When low blood pressure signals a hidden health problem

My blood pressure tends to run on the low side. A reading of 110 over 75 is not unusual.

But my doctor never seems concerned. I have no other symptoms, and it’s pretty consistent, not a sudden change… which would be cause for concern.

We spend a lot of time thinking about the dangers of high blood pressure. We know it damages the brain and the heart, causing strokes and heart attacks. It’s even been linked to Alzheimer’s disease.

But blood pressure isn’t always a case of “the lower, the better.”

Blood pressure that’s too low, especially if it drops suddenly, holds dangers of its own that you should know about…

Watch for changes in blood pressure

For people like me, “chronic” or ongoing hypotension (low blood pressure) is seldom a problem.

However, as we get older, the risk of both high and low blood pressure increases. Blood flow to the heart muscle and the brain declines with age, often as a result of plaque buildup in blood vessels. An estimated 10 to 20 percent of people over age 65 have postural hypotension (more about that in a moment).

So, if your blood pressure readings become much lower than usual, your doctor will want to investigate possible causes.

But chances are you’ll know it’s happening… even without putting the cuff on.

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Types of hypotension

A sudden drop in blood pressure will announce itself. You’ll probably experience one of the following symptoms:

• Dizziness or lightheadedness
• Fatigue and weakness
• Nausea
• Confusion
• Blurred vision
• Heart palpitations
• Cold, clammy, pale skin

You should see your doctor if any of these occur. They’ll be able to determine the underlying cause.

• Orthostatic hypotension is one reason for sudden drops in blood pressure. When a person changes position (for example, from sitting to standing), blood pressure can drop suddenly.
• Postoral hypotension is similar to orthostatic hypotension, except it occurs when you go from lying down to sitting up.
• Postprandial hypotension is a drop in blood pressure that occurs right after eating. Older adults, especially those with Parkinson’s disease, are more likely to develop this type of hypotension.
• Neurally mediated hypotension occurs after standing for a long time, or as a result of an extremely upsetting event.

Health conditions behind low blood pressure

Once your doctor has ruled out these types of hypotension, it’s time to do some tests to uncover some potentially more serious causes.

Blood work will reveal if there’s a thyroid deficiency or adrenal gland malfunction that’s disrupting cortisol levels. Both are common factors in hypotension. So is anemia.

Your doctor may recommend medications to regulate your thyroid or adrenal gland function or, in the case of anemia, iron supplements.

Low blood pressure can also reveal an underlying heart problem.

An abnormally low heart rate (bradycardia), heart valve problems and heart failure can also be reasons for hypotension. Your heart simply may not be able to circulate enough blood to meet your body’s needs.

Certain medications can cause blood pressure to fall dangerously. These include diuretics and beta blockers given for high blood pressure, drugs for Parkinson’s disease, tricyclic antidepressants and erectile dysfunction drugs.

Finally, septic shock can cause a profound and life-threatening drop in blood pressure when bacteria that leave the original site of infection (often in the lungs or urinary tract) enter the bloodstream and produce toxins that damage blood vessels.

Avoiding hypotension

If you continue to have any symptoms that concern you, consulting your doctor is the best thing to do.

If you’ve been experiencing bouts of dizziness, lightheadedness, nausea or other symptoms, it will help your doctor if you keep a record of symptoms and what you were doing or eating when they occurred.

Your doctor can work with you as you try the following dietary guidelines that will help adjust your blood pressure:

• Avoid dehydration. It’s always a good idea, but it’s particularly important with hypotension, as insufficient fluids will cause a decrease in blood volume and a drop in blood pressure.
• Eat foods high in B12. Avoid anemia by getting enough of this important vitamin in foods like eggs, fortified cereals and beef. (Almond milk and coconut milk are good choices if you are a vegetarian or vegan).
• Get enough folate by eating foods like asparagus, chickpeas and liver.
• Eat small meals more frequently. Large meals may cause more dramatic drops in blood pressure, as your body works harder to digest larger meals.

Sources:

1. Low Blood Pressure Can Be Dangerous, Too — Baptist Health South Florida
2. Everything You Need to Know About Low Blood Pressure — Healthline
3. Low Blood Pressure – When Blood Pressure Is Too Low — American Heart Association,
4. 10 Ways to Raise Low Blood Pressure — Healthline