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Types Of Low Blood Pressure, Causes, and Risk Factors Associated

With inputs from Dr Sreelekha Daruvuri

Updated on: November 2023

With inputs from Dr Sreelekha Daruvuri

Updated on: November 2023

Reviewed by Dr Raja Indana

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Low blood pressure, also known as hypotension, is a medical condition where your blood pressure drops to less than 90/60 (systolic/diastolic) mm Hg. (Normal blood pressure is less than 120/80 (systolic/diastolic) mm Hg).

Generally, low blood pressure needs monitoring if you don’t have any symptoms. But in case you do present with symptoms such as weakness, light-headedness, or loss of consciousness, you need to see a doctor straight away. Sometimes, low blood pressure can even be fatal or life-threatening.

In this guide, we will cover

The different types of low blood pressure and their symptoms
Causes of low blood pressure
Risk factors
Diagnosis
Treatment and
Some important FAQs on low blood pressure

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Chapter 1: Types of low blood pressure and their symptoms

There are mainly four different types of hypotension or low blood pressure types based on causes and some other factors, as described below:

(1) Orthostatic or postural hypotension

In this type of hypotension, there is a sudden drop in blood pressure when a person stands up from a sitting or lying down position.

It is the most common type of low blood pressure affecting people of any age group. Still, it’s mostly observed in elderly and pregnant women.

Symptoms: What does it feel like?

A person with this condition may feel

Dizzy
Light-headed
loss of consciousness

Why does that happen?

When you change the position from supine/sitting to standing, there is a sudden drop in blood pressure. But when you suddenly stand up, blood from your legs has a harder time reaching your heart due to gravity. Usually, this is compensated by an increase in heart rate and changes in blood vessels which help restore blood supply to the brain. In orthostatic hypotension, this compensatory mechanism fails. As a result, there is a temporary blood shortage in the heart, leading to a sudden drop in blood pressure and thereby decreased blood supply to the brain. This sudden drop in blood pressure is why you begin to see “stars.”

What does orthostatic hypotension point to?

This condition, therefore, points to a faulty cardiovascular and autonomic nervous system that doesn’t react properly to sudden movements.

About 30 to 50 percent of people with Parkinson’s disease (disease affecting the autonomic nervous system) and 30 percent of people with diabetes have orthostatic hypotension.

(2) Postprandial hypotension

In this type of hypotension, there’s a sudden drop in blood pressure after a meal.

This type of low blood pressure condition affects up to one-third of the elderly population. However, it’s hardly observed in younger adults.

Symptoms: What does it feel like?

A person with postprandial hypotension may feel the following symptoms within an hour or two hours after a meal:

Dizziness
Light-headed
Faint
Loss of balance

Why does that happen?

Usually, after a meal, relatively, blood flow increases to the gut, which decreases the blood supply to other vital organs. Normally, this is compensated by increasing heart rate and other mechanisms, and when they fail, it leads to hypotension.

What does postprandial hypotension point to?

This condition points to a faulty autonomic nervous system that regulates your internal biochemical processes.

People with Parkinson’s disease, multiple system atrophy, and diabetes are more likely to suffer from this medical condition than others.

(3) Neurally mediated hypotension

In this type of hypotension, a drop in blood pressure occurs due to standing upright for a long time. It mostly affects children and young adults.

Symptoms: What does it feel like?

A person with this condition may feel the following symptoms:

Light-headed
Dizziness
Chest pain
Weakness
Loss of consciousness
Impaired speech
Vision problems

Why does that happen?

In this condition, the blood has a harder time reaching your heart from your lower limbs.

It’s believed to occur due to a miscommunication between the heart and brain.

(4) Multiple system atrophy with orthostatic hypotension

In this type of hypotension, blood pressure drops due to a neurological disorder called Multiple System Atrophy (MSA) — it’s a condition that damages your Autonomic Nervous System (ANS), which is responsible for all involuntary functions in your body, including blood pressure.

