Optimal blood pressure is less than 120/80 (systolic/diastolic). In healthy people, low blood pressure without any symptoms is not usually a concern and does not need to be treated. But low blood pressure can be a sign of an underlying problem -- especially in the elderly -- where it may cause inadequate blood flow to the heart, brain, and other vital organs.
A sudden fall in blood pressure can be dangerous. A change of just 20 mm Hg — a drop from 110 systolic to 90 mm Hg systolic, for example — can cause dizziness and fainting when the brain fails to receive an adequate supply of blood. And big plunges, such as those caused by uncontrolled bleeding, severe infections or allergic reactions, can be life-threatening.
Some people may ask why doctors are lowering the threshold for high blood pressure, when it was already difficult for many patients to achieve the previous blood pressure targets of below 140 mm Hg/90 mm Hg, said Dr. Pamela B. Morris, a preventive cardiologist and chairwoman of the ACC's Prevention of Cardiovascular Disease Leadership Council. However, Morris said that the guidelines were changed because "we now have more precise estimates of the risk of [high] blood pressures," and these new guidelines really communicate that risk to patients. So, just because it's going to be difficult for people to achieve, "I don't think it's a reason not to communicate the risk to patients, and to empower them to make appropriate lifestyle modifications," Morris told Live Science.
Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
When blood pressure is not sufficient to deliver enough blood to the organs of the body, the organs do not work properly and can be temporarily or permanently damaged. Symptoms of low blood pressure caused by conditions or diseases depend upon the specific cause of the low blood pressure. For example, if insufficient blood flows to the brain, brain cells do not receive enough oxygen and nutrients, and a person can feel lightheaded, dizzy, or even faint.
Blood pressure rises with aging and the risk of becoming hypertensive in later life is considerable.[37] Several environmental factors influence blood pressure. High salt intake raises the blood pressure in salt sensitive individuals; lack of exercise, obesity, and depression[38] can play a role in individual cases. The possible roles of other factors such as caffeine consumption,[39] and vitamin D deficiency[40] are less clear. Insulin resistance, which is common in obesity and is a component of syndrome X (or the metabolic syndrome), is also thought to contribute to hypertension.[41] One review suggests that sugar may play an important role in hypertension and salt is just an innocent bystander.[42]
For example, in a hypertensive patient with asthma, it may be inadvisable to prescribe a beta blocker, as these drugs can aggravate that respiratory condition. Similarly, in patients prone to constipation (the elderly, for example) use of certain calcium channel blockers might best be avoided -- along with diuretics -- as both these classes of drugs can inhibit proper bowel function.
Early signs of pulmonary arterial hypertension can be related to the trouble you have getting blood to your lungs to get oxygenated. You might experience shortness of breath and a fast heart beat while doing activities that are otherwise routine, such as climbing stairs. You might also have chest pain, a reduced appetite, and pain in your chest or upper right portion of your abdomen.
This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.
One side effect of diuretics is a loss of potassium, which is carried out of the body in urine along with the sodium. Potassium is needed for proper muscular movement and a deficiency of this mineral can result in fatigue, weakness, leg cramps, and even problems with the heart. So often, patients on traditional diuretics will be advised to take their medication with a potassium-rich food, such as orange juice or a banana, or they'll be prescribed a potassium supplement.

Some forms of postural hypotension may require a test called a "tilt table" test. This test evaluates the body's reaction to changes in position. The person lies on a table, is safely strapped in, and the table is raised to an upright position for up to an hour. Blood pressure, heart rate, and symptoms are recorded. Often, medications are given to help guide treatment.

Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low a condition termed isolated systolic hypertension.[59] The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness, which typically accompanies aging and may be exacerbated by high blood pressure.[60]
Medications such as calcium channel blockers, beta blockers, and digoxin (Lanoxin) can slow the rate at which the heart contracts. Some elderly people are extremely sensitive to these medications since they are more likely to have diseased hearts and electrical conduction tissues. In some individuals, the heart rate can become dangerously slow even with small doses of these medications.

