Symptoms of hypotension (low blood pressure)

Most medical professionals do not consider hypotension a problem unless it is accompanied by certain signs and symptoms:

  • Confusion or difficulty concentrating
  • Dizziness
  • Fainting
  • Fatigue
  • Neck or back pain
  • Blurred vision
  • Nausea
  • Palpitations
  • Shortness of breath


When is blood pressure considered dangerously low?

There’s no specific value that determines when blood pressure is dangerously low in normal situations, although the clinical definition of hypotension is established for any reading below 90/60 mm Hg. However, it is crucial to pay attention to low blood pressure when symptoms of risk, such as those mentioned above, manifest themselves and to seek medical attention immediately in such cases.


When low blood pressure can occur

Some people have naturally low blood pressure and do not experience worrying symptoms. However, for those who are used to having higher blood pressure, a sudden drop in blood pressure can be an indicator of an underlying problem and may trigger the symptoms mentioned above.

The following conditions increase the likelihood of experiencing episodes of hypotension:

  • Changing position from lying down to standing after a long period in bed.
  • Being in the first 24 weeks of pregnancy.
  • Experiencing significant blood loss.
  • Being dehydrated.
  • Taking certain medications, such as antihypertensives, heart medications, Parkinson’s disease medications, tricyclic antidepressants, or erectile dysfunction medications.
  • Heart problems, such as very slow heart rate, heart valve disorders, heart attack or heart failure.
  • Endocrine disorders, such as hypothyroidism, parathyroidism, Addison’s disease (a disorder of the adrenal glands), hypoglycaemia or diabetes.
  • Serious infections affecting the bloodstream.
  • Having anaphylaxis, a life-threatening allergic reaction.
  • Having a neurological disorder that affects blood pressure.
  • Experiencing nutritional deficiencies, such as low levels of vitamin B12 and folic acid.


Can low blood pressure cause fatigue?

Low blood pressure can actually lead to fatigue, which is characterised by an overwhelming feeling of tiredness and lack of energy. Research has shown a link between low blood pressure and chronic fatigue syndrome, a condition characterised by profound fatigue, pain and sleep disturbances that are often aggravated by activity.

There is no specific cure for this type of fatigue, but doctors may recommend treatment of underlying causes, such as sleep disorders or mental health problems. In addition, treatment of low blood pressure through dietary modifications and implementation of adequate physical activity may help alleviate the fatigue associated with hypotension.


When is it necessary to seek medical attention for hypotension?

If your blood pressure is always low and you do not experience any of the worrying symptoms, there is usually no cause for concern. Similarly, if you record a single unusually low blood pressure reading at home with no accompanying symptoms, you probably don’t need to see a doctor right away. It is normal for blood pressure to fluctuate over time, and the body is usually able to regulate it on its own.

However, when you notice a recurring pattern or there is no clear explanation for what is happening, it is important to consult a doctor. If your blood pressure suddenly drops and you experience symptoms such as dizziness, you should contact your healthcare professional. This will allow for a proper evaluation to rule out underlying problems, such as internal bleeding, serious infections or allergic reactions.

Mapa tensión arterial


Treatment of hypotension will vary depending on the underlying cause. Immediate measures may include:

  • Use of compression stockings.
  • Increasing water intake.
  • Avoiding triggers for hypotension, such as prolonged standing and sudden changes in position.

After a thorough evaluation, our cardiologist may suggest the following recommendations:

  • Evitar el consumo de alcohol.Avoid alcohol consumption.
  • Modify your diet.
  • Adjusting the dose of medications (possibly reducing the dose of low blood pressure drugs).
  • Taking medications that increase blood pressure, such as fludrocortisone (Florinef) or midodrine (ProAmatine).


People experiencing hypotension-related shock will need emergency treatment to restore blood flow to organs and raise blood pressure to normal levels..

It is crucial to distinguish whether hypotension is a primary or secondary problem. A primary problem indicates that the body’s natural reflexes are not working properly, while secondary causes suggest that low blood pressure is a consequence of factors such as dehydration or the effects of certain medications.

Some antihypertensive drugs are more likely to cause hypotension than others, and much depends on the dose. In most people, there will be an easily identifiable secondary cause or a simple solution, even if it is a chronic problem with no apparent secondary cause. It is therefore important to consult a doctor for a proper assessment.

Keeping track of your blood pressure, even without apparent health problems, will allow you to know your personal normal range. If your blood pressure is monitored regularly, talk to our cardiologist about the target blood pressure range best suited to your situation.

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