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Disease Management: The Medicine Cabinet-Ask the Harvard Experts: What causes low blood pressure?
Source: Harvard Health Letters

Q: My blood pressure stays low. Sometimes it drops so low that it causes dizziness and weakness. What can cause this?

A: Many healthy people have low blood pressure. In fact, no specific blood pressure reading is considered too low, as long as the person feels fine and is generally healthy.

But in your case, your blood pressure is low enough to cause symptoms. So you need to see your doctor for an evaluation.

Here is my approach to someone with symptoms related to low blood pressure:

First, I review all medications the person is taking. If you take medicine for your blood pressure or your heart, the dose may be too high for you. These and many other drugs can lower blood pressure.

Next, I make sure the person has been drinking enough fluids. Even if you don't feel thirsty, you could still be dehydrated.

Also, many people restrict their salt intake. Usually this is healthy, but people with low blood pressure may actually need to increase the amount of salt in their diet.

These two factors, medications and dehydration, account for the great majority of low blood pressure episodes.

If neither of these applies to you, you could have postural hypotension. In this condition, blood pressure falls dramatically when someone stands. Usually this is caused by problems with the nerves that help regulate blood pressure. People who've had diabetes for a long time can have this problem.

When you do feel lightheaded, lie down immediately. If that's not possible, at least sit down. If you continue to stand while feeling lightheaded, you could faint and hurt yourself.

(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)

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