Low Blood Pressure : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 09/09/2022

Reduced blood pressure is normally observed in young people with an asthenic constitution, athletes, residents of high mountains. Common pathological causes of the symptom include: nutritional deficiency, anemia, neurocirculatory dystonia, various endocrine diseases. To identify the etiological factors of low blood pressure, a general and biochemical blood test, an assessment of the hormonal profile, instrumental methods (ECG, EchoCG) and functional tests are carried out. In addition to etiotropic therapy, adaptogens, nootropics, vitamin-mineral complexes are used to relieve symptoms.

Causes of low blood pressure

Physiological factors

Some people have blood pressure readings in the range of 90/6 mm Hg. Art. are a variant of the norm. At the same time, the state of health and working capacity are not disturbed, but when being in stuffy rooms, a feeling of faintness and weakness is characteristic. More often, constitutional hypotension occurs in young girls, people with asthenic physique. There are several more options for physiologically low blood pressure:

  • Orthostatic . Occurs with a sharp transition from a horizontal to a vertical position. Manifested by darkening in the eyes, weakness, dizziness.
  • Compensatory . It is noted in residents of high-mountain regions, all the functional systems of the body of which have adapted to a reduced oxygen tension.
  • Postprandial . It develops 10-2 minutes after eating, mainly when eating a large amount of carbohydrate food.

Athletes may have a combination of low blood pressure with bradycardia. The condition is due to the body getting used to constant overloads. Hypotension manifests itself in meteorologically dependent people with high humidity, sudden changes in weather, change of time zones. A short-term pressure drop occurs in response to the effects of electromagnetic fields, radiation.


25% of pregnant women in the early stages have low blood pressure. The condition is a consequence of a sharp change in hormonal levels. Usually the problem is exacerbated by toxicosis, which is caused by chronic loss of fluid and electrolytes with vomiting. Another typical cause of low blood pressure during gestation is iron deficiency anemia, which is diagnosed in 40-45% of pregnant women.

Protein-energy malnutrition

Strict diets are the most common cause of low blood pressure in young women. The symptom is associated with a lack of essential nutrients, vitamins, iron. The clinic appears gradually. Worried about weakness, reduced ability to work. When walking fast, climbing stairs, shortness of breath is observed. It becomes difficult to get up in the morning: dizziness, weakness in the legs, muscle tremor.


A decrease in blood pressure is often caused by impaired nervous regulation. This reason is more typical for young, emotionally labile patients. Women are more often affected. For low blood pressure in such cases, severe weakness, darkening of the eyes, pressing headache, blanching of the skin are typical. Symptoms are provoked by prolonged standing, lack of oxygen, stressful situation.



Low blood pressure is one of the main symptoms of anemia. The clinical picture is standard - weakness, dizziness, intolerance to stuffiness. With anemia, a decrease in pressure is accompanied by a sharp pallor, which persists constantly, and not only when the condition worsens. Taking into account the reason for the decrease in hemoglobin, additional signs are possible: brittle hair and nails, "lacquered tongue", paresthesia.

Hormonal diseases

Signs of persistently low blood pressure are a specific symptom of hypothyroidism. Such patients freeze even in warm rooms, feel drowsiness and weakness. The decrease in pressure is manifested by headaches, dizziness. With prolonged existence of the problem, memory and mental performance deteriorate. Chronic decrease in blood pressure occurs in patients with adrenal insufficiency (Addison's disease).

Organic lesions of the central nervous system

Hypotension develops as a reaction to a violation of the mechanisms of regulation of cardiovascular activity. It is observed with concussions and bruises of the brain, degenerative processes that affect the gray matter. These conditions are characterized by the presence of persistently low blood pressure, which cannot be normalized by standard therapeutic measures.

Acute conditions

Low blood pressure is a sign of many emergencies accompanied by shock. A sharp drop in blood pressure is manifested by severe dizziness, fainting, chills and drowsiness. Shock often ends in fainting. The skin becomes pale, covered with cold sweat. Signs of low blood pressure are characteristic of several groups of conditions:

  • Hypovolemic conditions : dehydration, massive bleeding, extensive burns.
  • Circulatory shock : anaphylactic, infectious-toxic.
  • Cardiac pathologies : acute heart failure, life-threatening arrhythmias, myocardial infarction.