It’s a very rare condition also known as Shy-Drager syndrome. People with this condition usually die within seven to ten years.

Symptoms: What does it feel like?

People with this condition may show the following symptoms:

Orthostatic hypotension along with hypertension when lying down
Slowed movements
Slurred speech
Vision problems
Tremors
Urinary incontinence

Why does that happen?

It occurs due to a faulty Autonomic Nervous System (ANS). i.e., the part of the brain that controls blood pressure doesn’t function as it should normally, causing abnormalities in your blood pressure.

What does multiple system atrophy with orthostatic hypotension point to?

This condition points to a neurological disorder called Multiple System Atrophy (MSA).

Chapter 2: What are the causes of low blood pressure?

Low blood pressure occurs when the volume (or amount) of blood supply to your heart decreases due to

External or internal injuries (during an accident) or
Loss of blood components (RBCs, WBCs, platelets, and water content) due to an underlying disease or medical condition.

Or a drop in blood pressure also occurs due to

A faulty autonomic nervous system (the part of the brain that controls your blood pressure), or
A faulty heart that just wouldn’t pump enough blood

As a result, the force with which your heart pumps blood through the blood vessels decreases.

Think of it this way — when gushing water flows through a pipe or a hose, it exerts pressure on the pipe. But when the amount of water is less, the pressure exerted on the pipe by the motor is also less. It’s the same principle when blood flows through our blood vessels.

how to lower blood pressure instantly

Further, since the heart doesn’t have enough blood at its disposal, it wouldn’t be able to supply sufficient blood to your brain, heart, and other vital organs. Since blood carries oxygen and other essential nutrients, an inadequate blood supply to these vital organs can make you feel dizzy or light-headed.

Low blood pressure due to health conditions

Following health conditions cause low blood pressure.

1) Heart problems:

Heart diseases can cause low cardiac output. It means the heart isn’t capable of pumping enough blood to your tissues and organs.

Following heart problems are known to cause hypotension in patients.

Heart attacks
Bradycardia (a condition with an extremely low heart rate)
Heart valve problems
Heart failure

2) Pregnancy:

Low blood pressure is very common during pregnancy, especially in the first two trimesters. But blood pressure usually returns to normal levels in the third trimester.

The drop in blood pressure during pregnancy is due to

Hormonal changes
Changes in the cardiovascular system

3) Endocrine disorders:

The endocrine system in our bodies is responsible for the secretion of hormones such as insulin, thyroid hormones, adrenaline, etc. These hormones regulate our day-to-day internal biochemical processes. Therefore, abnormalities in some hormone levels can cause low blood pressure in patients. Disorders like Addison’s disease and diabetes also can lead to low blood pressure.

4) Dehydration:

In dehydration, your blood volume decreases, causing hypotension.

Your blood is made up of liquids and solids. The liquid part is called the plasma and comprises water, salts, and proteins. Similarly, the solid part of your blood comprises RBCs, WBcs, and platelets.

Therefore, when you are dehydrated, the water content in your blood decreases. As a result, your overall blood volume decreases. Now since the heart doesn’t have sufficient blood to pump like it normally does in a healthy person, your blood pressure decreases, resulting in low blood pressure.

Following symptoms and activities can cause low blood pressure.

Vomiting
Severe diarrhea
Strenuous activities
Overuse of diuretics

5) Blood loss:

As blood volume in our bodies decreases, so does our blood pressure. Major internal or external injuries have been known to cause life-threatening low blood pressure in patients.

6) Severe infection (septic shock):

Septic shock or sepsis is a life-threatening health condition in which your blood vessels are damaged due to a bacterial or viral infection, causing internal bleeding and reducing circulating blood volume. Loss of blood leads to lower cardiac output and supply of oxygenated blood and nutrients to vital organs in your body, leading to multiple organ failures.

Following bacterial or viral infections can lead to very low blood pressure.

