Most of us are aware that having high blood pressure (hypertension) places you at increased risk for serious health conditions like heart attack, stroke and kidney damage. But did you realize that low blood pressure (hypotension) can be equally concerning?
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“Blood pressure is an essential part of your body’s normal physiology,” says heart rhythm specialist Jeffery Courson, MD. Blood pressure reflects your ability to send oxygen-rich blood to your vital organs — and especially your brain.
A “normal” blood pressure is 120/80 mmHg. The top number is the systolic pressure. That’s the amount of pressure in your arteries when your heart is contracting. The bottom number is the diastolic pressure. It represents the pressure in your arteries when your heart is relaxing. Any number at or below 90/60 mmHg is considered low.
Some people have chronic hypotension, which needs monitoring and treatment just like chronic hypertension does. But anyone can experience a sudden, sharp decrease in blood pressure. Bottoming out like that can be quite dangerous. Dr. Courson details what it feels like when you blood pressure goes through the floor — and what you can do in the moment to reverse it.
As important as it is to understand causes and symptoms, if you’re experiencing a sudden blood pressure dip, you need to act fast to avoid fainting. So, that’s where we’re going to start. Dr. Courson suggests doing the following:
When we’re horizontal, our blood vessels don’t have to fight gravity as much as they do when we’re standing. You could almost think about fainting as your body hitting CTRL + ALT +DEL: It’s forcing you into a position that will raise your blood pressure.
If you start feeling like your blood pressure’s dropping (that is, like you’re about to faint), the first and most important thing you can do is slowly change positions. If you’re standing, sit or lie down. If you sit, Dr. Courson advises, put your head between your legs. If you’re lying down, try to elevate your legs. And be aware of your surroundings avoid stairs, tile floors and the like if you’re feeling shaky.
Not only does changing your position raise your blood pressure and make you less likely to faint, it also means that — if you do pass out — you won’t fall and hurt yourself.
When your body’s properly hydrated, it does a better job regulating your blood pressure, period. If you have low blood pressure, Dr. Courson explains, adding some extra fluid will raise your blood volume. As a result, your veins and arteries will expand, improving your circulation.
If your blood pressure’s dipped too low, try coaxing it back up using your muscles. There are a few different ways you can do this:
We know. They aren’t the most comfortable thing in the world. But if you frequently struggle with low blood pressure, trust us: the squeeze is worth it.
Whether you’re wearing compression socks, stockings, leggings or abdominal straps, the idea behind them is the same: the pressure they put on your body promotes better circulation. That means less blood pooling in the veins in your lower body — which means more blood making its way back to your heart with every beat.
If you’re at home when you start feeling off, throw on your compression therapy gear if you can do so safely. If you’re prone to sudden dips in your blood pressure, it’s a good idea to have some compression socks, stockings, leggings or straps stored in your car, office or bag.
If it feels like your blood pressure’s bottoming out, it might be time to top up that cup of coffee you’ve been nursing all morning. It can be a pretty effective way to boost your blood pressure.
This suggestion is one where “your mileage may vary.” And that probably shouldn’t be surprising. After all, you need only walk around an office building at 8 AM to know that coffee doesn’t have the same impact on everybody.
How much you drink, your DNA and a whole host of other factors can change how you metabolize your “mud.” If you practically bathe in the stuff, it’s unlikely to be a super effective tool. So, while it’s possible that a cup o’ joe will raise your blood pressure fast, it shouldn’t be the only trick up your sleeve.
When you’re hot, Dr. Courson explains, your blood vessels expand, which slows down circulation and allows gravity to pull your blood toward your feet more easily. If you feel overheated, it’s always a good idea to (if possible), go inside and drink some water.
We’ve all heard of people passing out in a moment of grief, anguish, or surprise. Ditto the sight of blood or needles. It’s called “situational syncope.” It’s basically our body’s way of trying to protect us from emotional distress that’s severe enough to read as a threat. It’s almost like your body’s forcing you to play dead by forcing your blood pressure through the floor.
If you’re upset enough that it’s starting to affect you physically — for example, if you’re having a panic attack — sit or lie down and do some deep breathing exercises, like box breathing, five-finger breathing, or 4-7-8 breathing.
Okay, we’ve talked about how to resolve a sudden hypotensive episode. Now let’s back up a bit and talk about the kinds of symptoms that indicate your blood pressure’s dropping in a dangerous way.
We say “a dangerous way” because it’s perfectly normal for blood pressure values to fluctuate throughout the day, especially when your activity levels change. You need higher blood pressure when exercising and lower blood pressure when at rest because your oxygen requirements differ under these conditions.
Your autonomic nervous system is responsible for regulating your blood pressure.
“I think of it as our ‘automatic’ nervous system because we don’t control it by thought,” says Dr. Courson. You can’t “think” your blood pressure up or down, but if you get upset or exercise, your blood pressure will rise. And if you meditate, do breathwork or spend a few minutes cuddling your pet, your blood pressure will probably drop.
A sudden, dramatic drop in blood pressure can happen for many different reasons, but the symptoms look similar across the board. If your blood pressure’s gone through the floor, you may:
If not addressed immediately, a sharp drop in blood pressure can cause you to pass out (syncope) and — left untreated — has the potential to do permanent damage.
The consequences of a hypotensive crisis can be deadly. That’s because a drop in blood pressure can reduce the amount of blood getting to your organs. If they’re starved of oxygen for too long, it can cause the body to go into shock.
While occasional low blood pressure (or even asymptomatic long-term low blood pressure) isn’t necessarily a problem, a sudden episode of severe hypotension should be treated as a medical emergency.
There are some cases when it’s obvious that low blood pressure is an emergency, like when somebody’s lost a lot of blood, or is in anaphylactic shock. But your blood pressure can also drop dangerously low without an immediately obvious cause — like when you’re bleeding internally.
So, how low is dangerously low? According to Dr. Courson, it depends on what you consider a “normal” blood pressure.
A sudden drop in blood pressure of just 20 mm/Hg is enough to make a person pass out. In other words, if you have chronic high blood pressure, dropping to a “healthy” level all of a sudden could count as a hypotensive crisis. For that reason, it’s best to focus on the kind and severity of the symptoms a person’s experiencing, not a specific number on a BP monitor.
If the following have happened suddenly and without explanation, call 911:
If you’re on the fence about getting help, it’s best to air on the side of caution. “When in doubt, make the call,” Dr. Courson advises.
Have you had multiple attacks of low blood pressure recently? If you’re experiencing these symptoms frequently, or in a way that’s negatively impacting your quality of life, you should contact your doctor. They can perform a series of tests to determine the cause of your hypotension.
Whatever your situation, it’s a good idea to let your provider know if you’re regularly battling with your blood pressure. They can run tests to help you figure out what’s triggering those dips and make suggestions for managing hypotensive episodes when they happen.
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