Understanding Highs and Lows of Your Blood Pressure (Video)

How low your blood pressure should go


Here at Cleveland Clinic, patients frequently ask us cardiologists this question: “Is my blood pressure too high, or is it too low?” We’re always happy to answer, because it’s important for you as a patient to understand your blood pressure. Blood pressure is the measurement of the pressure or force inside your blood vessels or arteries with each beat of the heart. When that pressure is above normal, we say your blood pressure is high. Ideal blood pressure should be 120/80 and it enters the “high” range at 140/90.

Dash for lower blood pressure

Good news: We can lower blood pressure in some people by five or ten points when they eat a more heart-healthy diet, like the DASH diet. DASH stands for “Dietary Approaches to Stop Hypertension” and this eating plan places a major nutritional focus on plants, fruits and vegetables, nuts, low-fat and non-fat dairy, lean meats, fish, poultry, mostly whole grains, and heart-healthy fats.  It tastes great, too. In addition, other lifestyle changes like increasing exercise and losing weight also have a big impact on lowering high blood pressure.


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Understand low numbers and symptoms

Many cardiologists believe that no specific number is really “too low,” if patients don’t exhibit symptoms. It’s true that we hear more about high blood pressure “problems” than low, so I want to talk about numbers that fall below normal, especially when we are treating for high blood pressure. Maybe you’re taking blood pressure medication, and your top number is 110 or even 100. Don’t be alarmed, but you should talk to your doctor if you have concerns like dizziness when you stand up, or if your top or systolic number falls below 100.

Know how low numbers help

We know now that defining blood pressure is not the same for everyone and that blood pressure goals with medication treatment can be controversial. For example, we know that some patients who have congestive heart failure may consistently have lower numbers—congestive heart failure is a chronic long-term disease managed with medication, because the heart doesn’t function or pump as well as it should. When the heart doesn’t pump out blood that it pumps in, it can cause excess fluid to accumulate in the lungs and other bodily tissues. We find that in many cases, these unusually low numbers aren’t harmful because they allow the heart to pump more effectively, plus they lighten the heart’s workload—all good.  While blood pressure control may be looser in the elderly, a higher number such as 150/90 may be the goal to prevent dizziness and falls seen with lower numbers. These are not certain recommendations and should be individualized.

Tips to control blood pressure

Your blood pressure numbers matter. Here are three tips that will help you get your blood pressure in control:

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  1. Ask your doctor what the right blood pressure is for you
  2. Check your blood pressure at home. Keep a chart and bring it to your doctor’s visits. You should measure your blood pressure sitting after a period of quiet the same time every day – morning and evening.
  3. Make necessary lifestyle changes to help lower your blood pressure. DASH diet, exercise and get to your healthy weight.

Ask for help to control your blood pressure for a lifetime. You can make a real difference.  

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Steven Nissen, MD

Steven Nissen, MD, is Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic. In 2007, TIME Magazine named him “one of the 100 most influential people in the world.”
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  • Stephanie Marie

    The top number is systolic not diastolic.

    • The_Beating_Edge_Team

      You are correct – even after several proof readers – we missed that one! thanks for pointing it out. betsyRN

  • bbbb

    You fail to address low BP with accompanying dizziness, wooziness, etc…..we havr been told 74/44 or 80/50 is as dangerous as 200/110. Misleading as written!

    • The_Beating_Edge_Team

      we are changing the last sentence of the first paragraph – (thank you Stephanie who pointed out the error). And the video certainly explains this more. However we do say “you should talk to your doctor if you have concerns like dizziness when you stand up, or if your top or SYSTOLIC number falls below 100.” The point of this is that some people do have lower blood pressure – but if you have blood pressure lower than 100 with symptoms – you should check with your doctor. The goal, depending on your condition, may be to keep the blood pressure low – but you are correct – if you are having symptoms of feeling dizzy or lightheaded – call your doctor as your medications may need to be adjusted. If your blood pressure is very low (such as the numbers you listed) and you are feeling faint, short of breath, clammy or your heart rate is very fast – that is a sign that you need to call for emergency assistance. betsyRN

  • https://plus.google.com/+Securitycamera-ny/about?hl=en Mark

    good point.Tool… Get over it. Get a life.

  • Marsha

    Just had a colonoscopy where they could not give me anymore anesthesia because My blood pressure was dropping too low. I felt 2/3’s of the procedure. My concern is that I am having a couple surgeries next month (carpal tunnel) and sure don’t want to go through this again. I have been on a blood pressure pill for years Lotensen and wonder now if I even need to be taking it at least before any surgeries.