Blood Pressure: How Low Is Too Low
Many of us worry about high blood pressure. And for good reason. It leads to heart disease and increases your risk of stroke and early death.
Thats why millions of Americans take hypertension medications. But a Harvard University analysis recently revealed a surprising new danger associated with these drugs. They might actually be too effective in reducing blood pressure.
Optimal blood pressure is about 120/80. After age 60, these numbers increase slightly. But when blood pressure is more than 140/90, doctors usually recommend medication to lower it.
Harvard researchers analyzed two major studies and found that lower blood pressure is not always better.
One study followed more than 11,000 adults for 30 years. None of the participants had heart disease at the beginning of the study. They averaged 57 years of age.
Scientists found that people with slightly low diastolic blood pressure of 60 to 69 mm/Hg were not healthier. In fact, they were 2.2 times more likely to have heart damage as people with diastolic blood pressure between 80 and 89.
A second study collected data on more than 22,000 people with heart disease from 45 countries. It was published in the journal The Lancet.
As expected, they found that people with systolic blood pressure of 140 or higher and diastolic blood pressure higher than 80 were more likely to suffer heart attacks or strokes.
But there was another, more surprising finding
Surprising Way Hypertension Drugs Can Threaten Your Health
Cut Down On Rapidly Digested Carbs
Foods like white rice, white bread, sugary drinks, and potatoes are quickly digested and passed from your stomach to your small intestine. This leads to postprandial hypotension. So cutting back on foods like this and adding more foods that are slowly digested for instance, protein, beans, and whole grains can help prevent your blood pressure from dipping too low after a meal.11
Treatment Of Low Blood Pressure
Low blood pressure may or may not require treatment, depending on the cause.
Healthy people with low blood pressure that is not causing any symptoms generally do not need any treatment.
If low blood pressure is causing symptoms, the aim of treatment is to bring the blood pressure back to normal to relieve the symptoms, as well as treat the cause. If the underlying cause is a particular type of medicine, your doctor may advise you to stop taking it or reduce the dose.
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Is My Blood Pressure Too Low
Most doctors agree that a healthy blood pressure is anything under 120/80 mmHg. But how low is too low for blood pressure? Hypotension can occur when blood pressure drops below 90/60 mmHg.
This isnt a hard and fast rule, though. Since factors, like age, weight, and level of physical activity contribute to blood pressure, your doctor may not diagnose you with hypotension even if your blood pressure is a little low.
Low blood pressure typically becomes an issue only if youre experiencing symptoms, such as:
- Over-the-counter cold medicines
Postural Or Orthostatic Hypotension
Postural or orthostatic hypotension occurs when your blood pressure falls after a sudden movement. For example, you may feel dizzy or faint after changing posture, such as sitting up from a lying position, or standing up from a sitting position. This may cause you to lose your balance and fall over. You may also feel light-headed, have blurred vision, or lose consciousness.
The symptoms of postural or orthostatic hypotension should only last a few minutes as your blood pressure adjusts to your new position. This type of low blood pressure tends to affect people more as they get older when it can lead to more frequent falls. Similar symptoms may also occur after exercise.
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Low Diastolic Pressure: No Symptoms
“When your systolic blood pressure gets too low, it can manifest as lightheadedness, fainting, and weakness. But low diastolic pressure by itself doesn’t have any symptoms,” says Dr. Paul Conlin, professor of medicine at Harvard Medical School and chief of medicine at the VA Boston Healthcare System.
One of the new studies, which analyzed the medical records of more than 11,000 adults over a period of three decades, found that people who had low diastolic blood pressure were twice as likely to have subtle evidence of heart damage compared with people whose diastolic blood pressure was 80 to 89 mm Hg. Low diastolic values were also linked to a higher risk of heart disease and death from any cause. The findings appeared in the Aug. 30, 2016, Journal of the American College of Cardiology.
Another study, published in The Lancet, involved more than 22,000 people with heart disease, whom researchers grouped according to their blood pressure readings. People with well-controlled blood pressure values were considered the reference group.
Not surprisingly, people with high systolic blood pressure were more likely to experience heart attacks or strokes, be hospitalized with heart failure, or to die compared with people in the reference group. But the same was true for heart attacks, heart failure, and death in people with low blood pressure .
When To See The Doctor
If you have had episodes where you feel faint or have fainted, see your doctor. In many cases, an episode of low blood pressure is nothing to worry about, but some people may have an underlying problem that needs treatment.
Treating low blood pressure will help reduce symptoms and lower the chances of you fainting or falling and injuring yourself.
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Symptoms Of Low Diastolic Blood Pressure
Symptoms of isolated diastolic hypotension include tiredness, dizziness, and falls.
Because low diastolic pressure decreases blood flow to your heart, you may also have chest pain or symptoms of heart failure. Heart failure symptoms may include shortness of breath, swelling of your feet or ankles, confusion, and heart palpitations.
Seek immediate medical attention if you have chest pain or difficulty breathing.
