You’re standing up from the couch after a long Netflix binge. Suddenly, the room tilts. Your vision goes a bit grainy, like an old TV set, and you have to grab the armrest to keep from toppling over. Most people just call it a "headrush" and move on with their day. But if this happens a lot, you're likely dealing with hypotension. Understanding what to do if blood pressure is too low starts with realizing that "low" is a relative term in the medical world.
For some, a reading of $90/60$ mmHg is just their baseline. They feel fine. For others, that same number means they’re about to faint.
The heart is basically a pump. If the pressure in the pipes drops too low, the blood can't fight gravity to reach your brain. That’s the "why" behind the dizziness. It’s not just a quirk of your body; it’s a delivery failure. Honestly, doctors often ignore low blood pressure because they spend all day worrying about the "silent killer"—high blood pressure. But when you’re the one staring at the floor trying not to pass out, it feels pretty urgent.
The immediate "right now" fix
If you feel the world spinning right now, stop what you're doing. Sit down. Better yet, lie down and prop your feet up on a pillow. This uses gravity to help blood flow back toward your heart and brain. It sounds simple, but it’s the most effective way to prevent a fall-related injury. Drink a glass of water immediately. Dehydration is the most common culprit behind a sudden dip. When your blood volume drops because you haven't had enough fluids, your pressure tanks.
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Eat something salty. I know, we’ve been told for decades that salt is the enemy. But in the world of hypotension, salt is your best friend. A handful of pretzels or a bit of soy sauce can help pull water into your bloodstream, which increases your blood volume and raises your pressure.
Understanding why your numbers are tanking
Low blood pressure isn't a one-size-fits-all diagnosis. There’s orthostatic hypotension, which is that specific dizzy spell you get when you stand up too fast. Then there’s neurally mediated hypotension, which happens after you’ve been standing for a long time—like waiting in a long line at the grocery store. Your brain and heart stop communicating properly, and the brain basically tells the heart to slow down when it should be speeding up.
Postprandial hypotension is another weird one. This happens after you eat. After a big meal, your body sends a massive amount of blood to your digestive tract. In some people, the rest of the body doesn't compensate by constricting other blood vessels, so the brain gets left out in the cold.
Medications and hidden triggers
Sometimes the thing trying to help you is actually the problem. Beta-blockers, diuretics, and even certain antidepressants can cause your numbers to slide. If you’ve recently started a new prescription, that’s the first place to look. Even OTC stuff can be a factor.
Pregnancy is another big one. Because the circulatory system expands rapidly during the first 24 weeks of pregnancy, blood pressure often drops. It’s usually temporary, but it can make the first two trimesters feel like you're constantly walking on a boat.
Long-term strategies for what to do if blood pressure is too low
You can't just live on the floor with your legs up. You need a strategy.
First, look at your water intake. Not just "I drink some water," but actual, consistent hydration. We’re talking 2 to 3 liters a day for most adults. If you’re active or live in a hot climate, you need even more. Adding electrolytes—sodium, potassium, magnesium—is often more effective than plain water because it helps the cells actually hold onto the fluid.
Compression stockings are a literal life-saver for people with chronic low pressure. They aren't just for your grandma. These tight socks apply pressure to your lower legs, which prevents blood from "pooling" in your feet. This keeps the circulation moving upward. You can find 15-20 mmHg or 20-30 mmHg versions that look like regular athletic socks now.
Small habit shifts that matter
- Move your ankles. Before you get out of bed in the morning, pump your feet up and down. This "wakes up" your circulation before you challenge it by standing.
- Eat smaller meals. Instead of three massive meals, try five or six small ones. This prevents that "post-meal dip" by not overwhelming your digestive system.
- Watch the booze. Alcohol is a vasodilator, meaning it opens up your blood vessels. It also dehydrates you. That’s a double whammy for low blood pressure.
- Add salt purposefully. If your doctor has cleared it, keep a salt shaker handy. A little extra on your eggs or in your soup can make a massive difference in how you feel by mid-afternoon.
When should you actually worry?
Low blood pressure by itself isn't usually a medical emergency. But if it’s accompanied by "cold and clammy" skin, rapid breathing, or a weak, thready pulse, you might be heading into shock. That’s a different ballgame.
If you see someone who is confused or losing consciousness, that’s an ER visit. Chronic low pressure that leaves you fatigued or unable to focus also needs a professional look. It could be an underlying heart valve issue, an endocrine problem like Addison’s disease, or severe anemia.
The Mayo Clinic notes that while we focus on the $120/80$ ideal, many athletes and very fit people naturally sit much lower. The key is how you feel. If you’re at $95/65$ but you’ve got plenty of energy and don't get dizzy, you're probably fine. If you're at $105/70$ but feel like you're walking through molasses, something is wrong.
Getting a diagnosis that sticks
Don't just walk into the doctor and say "I feel dizzy." They’ll give you a pamphlet and tell you to drink more water. You need data.
Buy a home blood pressure cuff. Take your reading three times: once while lying down, once while sitting, and once after standing for three minutes. This is called a "tilt test" or "orthostatic vitals." If your systolic (top) number drops by more than $20$ points or your diastolic (bottom) number drops by more than $10$ points when you stand, you’ve given your doctor a clear map of what’s happening.
Sometimes, blood work is necessary to rule out vitamin $B_{12}$ deficiency or folate issues, which can cause low pressure by affecting your red blood cell count.
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Actionable steps to take today
- Start a log. Record your readings and what you were doing right before you felt symptomatic. Did you just eat? Did you just workout?
- Increase salt intake slowly. Don't go overboard and give yourself a headache, but start adding a bit more to your main meals.
- Check your supplements. Things like Vitamin B3 (Niacin) or even high doses of Garlic can lower blood pressure further.
- Buy the right socks. Order a pair of 15-20 mmHg compression socks and wear them for a full day. See if that "heavy leg" feeling goes away.
- Talk to your pharmacist. Ask if any of your current medications have "hypotension" or "syncope" listed as a common side effect.
Low blood pressure is manageable, but it requires a more proactive approach than high blood pressure because there isn't always a "magic pill" to fix it. It's about blood volume, vessel constriction, and lifestyle tweaks. Pay attention to the signals your body is sending when the room starts to tilt. It’s usually just asking for a little more salt and a lot more water.