Covid-19
Bacterial infections due to burns or wounds
Bacterial infection of the digestive system
Bacterial infection at catheter sites

7) Vitamin B-12 deficiency:

A lack of Vitamin B-12, folate, and iron levels in your body can lead to anemia. Due to a shortage of RBCs, your blood volume effectively decreases, leading to low blood pressure.

Low blood pressure due to medications

Following medicines causes low blood pressure due to a reduction in blood volume or loss of compensatory mechanism due to abnormal neural pathways.

Diuretics (or water pills)
Alpha-blockers
Beta-blockers
Pramipexole
Antidepressants
Drugs for erectile dysfunction

Chapter 3: Who is at high risk for low blood pressure?

Low blood pressure can occur in anyone, although certain blood pressure types are more common depending on your age, health conditions, or other factors. Following people are at higher risk for low blood pressure than others:

1) The elderly:

People over 65 are usually at risk of low BP. With age, your physiology and compensatory mechanisms also deteriorate and may often cause low blood pressure.

2) People with health conditions:

People with the following health conditions are at risk for low BP

Diabetes
Heart diseases
Parkinson’s disease
Alcoholics
Multiple System Atrophy
Neuropathy (nerve diseases)
Anemia

3) People under medication:

People taking medications for hypertension, such as Alpha-blockers, are at higher risk for low blood pressure.

Chapter 4: When to see a doctor?

Low blood pressure isn’t a cause of major concern for most people until it gets too low, causing symptoms. If your blood pressure is low (< 90/60 mm Hg) and you experience the following symptoms, you need to seek immediate medical attention.

Mental confusion
Loss of consciousness
Very weak but rapid pulse
Shallow but rapid breathing
Skin discoloration, especially blue hue.

Further, if you are on medication for hypertension, you need to keep track of your blood pressure. In case it gets abnormally low, please consult your doctor.

Chapter 5: Diagnosis

The diagnosis of low blood pressure involves measuring your blood pressure using a manual instrument called a ‘Mercury sphygmomanometer’ or a digital BP monitor.

Additionally, your doctor may also prescribe a blood test and ECG to check if there’s an underlying cause or medical condition that’s making you sick.

Chapter 6: Why is a blood pressure check done?

A blood pressure check is done for routine health checks. Find out why you should have your blood pressure measured:

If you are 18 or older. Doctors recommend having your blood pressure checked at least once every two to five years.
If you are 40 or older. The likelihood of people getting cardiovascular diseases increases with age. Therefore, doctors recommend checking your pressure at least once every year as part of your routine health checkup.
If you have chronic health conditions. People with chronic health conditions such as hypertension, diabetes, Parkinson’s disease, heart diseases, and kidney diseases may need to have their pressure monitored more often.

If you need to get your blood pressure monitored very often, it may not always be possible or convenient. Therefore, it’s good to keep a digital BP monitor handy at home for your daily use.

Also, did you know that you can now measure your blood pressure using your smartphone?

Using the MFine BP monitor, you can check your blood pressure with an accuracy of 90% anytime, anywhere.

Read more on the MFine BP monitor.

Chapter 7: Risks associated with blood pressure check

There are no known risks. It’s a painless and non-invasive procedure. You may feel a bit uncomfortable when the cuff is tightened around your arm, but it isn’t painful.

Chapter 8: Test procedure to measure low blood pressure

Since blood pressure can now be monitored using several devices, test procedures are different for different devices, as shown below.

Sphygmomanometer test procedure	Digital BP Monitor test procedure	MFine BP Monitor test procedure
A cuff is placed over your upper arm. The cuff is then inflated manually, using a small hand pump. As the cuff inflates, it squeezes your arm and artery. The pressure is then released from the cuff post which the examiner tells you what your systolic and diastolic readings are.	A cuff is placed over your upper arm. The cuff is then inflated automatically by turning on the digital device. As the cuff inflates, it squeezes your arm and artery. The pressure is then released automatically from the cuff. Your systolic and diastolic readings are displayed on the device monitor.	Launch the MFine app. Scroll down to the Blood Pressure Monitor tracker. Click on the “Measure” icon. Place your finger on the phone’s camera. In 30 seconds, your test report will be displayed on your phone’s screen.