Symptoms of low diastolic blood pressure along with low systolic blood pressure include:
What Can Cause Low Blood Pressure
Factors that can cause low blood pressure include:
- Medical conditions like heart problems, hormonal problems, septic shock, neurological disorders, anemia etc.
- Certain medications for instance, some antidepressants or beta blockers prescribed for heart conditions
- Blood pressure tends to drop during the first twenty-four weeks of pregnancy.34
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Recent Findings Raise Concerns About Lowering Diastolic Blood Pressure The Second Number In Your Blood Pressure Reading Too Far
More of us than ever before are taking medications to lower our blood pressure. Longstanding guidelines suggest that most people should aim for a systolic blood pressure no higher than 140 millimeters of mercury . But in 2015, the results of the Systolic Blood Pressure Intervention Trial suggested that reaching a target of 120 mm Hg could further reduce the risks associated with high blood pressure, including heart attack, stroke, heart failure, and death.
Yet reaching that lower target often requires three blood pressure medications, which can increase the likelihood of side effects. Two observational studies and one clinical trial have raised concerns about lowering blood pressure particularly diastolic pressure too far. Diastolic blood pressure represents the pressure between beats when the heart relaxes. “When your systolic blood pressure gets too low, it can manifest as lightheadedness, fainting, and weakness. But low diastolic pressure by itself doesn’t have any symptoms,” says Dr. Paul Conlin, professor of medicine at Harvard Medical School and chief of medicine at the VA Boston Healthcare System.
About Heart And Vascular Institute
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.
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More Serious Or Lasting Causes
Some potentially more severe health issues can also cause low blood pressure, including:
- Nutrient deficiencies: These might involve vitamin B12 or folic acid.
- Neurally mediated hypotension: This disorder causes a drop in blood pressure after the person has been standing up for a prolonged period.
- Endocrine problems: These affect the regulation of the bodys hormones. One example is hypothyroidism, also known as an underactive thyroid.
- Heart problems: These can limit how effectively the heart pushes blood around the body.
- : This is a potentially life threatening response to a severe bacterial infection.
- Anaphylactic shock: This is a potentially life threatening complication of anaphylaxis, which is a severe allergic reaction.
In addition, loss of blood due to an injury can lead to low blood pressure.
Be Still My Heart: How A Heart Rhythm Specialist Can Help
When this happens, electrophysiologists first try and slow theheart rate using medicines, Dr. Taigen says. But these medicines, known asbeta-blockers or calcium channel blockers, can also drop the blood pressure,he notes. Quite often, theres not much room for blood pressure to go lower.
If your blood pressure is too low for medications, aprocedure called direct current cardioversion can get the rhythm back tonormal.
With this procedure, we put pads on the front and back of the chest and sedate the patient for a minute or two, Dr. Taigen explains. When they are asleep, we deliver a shock that stops the heart from beating irregularly, so the natural heartbeat resumes.Once the heart rhythm is back to normal, anelectrophysiologist determines if a more permanent treatment is needed. Thesecould include:
- Ablation: This procedure uses cold orheat energy to stop faulty electrical signals.
- Pacemaker: Doctors place a small deviceunder the skin to send electrical impulses that change the heart rhythm.
- Implantable cardioverter defibrillator :Like a pacemaker, the ICD works by detecting and stopping faulty heart rhythmswith electrical signals.
- Surgery: Surgeons create scar tissue withincisions to permanently interrupt faulty electrical pathways in the heart.
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Is Low Blood Pressure A Problem
For some people, low blood pressure is a sign of good health. These are generally people who are very fit and who have a slow pulse. For other people, low blood pressure is a problem.
Often, people with low blood pressure can be expected to lead longer lives.
However, people who experience continuing symptoms of low blood pressure should see a doctor. Sudden, severe low blood pressure can be associated with serious medical conditions.
A Low Reading Could Simply Mean Your Heart Is Healthy Or It Could Mean That Youre At Risk Of Falling Heres How To Tell The Difference
A low blood pressure reading is good news, right? After all, the oppositehigh blood pressurecan lead to heart attack, stroke, vision loss, and other health problems.
Unfortunately, the answer isnt so straightforward.
Sure, you might want to post a reading thats below 120/80 mmHg on your fridge as a boast that your ticker is in good shape. But there is such a thing as a reading thats too low, says Laxmi Mehta, M.D., director of preventative cardiology and womens cardiovascular health at Ohio State University Wexner Medical Center.
Abnormally low blood pressure, or hypotension, can be troublesome for some peopleespecially if its causing outward symptoms. If youre feeling dizzy, fatigued, short of breath, or youre passing out, or you have chest pain, that would be concerning, she says.
Heres what you need to know about the possible downsides of low blood pressureand six things you can do if your latest readings have been low.
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Low Blood Pressure Also Known As Hypotension Is When You Have A Blood Pressure Level That Is Below The Normal Range
If your blood pressure is naturally low, this probably wont cause you any problems and wont need treating. In fact, the lower your blood pressure, the lower your risk of heart disease and stroke.
