When Blood Pressure Is Too Low

Talk around blood pressure typically centers on what to do if blood pressure is too high. We know that high blood pressure is more common in people with diabetes than people without diabetes. We also know that uncontrolled high blood pressure is a risk factor for stroke, heart disease, and kidney disease. The American Diabetes Association recommends a blood pressure goal of less than 140/80 for most people with diabetes. But what if your blood pressure is too low? Is it cause for concern? And what do you do about it?


Low blood pressure defined
Low blood pressure is also known as “hypotension.” You might be thinking that low blood pressure is a good thing, especially if yours tends to run on the high side. But the reality is that low blood pressure can be a serious condition for some people.

For people without diabetes, the American Heart Association recommends a blood pressure of less than 120 over 80 (written as 120/80). Low blood pressure is generally defined as a blood pressure of less than 90/60. If your blood pressure tends to hover in that area without any symptoms, then there’s likely no cause for concern. But if symptoms occur, that’s a signal that something is amiss.

Symptoms of low blood pressure
Low blood pressure may be a sign that there’s an underlying medical condition, especially if your blood pressure drops suddenly or if you have the following symptoms:

• Dizziness or lightheadedness
• Fainting
• Fast or irregular heartbeat
• Feeling weak
• Feeling confused
• Lack of concentration
• Blurred vision
• Cold, clammy skin
• Nausea
• Rapid, shallow breathing
• Depression
• Dehydration

That’s quite a list. Some of the above symptoms can occur if you have, say, the flu, a stomach bug, or have been outside for a long time in hot weather. You might occasionally get dizzy if you sit in a hot tub for a while, for example. These are generally not signs of a serious medical problem. But if these symptoms do occur, especially on a frequent basis, it’s important to seek medical help.

Blood pressure that drops upon standing is called orthostatic or postural hypotension. This type of low blood pressure is common in older adults. Blood pressure that drops after eating is called postprandial hypotension, and this type is also more common in older adults, as well as in people who have high blood pressure or Parkinson disease.

Causes of low blood pressure
A “low” blood pressure for one person may be different for someone else. In other words, some people naturally have low blood pressure and are perfectly healthy. However, certain medical conditions can cause low blood pressure, including:

Pregnancy. A woman’s circulatory system expands during pregnancy, which can lead to low blood pressure.

Prolonged bed rest. This can trigger orthostatic hypotension.

Heart problems. Heart failure, heart valve problems, and heart attack can lower blood pressure.

Dehydration. Dehydration reduces blood volume, thus lowering blood pressure.

Blood loss. Blood volume and, therefore, blood pressure, drops as a result of internal bleeding or some kind of major trauma (like being in a car accident, for example).

Endocrine problems. Thyroid disease, Addison disease, low blood glucose, and nerve damage from diabetes may lower blood pressure.

Severe infection. If an infection enters the bloodstream, this can lead to a life-threatening drop in blood pressure called septic shock.

Severe allergic reaction. An allergic reaction to medicine, foods, or, say, a bee sting can cause a drop in blood pressure, along with difficulty breathing, hives, and itching. This is called anaphylactic shock.

Medicines. Some medicines can cause blood pressure to drop too low. These include diuretics (water pills), beta blockers (like atenolol [brand name Tenormin] and propranolol [Inderal, Innopran XL, and more]), some Parkinson disease drugs, some antidepressants, and sildenafil (Viagra) and tadalafil (Cialis).

Vitamin B12 and folic acid deficiency. A lack of either of these B vitamins can cause anemia, which, in turn, can lead to low blood pressure.

Treating low blood pressure
Sometimes low blood pressure does not need to be treated, especially if there are no symptoms or if the symptoms are very mild, such as a brief spell of dizziness when you stand up. If you have any of the above-mentioned conditions that may be causing low blood pressure, your doctor needs to address and treat the underlying cause, such as heart failure or diabetes, or possibly change the type of medicine that you take. Other treatments for low blood pressure include:

• Drinking more fluids
• Adding more salt to your diet
• Avoiding or limiting alcohol
• Wearing compression stockings
• Taking certain medicines, such as fludrocortisone or midodrine (Orvaten)
• Going very slowly from a sitting to a standing position

It’s also a good idea to purchase a home blood pressure monitor so that you can check your blood pressure regularly, and especially if and when you get symptoms. Again, let your doctor know if you have symptoms of dizziness or fainting. Just like high blood pressure, low blood pressure is treatable.

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  • Candy Walton

    Ok I am a type 2 diabetic it started during pregnancy a few years ago and stuck around. I use to be on insulin but for the past year I have been untreated due to constant moving and homelessness. I have been getting dizzy what I can only describe as a sudden head rush and not just when moving but while sitting or laying down too. I have been checking my blood pressure and it bounces around. An hour ago it was 115/48 and now it’s 133/83. I haven’t done anything except drink some work per water any ideas what’s going on?

    • acampbell

      Hi Candy,
      Blood pressure normally changes throughout the day. For example, it tends to be lower while you’re sleeping and then begins to rise a few hours before you wake up. Then, as the day winds down, blood pressure usually begins to drop again. In terms of your symptoms, they certainly could be related to a drop in blood pressure, but there may be other causes, as well. It’s best to check with your doctor and get evaluated for possible causes.

  • yeptholimi

    my aunt is both diabetic and has low blood pressure i has searched low and high for solution and food recommended but to no avail help thank you

    • dkaj

      Eating protein helps with slowing down the absorption of sugars / carbs and stabilizes this some. If you can get her to eat meats that she tolerates every couple hours and especially with carbs this will help. Also, keeping her well hydrated. been going through this same thing with my Dad. It works almost every time. Protein and water.

  • Linda

    My mom has type 2 diabetic lately her blood pressure drops to 68/40 And her pulse ia160 today her blood sugar was 167 what should I do

  • Beth

    I’m diabetic type 1 and blood sugar was 188 and had an overwhelming feeling of passing out. I checked my blood pressure was 85/71 heart rate was 119.. I normally have a blood pressure last one took before that was like 108/87.. heart rate 91.. I just a baby 2.5 months ago.. should I talk to my doctor?

    • acampbell

      Hi Beth,
      Yes, to be on the safe side, let your doctor know about your recent episode. You could be dehydrated, for example, but it’s best to let him or her know to help determine the cause and hopefully prevent this from happening again.

  • Rashoun

    I’m a type 1 diabetic and lately my blood pressure has been running low w on most occasions around 81/61 I have had depression symptoms lightheaded and sometimes blurred vision..?! Very concerned

  • Maruf Hasan

    hello .
    1 weak ago i had been dhyreeah./dehydration.after dehydration i wasnt take food properly coz of bad smell.all food was bad smell for me.now i m suffering for low blood pressure.sometimes BP is lees then 90(up) nd 60(down).i fell too week.BP all time flactuate right now.so plz can u tell me wt should i do?for ur kind information i m taking lots of ege.nd salt with food.nd salt water(salaine).plz help me.i m 34 years old lady from bangladesh.i have no diabetis.

    • Maree Paolini

      I’m not a medical expert, but I think so much salt will dehydrate you more and blood pressure continue it’s downward cycle. more water less salt, I would suggest.