Chapter 9: How to prepare for the test?

No special test preparation such as a fast is required for this test. However, you need to take the following precautions.

Avoid smoking, exercising, or caffeinated drinks an hour before the test
Wear comfortable clothes. Consider wearing a half sleeved shirt. That way it becomes easier for your doctor to access your upper arm.
Your doctor needs to be informed about your medications and health conditions if any.

Chapter 10: How to interpret your test results?

90/60 mm Hg>	Hypotension>
120/60 mm Hg>	Normal>

Chapter 11: Treatment

Treatment for low blood pressure depends on treating the underlying cause that’s causing your blood pressure to drop. For example, if it’s a medication that’s causing your blood pressure to drop, then the whole idea is to decrease its dose or replace the medication.>

Similarly, if it’s >diabetes>, then your doctor will try to lower your blood sugar levels and suggest >ways to increase your blood pressure>.>

Therefore, depending on the underlying cause, symptoms, type of low blood pressure, and risk factors, treatment may involve one or more of the following:>

Including adequate salt content in your diet: Sodium, commonly found in table salt, is known to increase blood pressure. This can be a good thing for people with hypotension. However, since excess salt can also cause other health problems such as heart diseases among the elderly, it’s advisable not to self-medicate but seek help from a doctor. Feel free to check our doctor consultation and lab test services. At MFine, we provide >affordable doctor consultations>, all from the comfort of your home. >Download the app now>!>
Drink adequate water: Water increases the blood volume. Blood is made up of several components — water, salts, nutrients, RBCs, WBCs, etc. When any one or more of these components decreases, so does your blood volume. Low blood volume decreases your heart’s ability to pump blood with adequate force, causing low blood pressure. Therefore, one of the ways to increase blood volume and also blood pressure is by drinking adequate water.>
Medications: Following are some medications to treat low blood pressure:>
1. Fludrocortisone: This medicine works by promoting sodium retention in the body (Sodium, a form of salt, is known to increase blood pressure).>
2. Midodrine: It works by narrowing down the blood vessels leading to an increase in blood pressure. This medicine is usually prescribed to people with postural hypotension.>
Home remedies: It includes making lifestyle changes, diet, and exercises:>
1. Replace alcohol with water: Do you ever wonder why you feel excessively thirsty after drinking alcohol or during a hangover? That’s because alcohol is a dehydrating agent; it causes your body to remove fluids from your blood through the kidneys at a much quicker rate than other liquids.>
2. Eat low carb small meals: If you have postprandial hypotension, eat smaller portions of food low in carbs. When you eat smaller meals, less blood is sequestered by the intestines to digest food. As a result, the likelihood of a drop in blood pressure is significantly reduced.>
3. Pay attention to how you sit: If you suffer from orthostatic or postural hypotension, paying attention to your sitting postures can help prevent a sudden drop in blood pressure. The reason why you have this condition in the first place is because blood from your lower limbs isn’t reaching your heart in time. This causes a sudden drop in blood pressure (when you suddenly stand up). Therefore, the whole idea here is to incorporate moves or positions that will encourage blood flow from your limbs to your heart. Follow these suggestions if you are experiencing symptoms.>

While standing up, do so gently. Avoid abrupt moves>
Try avoiding crossing your legs>
Cross your thighs in a scissor fashion and squeeze>
Put one foot on a chair and lean forward>

Wear compression stockings: If you have varicose veins, compression stockings can help prevent blood pooling in your veins and prevent a drop in blood pressure.>
Start working out: >Exercises help pump up your heart and blood pressure. Regular exercises also strengthen your heart, muscles, and blood vessels. Aim for at least 30 to 60 minutes of workout each day for 4 to 5 days a week. Try to avoid working out in hot and humid climates, as doing so may dehydrate you.>

References

(1) What to do if there’s an emergency due to hypotension at home?