Low blood pressure can sometimes be caused by medications or can be a sign of another health problem. This can sometimes cause problems such as falls, fainting and feeling dizzy, so it might need looking into and treating. Speak to your doctor or nurse if youre worried about low blood pressure.
Plus, take a look at the animation below on how to manage low blood pressure when you stand up.
Home Remedies To Treat Low Blood Pressure Naturally
Some people naturally have low blood pressure. This generally doesnt cause any symptoms and should not be a cause for worry. Remember, low blood pressure requires treatment only when its causing symptoms that affect your normal life. If your low blood pressure is caused by an underlying condition, your doctor may initiate treatment for it. And in some cases, medication may be prescribed for your condition. However, the symptoms of low blood pressure can usually be treated with home remedies and lifestyle changes. Here are some measures you can try.
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What Else Can Cause An Elevated Heart Rhythm Along With Low Blood Pressure
When the hearts electrical circuits arent properly functioning,the result can be a high heart rate coupled with low blood pressure, Dr. Taigenexplains.
When the heart has a fast, abnormal rhythm anything over 100, but closer to 160 beats per minute it cant adequately fill with blood. The chaotic electrical signaling causes the heart muscles to be out of sync between the top and bottom chambers, he says. Less efficiency in the heart means less blood is pumping through the body which means low blood pressure.
Low Blood Pressure When You Stand Up
Sometimes, changes in your posture can cause your blood pressure to drop, for example, going from sitting or lying down to standing up. You might feel the symptoms listed above when you stand up, such as feeling dizzy or faint. They will pass quickly as your body adjusts, but can put you at risk of falls.
This is called postural hypotension or orthostatic hypotension. Its caused by changes to your arteries which happen as you get older and if youre taking medications to lower your blood pressure.
The animation below provides information on the causes, symptoms and potential interventions related to orthostatic hypotension.
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Low Blood Pressure Consequences
Low blood pressure means that your organs are not getting enough blood and oxygen. When your low blood pressure is an emergency, the following severe complications can occur :
Heart Attack: When your heart loses a supply of blood.
Stroke: Persistent low blood pressure can cause the brain to fail rapidly.
Kidney failure: When insufficient blood is delivered to the kidneys, they dont eliminate wastes from the body. The amount of waste in the blood increases.
Shock: Shock is a life-threatening condition as a result of low blood flow throughout the body . The main symptom of shock is low blood pressure. The following are the different kinds of shock:
- Hypovolemic shock: Caused by severe fluid and blood loss. The heart is unable to pump enough blood to the body, or theres not enough blood to deliver oxygen through the body.
- Cardiogenic shock: This occurs when a damaged heart is unable to supply enough blood to the body.
- : When bacteria enters the blood producing toxins that lead to a decline of blood pressure.
- Anaphylactic shock: Sometimes fatal, an allergic reaction that can result in a dramatic fall in blood pressure.
Blood Pressure Before Death
When a patient is approaching death, the body will begin to shut down as the end nears. Because the heart is unable to pump normally, blood pressure lowers and blood is unable to circulate properly throughout the body. While it is never easy to watch a loved one slip away, this is all part of the natural dying process.
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Perk Up With Caffeine
One study found that when caffeine was administered after a meal, it prevented the postprandial fall in blood pressure in elderly, fit participants. So ending your meal with a cup of coffee might be useful in tackling low blood pressure.8
However, do keep in mind that coffee may have beneficial as well as adverse effects it could help lower your risk for diabetes and kidney stone but might increase your risk for heart disease and stroke. So if youre not a regular coffee drinker, do speak to your doctor before increasing your caffeine intake.9
Healthy And Unhealthy Blood Pressure Ranges
Learn whats considered normal, as recommended by the American Heart Association.
|SYSTOLIC mm Hg||and/or||DIASTOLIC mm Hg|
|HIGH BLOOD PRESSURE STAGE 1||130 139|
|HIGH BLOOD PRESSURE STAGE 2||140 OR HIGHER|
|HYPERTENSIVE CRISIS||HIGHER THAN 180||and/or||HIGHER THAN 120|
Note: A diagnosis of high blood pressure must be confirmed with a medical professional. A doctor should also evaluate any unusually low blood pressure readings.
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Why You Should Pay Attention To Your Blood Pressure
Hypertension can wreak havoc on the body before alarming symptoms appear. Thats why regular checkups are a must.
Sometimes, Dr. Lioudis asks patients to check their blood pressure at different times of the day. Its the only way to spot masked hypertension. People with this condition have normal blood pressure in the doctors office, but high blood pressure at home.
We cant do anything for hypertension unless we know it exists, he says. Thats why we advise everyone to have their pressures checked at least yearly. They should also talk with their family doctor about stress, heart or kidney disease, family history of high blood pressure and any other potential contributing factor. By working together, you can bring your blood pressure under control.
This article originally appeared in Cleveland Clinic Heart Advisor.