The Blood Pressure Problem Many Doctors Miss

You know that high blood pressure can be a threat to your health – endangering your heart, arteries, and your brain. High blood pressure can increase your risk of a heart attack, stroke, and even Alzheimer’s disease.

But there’s another blood pressure problem that often gets overlooked, and it can be just as dangerous: Blood pressure that’s too low.

Key Takeaways

Hidden Blood Pressure Problems

Certainly if you’re middle-aged or younger and have very high blood pressure it should be treated. However, take care not to lower blood pressure too aggressively with drugs, which can result in other health problems.

In fact, several medications of all kinds—not just blood pressure medications— are linked to low blood pressure, especially a condition called orthostatic hypotension.

Orthostatic Hypotension is a Common Drug Side Effect

Orthostatic hypotension happens when there’s a steep drop in blood pressure when you stand up from sitting or lying down. A drop in blood pressure from orthostatic hypotension can be so severe that you grow dizzy and may faint.

This condition can make you liable to fall and break a bone, a serious and potentially life-threatening consequence for older people. And according to research at Johns Hopkins, if you have orthostatic hypotension in middle age, you’re at increased risk of dementia later in life, perhaps decades later.¹

The Hopkins study involved more than 11,000 people, average age 54, whose health was tracked for an average of 25 years. The people who suffered from orthostatic hypotension at the beginning of the study were 54 percent more likely to eventually succumb to Alzheimer's and other types of dementia compared to folks without it.

"Measuring orthostatic hypotension in middle-age may be a new way to identify people who need to be carefully monitored for dementia or stroke," says researcher Andreea Rawlings. "More studies are needed to clarify what may be causing these links as well as to investigate possible prevention strategies."

What To Do About Orthostatic Hypotension

If you believe that you suffer from orthostatic hypotension, the first place to look is in your medicine cabinet. Reconsider any prescription drugs that you’re taking. Bring a list and ask your healthcare provider or pharmacist if one of your prescriptions could cause this problem—it frequently is.

Fortunately, according to experts, there are several natural ways to treat orthostatic hypotension. For example:²

• Wear compression stockings and/or abdominal bindings to keep blood from pooling in your legs.
• Drink more water and avoid alcohol. Some experts recommend drinking water rapidly during meals to avoid low blood pressure problems after the meal.
• Try taking vitamin B12. A B12 deficiency can cause orthostatic hypotension.
• Elevate the head of your bed.
• Avoid standing up too fast. And after you stand, pause for a moment to ensure that you can walk without difficulty.
• Don’t cross your legs when you are sitting.
• Eat more salt with your meals – but don’t go overboard.
  
• Get regular exercise but don’t exercise in hot, humid conditions.
• Pick things up off the floor by squatting. Don’t bend from the waist.

Low Blood Pressure Increases Death Risk

If you’re going to have an operation, a study in Germany shows that having low blood pressure is more of a health danger than having elevated blood pressure.

This study used data collected on more than 250,000 surgical patients in the United Kingdom. The analysis demonstrated that having systolic blood pressure (the top number) below 100 mmHg before the surgery increased the chances of dying by 40 percent. And if a patient’s diastolic pressure (the bottom number) was less than 40 mmHg, the risk of death was 2.5 times more likely. And blood pressure where both the systolic and diastolic pressures were low further increased the risk of death.³

Higher Blood Pressure? You’ll Live Longer

While this is not a popular opinion among conventional doctors, for older people, the research shows that there are serious questions about the effects of lowering blood pressure at all unless it’s very, very high.

According to the Centers for Disease Control (CDC), high blood pressure is anything over 130/80 mmHg, normal blood pressure is less than 120/80 mmHg, and low pressure is at 90/60 mmHg or lower.⁴

Researchers have raised some questions about the conventional blood pressure parameters, especially as you age.

A study in England that analyzed the health records of more than 400,000 people found that those aged 75 or older with blood pressure below 130/80 mmHg were more likely to die during the ten-year study than people with higher blood pressure.

In particular, people over age 75 who were considered “frail” had a 62 percent higher risk of dying if their blood pressure was less than 130/80 mmHg.

And contrary to what many conventional doctors might presume, the people in the study over the age of 85 who had high blood pressure experienced a lower rate of death compared to those with lower blood pressure – whether they were frail or not.⁵

Jane Masoli, the researcher who led the study at the University of Exeter, warns, "We need more research to ascertain whether aggressive blood pressure control is safe in older adults, and then for which patient groups there may be benefit, so we can move towards more personalized blood pressure management in older adults."

But she also says that, “We would not advise anyone to stop taking their medications unless guided by their doctor."

I agree with that advice, but for what it’s worth, I’ll tell you what I do. A famous alternative doctor advised people years ago not to worry about moderately high blood pressure, and – call me crazy – I believed him and acted accordingly. My top number is generally a bit over 140, and I don’t worry about it.

Getting Your Blood Pressure Numbers Just Right

I’ve always held the belief that slightly higher blood pressure is better blood pressure. I’m not one to take blood pressure medication just because my blood pressure has entered the range that doctors now say is “too high.” I believe following a healthy diet that limits processed foods and sugar, exercising regularly, and sleeping well is important for maintaining blood pressure that’s healthy for your heart.

That being said, some people benefit from medication if natural methods of reducing blood pressure fail them. As with everything, it depends on your unique health situation. So, no matter your age or health condition, you should check your blood pressure regularly, watch for changes, and work with an integrative doctor you trust to keep your blood pressure and heart healthy.

Summary

While high blood pressure is a well-known health risk, dangerously low blood pressure—often caused by overuse of medications or certain conditions—poses its own significant dangers. Orthostatic hypotension, a condition where blood pressure drops upon standing, is linked to falls, fractures, and even increased dementia risk. Research also shows that older adults with moderately higher blood pressure may actually live longer than those with overly aggressive blood pressure control. Personalized blood pressure management is essential, particularly for older individuals.

Frequently Asked Questions

What is orthostatic hypotension?

Why is low blood pressure dangerous?

Should older adults aim for lower blood pressure?

What are natural ways to manage low blood pressure?

Can medications cause low blood pressure?