Complications of pharmacotherapy

Overdose of antihypertensive drugs is a common cause of pathologically low blood pressure in the treatment of hypertension. The symptom is more often observed when taking diuretics, nitrates, beta-blockers. The peculiarity is that discomfort in such patients may appear with normal tonometer readings - systolic pressure at the level of 100-12 mm Hg. Art. This is due to the restructuring of all body systems, adaptation to arterial hypertension.

Rare Causes


During the initial examination, the general practitioner or cardiologist assesses the constitution and nutritional status, conducts a physical examination of the respiratory and cardiovascular systems. In addition to the standard blood pressure measurement, 24-hour blood pressure monitoring is recommended to obtain a complete picture. Diagnostic search involves the appointment of a complex of laboratory and instrumental methods:

  • Blood tests. In the hemogram, the content of hemoglobin and erythrocytes is often reduced, with infectious shock, high leukocytosis is observed. In a biochemical study of blood, attention is paid to the level of total protein, electrolytes, and cholesterol. With symptoms of anemia, indicators of serum iron, ferritin, transferrin are examined.
  • Hormonal studies. If persistently low blood pressure is detected, the level of thyroid hormones T3 and T4, the pituitary hormone TSH is necessarily measured. In the blood and urine, the concentration of catecholamines, steroid hormones of the adrenal glands, is determined. According to the indications, the level of insulin and C-peptide is assessed.
  • ECG. It is used as a screening method for assessing the electrical activity of the heart. If cardiac arrhythmias, signs of myocardial ischemia are found on the cardiogram, echocardiography is necessary. With echocardiography, the contractility of the heart is evaluated, anomalies in the structure are found.
  • Neurological examination. In the absence of other causes of low blood pressure, the patient is referred to a neurologist. To assess the work of the autonomic nervous system, the doctor conducts tests with holding the breath on inhalation and exhalation, orthostatic and clinostatic tests.


Help before diagnosis

With a clinic of low blood pressure, a person needs to lie down with his legs up. Windows must be opened to allow fresh air to enter. When feeling faint, the face and neck are rinsed with cool water. The patient is given to drink strong sweet tea or coffee, a caffeine tablet. With short-term hypotension, these actions are enough for the condition to normalize. If the condition worsens, urgent medical attention is required.


Medical therapy

The first step in the treatment of low blood pressure is the normalization of lifestyle, physical activity and nutrition. If the condition is caused by taking antihypertensive medications, the dose is adjusted or the drug is replaced. When selecting conservative measures, they proceed from the main cause of hypotension. For the treatment of low blood pressure, the following groups of drugs are used:

  • Iron preparations . They are prescribed for iron deficiency anemia in the form of oral or parenteral forms. With a reduced level of hemoglobin against the background of vitamin deficiency states, preparations of cyanocobalamin B12, folic acid are recommended.
  • Adaptogens . Medicines based on plant extracts are designed to increase the adaptive capacity of the body. They are effective in the physiological causes of low blood pressure and as an addition to the etiopathogenetic therapy of other types of hypotension.
  • Nootropics . Drugs are prescribed to eliminate cognitive impairment caused by chronic insufficiency of cerebral blood supply. To enhance the effect, nootropics are taken in combination with cerebroprotectors and antioxidants.
  • Adrenomimetics . Indicated for emergency care in shock conditions, accompanied by a sharp drop in blood pressure. Most often, hormonal drugs are administered - adrenaline, norepinephrine. In critical conditions, analeptics are also used.


If a patient has chronically low blood pressure, drug treatment is supplemented with physiotherapeutic methods. To improve compensatory capabilities, hydrotherapy is used - hydromassage, Charcot's shower, mineral baths. With neurological causes of hypotension, methods of electrosleep, electrophoresis of the collar zone are effective. With neurocirculatory dystonia and emotional lability, a course of psychotherapy, herbal medicine is recommended.

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