Health care providers measure blood pressure with a sphygmomanometer (sfig-mo-muh-NAH-muh-ter), which has a cuff that's wrapped around the upper arm and pumped up to create pressure. When the cuff is inflated, it squeezes a large artery in the arm, stopping the blood flow for a moment. Blood pressure is measured as air is gradually let out of the cuff, which allows blood to flow through the artery again.
In November, the American Heart Association and the American College of Cardiology issued new guidelines that change how high blood pressure, or hypertension, is diagnosed. Previously, it wasn’t until an adult’s blood pressure reached 140 mmHg or higher systolic (the top, or first, number) or 90 mmHg diastolic (the bottom, or second, number) or higher that high blood pressure was diagnosed. According to the new parameters, high blood pressure should be treated at 130/80 rather than 140/90, as that is the point when our risk for heart attack, stroke, and other consequences for hypertension almost doubles.
Researchers at the University of Melbourne and Macquarie University have uncovered unusual activity between neurons controlling breathing and blood pressure during the development of essential hypertension. Essential hypertension, which is high blood pressure with no known cause, affects 30% of the global population and is a major contributor to cardiovascular disease.
^ Martin-Cabezas, Rodrigo; Seelam, Narendra; Petit, Catherine; Agossa, Kévimy; Gaertner, Sébastien; Tenenbaum, Henri; Davideau, Jean-Luc; Huck, Olivier (October 2016). "Association between periodontitis and arterial hypertension: A systematic review and meta-analysis". American Heart Journal. 180: 98–112. doi:10.1016/j.ahj.2016.07.018. ISSN 1097-6744. PMID 27659888.
High blood pressure is the most common chronic medical problem prompting visits to primary health care providers in USA. The American Heart Association estimated the direct and indirect costs of high blood pressure in 2010 as $76.6 billion.[144] In the US 80% of people with hypertension are aware of their condition, 71% take some antihypertensive medication, but only 48% of people aware that they have hypertension adequately control it.[144] Adequate management of hypertension can be hampered by inadequacies in the diagnosis, treatment, or control of high blood pressure.[164] Health care providers face many obstacles to achieving blood pressure control, including resistance to taking multiple medications to reach blood pressure goals. People also face the challenges of adhering to medicine schedules and making lifestyle changes. Nonetheless, the achievement of blood pressure goals is possible, and most importantly, lowering blood pressure significantly reduces the risk of death due to heart disease and stroke, the development of other debilitating conditions, and the cost associated with advanced medical care.[165][166]
Health care providers measure blood pressure with a sphygmomanometer (sfig-mo-muh-NAH-muh-ter), which has a cuff that's wrapped around the upper arm and pumped up to create pressure. When the cuff is inflated, it squeezes a large artery in the arm, stopping the blood flow for a moment. Blood pressure is measured as air is gradually let out of the cuff, which allows blood to flow through the artery again.
Modern understanding of the cardiovascular system began with the work of physician William Harvey (1578–1657), who described the circulation of blood in his book "De motu cordis". The English clergyman Stephen Hales made the first published measurement of blood pressure in 1733.[152][153] However, hypertension as a clinical entity came into its own with the invention of the cuff-based sphygmomanometer by Scipione Riva-Rocci in 1896.[154] This allowed easy measurement of systolic pressure in the clinic. In 1905, Nikolai Korotkoff improved the technique by describing the Korotkoff sounds that are heard when the artery is ausculated with a stethoscope while the sphygmomanometer cuff is deflated.[153] This permitted systolic and diastolic pressure to be measured.
First-line medications for hypertension include thiazide-diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs).[13] These medications may be used alone or in combination (ACE inhibitors and ARBs are not recommended for use in combination); the latter option may serve to minimize counter-regulatory mechanisms that act to restore blood pressure values to pre-treatment levels.[13][129] Most people require more than one medication to control their hypertension.[111] Medications for blood pressure control should be implemented by a stepped care approach when target levels are not reached.[128]
tilt table test – usually recommended if your doctor suspects you might have orthostatic hypotension or NMH (During this diagnostic test, a person lies on a table and then the table is tilted to raise the upper part of their body. This simulates the change in position from sitting or lying down to standing up. People with orthostatic hypotension or NMH may feel dizzy, lightheaded, or even faint when their position changes.)
Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.
Vasovagal syncope can be treated with several types of drugs such as beta blockers, for example, propanolol (Inderal, Inderal LA) and selective serotonin reuptake inhibitors such as fluoxetine (Prozac), escitalopram oxalate (Lexapro), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and fluvoxamine (Luvox). Fludrocortisone (Florinef) (a drug that prevents dehydration by causing the kidney(s) to retain water) also may be used. A pacemaker can also be helpful when a patient fails drug therapy.
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