If there’s a medical emergency due to hypotension at home, give adequate water mixed with a pinch of salt to the patient, make the patient lie down with an elevated foot, and seek immediate medical help as soon as possible.

(2) What can happen if BP is too low?

Low BP can cause

Dizziness
Fainting
Weakness and
Increases your risk of injuries due to a fall

(3) What are the dos and don’ts of low blood pressure?

Dos:

Hydrate well
Eat more frequent but smaller meals low in carbs
Exercise at least 4 to 5 days a week

Don’ts:

Reduce your consumption of alcoholic beverages
Avoid large meals, especially if that is unhealthy

(4) Is banana good for low blood pressure?

Banana is rich in potassium, an important salt known to reduce hypertension or high blood pressure. Therefore, eating bananas is not a good option for low blood pressure. Eating bananas in moderation is okay since they are also packed with other vital nutrients.

(5) How do you treat low blood pressure immediately?

Increase salt and water content in your food
Medications
Diet and lifestyle changes

If it is a medical emergency, you need to seek immediate medical attention.

(6) What vitamins help with low blood pressure?

Here, it’s important to know what exactly is the cause of your low blood pressure. If it’s anemia, then iron, folic acid, and Vit b12 can help manage your condition. Understanding the root cause of hypotension is paramount to your diagnosis and treatment.

(7) Is coffee good for low blood pressure?

Caffeine in coffee is known to increase your blood pressure temporarily. Therefore, coffee over tea can be a good option for low blood pressure. But this is temporary management, and one needs to address the cause of low blood pressure.

(8) Is Egg good for low blood pressure?

There is no direct scientific evidence that eggs can help with low blood pressure.

(9) Does exercise increase blood pressure?

Exercise temporarily increases your blood pressure within physiological limits. In the long run, exercise does help with low blood pressure. However, it’s advisable to seek medical help for your condition.

(10) Does low blood pressure make you tired?

Low blood pressure can make you feel tired, faint, dizzy, and weak.

(11) Can Vitamin B12 deficiency cause low blood pressure?

Vitamin B12 deficiency causes anemia. And anemia is known to cause low blood pressure.

(12) Can sleeping position affect blood pressure?

Your blood pressure is lower when you are sleeping than when you are in a standing position. Sleeping on the right side can compress major vessels and diminish the blood supply returning to the heart from the legs, further reducing blood pressure.

(13) Why is my blood pressure so low in the morning?

Blood pressure varies throughout the day. It’s lowest when you sleep and peaks during noon. Therefore, it’s normal to have a low BP within physiological limits when you wake up in the morning. But if your BP is causing you to feel dizzy, tired, weak, or faint, you need to see a doctor.

(14) Which fruit is best for low blood pressure?

Citrus fruits rich in folates (folic acid) are known to help maintain normal blood pressure when you have anemia:

Lime
Orange and
Grapefruit

(15) Is eating sugar good for low blood pressure?

It’s best to avoid sugary food or diet if you have low blood pressure.

(16) What should I do if I have low blood pressure and feel dizzy?

Low blood pressure is not a major cause for concern unless you show symptoms. Therefore, if you feel dizzy, it’s advisable to speak with a doctor.

(17) Does anxiety cause low blood pressure?

Anxiety is known to cause stress, a risk factor for hypertension. But anxiety can also cause low blood pressure. When people are anxious, they may not breathe properly, causing abnormalities in blood vessels leading to hypotension.

(18) Can vitamin D raise blood pressure?

Vitamin D does not raise blood pressure. On the contrary, its deficiency can lead to heart diseases and hypertension. Therefore, it’s not advisable to self-medicate. Speak to a doctor to see if you need vitamin D supplements.

(19) What lack of nutrients causes low blood pressure?

According to doctors, a lack of Vitamin B12, folic acid, and iron causes anemia, which in turn, can cause a drop in your blood pressure.

(20) Can overthinking cause low BP?

No evidence suggests that overthinking causes hypotension.

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