Low blood pressure (Hypotension)

All people have different pressures in their bloodstream. Blood pressure can change during the day and in different situations. Those with low blood pressure are more likely to experience fast drops in blood pressure, causing dizziness – or even blacking out / temporary loss of consciousness. Sometimes this happens when changing position from sitting to standing. Low blood pressure is usually harmless and rarely requires treatment.


Normal blood pressure is around 120/80 but can go down to 90/60 before it is considered low. Low blood pressure is also called hypotension. Having low blood pressure is preferable in the long term to high blood pressure, which is associated with more health risks.
Changing position from sitting or lying down to standing can make you feel dizzy. Sometimes it can feel like it is getting darker in the eyes. A blood pressure drop in a change of position is called orthostatic hypotension. It is temporary and means that blood circulation does not reach the brain quickly enough. This is especially common in older people but also in younger people who are in a rapid growth phase.


Low blood pressure can be caused by low blood volume, hormonal changes, widening of blood vessels, medicine side effects, anemia, heart problems or endocrine problems.


Reduced blood volume, hypovolemia, is the most common cause of hypotension. This can result from hemorrhage; insufficient fluid intake, as in starvation; or excessive fluid losses from diarrhea or vomiting. Hypovolemia can be induced by excessive use of diuretics. Low blood pressure may also be attributed to heat stroke which can be indicated by absence of perspiration, lightheadedness and dark colored urine.


Other medications can produce hypotension by different mechanisms. Chronic use of alpha blockers or beta blockers can lead to hypotension. Beta blockers can cause hypotension both by slowing the heart rate and by decreasing the pumping ability of the heart muscle.


Decreased cardiac output despite normal blood volume, due to severe congestive heart failure, large myocardial infarction, heart valve problems, or extremely low heart rate (bradycardia), often produces hypotension and can rapidly progress to cardiogenic shock. Arrhythmias often result in hypotension by this mechanism.


Excessive vasodilation, or insufficient constriction of the blood vessels (mostly arterioles), causes hypotension. This can be due to decreased sympathetic nervous system output or to increased parasympathetic activity occurring as a consequence of injury to the brain or spinal cord. Dysautonomia, an intrinsic abnormality in autonomic system functioning, can also lead to hypotension. Excessive vasodilation can also result from sepsis, acidosis, or medications, such as nitrate preparations, calcium channel blockers, or AT1 receptor antagonists (Angiotensin II acts on AT1 receptors). Many anesthetic agents and techniques, including spinal anesthesia and most inhalational agents, produce significant vasodilation.


Low blood pressure can be associated with several different symptoms:


  • Dizziness and difficulty with balance.
  • Fainting.
  • Heart palpitations.
  • Cold sweat.
  • Fatigue.
  • Weakness.
  • Nausea.
  • Swelling around the ankle or lower leg (edema).


In combination with some conditions, low blood pressure is a very serious condition:


  • high fever
  • change consciousness
  • bleeding in progress
  • severe physical injury
  • vomiting and diarrhea with fluid loss
  • myocardial infarction or arrhythmia


Bear in mind that dizziness and fainting may have causes other than low blood pressure. The blood supply to the head can change rapidly in cases of sudden pain or fear. Dizziness may also be associated with benign positional dizziness, migraine or other neurological conditions.

Prevention and protection

If you have low blood pressure, it is important to drink enough water. It can also be helpful to:


  • exercise regularly to increase heart rate
  • Get up slowly from sitting or lying down
  • Be careful about drinking alcohol.
  • Wear support socks for varicose veins.


Consult your physician if you are taking medicines for other conditions and have low blood pressure.


The doctor will make a physical examination, checking the blood pressure and heart rate while lying down, sitting and standing. You may also have blood tests to measure blood values ​​and have your heart examined with ECG. The doctor will listen to your heart sounds, check your reflexes and may make other neurological tests.


You can measure your blood pressure yourself using the blood pressure monitor. Make sure you are well rested and don’t drink coffee, tea or smoke at least half an hour before you take the measurement.
There is no drug treatment for low blood pressure unless there is an underlying cause for the disease.

When to consult a doctor

Seek urgent care if you or your relatives suffer from sudden dizziness or fainting feeling in combination with any of these conditions:


  • chest pain
  • high fever
  • change consciousness
  • bleeding in progress
  • severe physical injury
  • vomiting and diarrhea with fluid loss
  • disruption of the heartbeat


If you have recurring problems with low blood pressure, you can consult a doctor to investigate further.

How APPOTEK can help

APPOTEK can help with low blood pressure. A nurse or physician will make an individual assessment based on your symptoms. You may then be prescribed treatment or referred for further care. A physical examination is advised for low blood pressure. Bear in mind that if your child has a problem, he or she should see a doctor.


Vadym Diadiun, Doctor of Medicine, M.D.