Understand When Low Blood Pressure Is a Cause for Concern

Your age, current health, and medical history help determine if your low blood pressure is harmless or a health risk.

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If your blood pressure is still as low as it was when you were much younger, you might be inclined to take pride in avoiding a condition that threatens the health of millions of Americans: high blood pressure (hypertension).

Unfortunately, maintaining a healthy blood pressure isn’t simply a numbers game, explains Cleveland Clinic cardiologist Mouin Abdallah, MD. “A young, healthy patient may have a resting blood pressure of 90/60 mmHg and feel absolutely fine,” he says. “On the other hand, an older patient with heart problems, might feel weak and dizzy with a blood pressure of 115/70 mmHg.”

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By the Numbers

A healthy blood pressure is considered to be under 120/80 mmHg. But if it’s under 90/60 mmHg, it’s usually labeled hypotension (low blood pressure). For some people, lower-than-normal blood pressure isn’t a problem. For others, though, hypotension can cause symptoms such as lightheadedness, dizziness, fainting, difficulty concentrating, rapid or shallow breathing, fatigue and depression.

“If you feel perfectly fine, then odds are your blood pressure, even if lower than average, is probably okay for you,” Dr. Abdallah says.

What’s Right for You?

Your optimal blood pressure depends on your medical history and current health status. Your age is also a consideration. For example, the threshold for starting antihypertensive treatment is higher for older adults than it is for younger people. Older adults, especially those in their 80s and above, may need greater blood pressure to help ensure sufficient blood flow to the brain.

But if you’re at the lower end of normal or you have hypotension, there may not be any reason to boost your blood pressure, regardless of your age. The key is paying attention to symptoms. If you get lightheaded frequently, you may need medications such as fludrocortisone, to increase your blood volume. This medication is commonly prescribed for people with a condition called orthostatic hypotension. It means your blood pressure drops noticeably when you stand after sitting or lying down.

Causes of Hypotension

A variety of factors can cause orthostatic hypotension. They include medical conditions, such as heart failure or thyroid disease, as well as temporary conditions, such as dehydration or prolonged bed rest. Standing up slowly and staying well-hydrated can often help reduce episodes of orthostatic hypotension.

Sometimes medications to lower blood pressure can be too effective. If your blood pressure drops into the hypotension range, be sure to talk with your doctor about adjusting your dose or possibly switching medications. Other types of medications, including those for Parkinson’s disease and erectile dysfunction, can also contribute to low blood pressure. Be sure to ask your doctor or pharmacist about such side effects.

You may be someone who naturally maintains a low blood pressure without symptoms and without causes. If so, that’s probably a good sign. But if you check your blood pressure regularly and you notice occasional dips or a gradual decrease over time, tell your doctor. It may be nothing, but any changes to your blood pressure—up or down—are worth noting, especially if you also experience symptoms.

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