Very low blood pressure

Posted by roosterry @roosterry, Aug 18 12:36pm

Am 80, history of heart and artery disease, now have heart failure, came home from hospital with blood pressure lowering meds, but I find daily my bp is about 90/44 pulse 50 It has been like that for over two weeks, I want to know how low is too low, and perhaps I should try to see doctor again, but usually takes many weeks. Anyone have info on low bp Thanks, first time on!!!

Interested in more discussions like this? Go to the Heart & Blood Health group.

Welcome to Mayo Connect. We are a community of people living with a variety of challenges, but are not medical professionals so we cannot diagnose, only to share our own experiences.

The blood pressure you report is definitely low, but not knowing your history or medications, I cannot say how critical this is for you. Please at least telephone the doctor and report your symptoms. If that is not possible, please visit an Urgency Center or Emergency Department. When you do go in person, be sure to take your blood pressure unit with you, so they can compare the readings you are getting with their frequently calibrated machine.

Are you able to contact the doctor or his staff by phone?
Sue

REPLY

Thank you, we are having a terrible medical problem here in British Columbia, Canada. Severe shortage of doctors, many thousands of folks who do not have a primary care doctor, and clinics so overbooked it is almost impossible to get in. Am seeing my cardiologist but not till Sept 20 when he is back. I find the local ladies in our heart pharmacy to be extremely knowledgeable about drugs, interactions, etc, and have many times questioned doctors prescriptions, always coming out as being right…so I will see them today….I am not doing very much, as have been told to basically not to pick up, or do anything….Thank you for replying. Terry

REPLY

How Low Should You Go? *******
Lower is not necessarily better when it comes to blood pressure. A 2013 study published in the journal JAMA Neurology found that people with heart disease or stroke who had lower-than-normal blood pressure (in which the bottom, or diastolic, number was less than or equal to 70 mm Hg) were more likely to show changes in the brain that can affect cognition and memory. National guidelines recommend people with hypertension who are 60 and older aim for a goal of less than 150/90 mm Hg, while those ages 30 through 59 aim for a diastolic goal of less than 90 mm Hg. Younger people should aim for a goal of less than 140/90 mm Hg. Consult with your doctor about the best target for you.
Abstract
Isolated systolic hypertension is predominantly observed in the elderly because of increased arterial stiffness. Aggressive treatment leads to excessive lowering of diastolic blood pressure and favors the presence of a J-shaped curve association with mortality. We investigated whether, in the elderly, this pattern of association is a simple epiphenomenon of increased arterial stiffness and impaired cardiac function. In a cohort of 331 hospitalized subjects >70 years old (mean age±SD: 85±7 years), aortic pulse wave velocity and pressure wave reflections, by pulse wave analysis, and cardiac function, by ultrasound, were assessed. During a 2-year follow-up period, 110 subjects died. No association of prognosis with systolic pressure, pulse pressure, or pulse wave velocity was observed. A J-shaped association between diastolic pressure and overall and cardiovascular mortality was observed. Unadjusted Cox regression analysis showed that patients in the first tertile of diastolic pressure (≤60 mm Hg) had higher mortality. In Cox regression analysis, diastolic pressure ≤60 mm Hg was a predictor of mortality independently from cardiac–vascular properties, cardiovascular risk factors, and drug treatment. Multivariate regression analysis showed that increased age and low total peripheral resistance, but not left ventricular function, were the cardinal determinants of low diastolic pressure. An “optimal” diastolic pressure of 70 mm Hg in subjects with isolated systolic hypertension was found. We showed that, in the frail elderly, a value of diastolic blood pressure ≤60 mm Hg is associated with reduced survival, independent from large artery stiffness and left ventricular function, suggesting that more rational antihypertensive therapy, not only based on systolic pressure level, is needed.
The goal of antihypertensive treatment is to prevent cardiovascular (CV) complications through the reduction of systolic (SBP) and diastolic blood pressure (DBP). However, since the primary work of Cruickshank et al,1 several reports, but not all, have shown that, in hypertensive subjects treated with drugs, low DBP is frequently associated with increased mortality (reviewed in Reference 2). This finding was constantly difficult to evaluate. First, it is difficult in epidemiological studies to assess a J- or U-shaped association with mortality, and it is often easier, using a semilogarithmic scale, to show a linear relation between DBP and mortality. Second, in humans, the decrease of DBP is the consequence of both the aging process3 and the result of drug treatment, making the net drug effect quite difficult to define. Finally it should be noted that isolated systolic hypertension is difficult to treat and, therefore, aggressive treatment may lead to excessive lowering of diastolic blood pressure and that, in the oldest old, treating high SBP is not always related to reduced overall mortality.3–6
Guichard and Ali Ahmed, M.D., then a professor of medicine in UAB’s Division of Gerontology, Geriatrics and Palliative Care
That paper coined a new term, “isolated diastolic hypotension,” which refers to a low diastolic blood pressure (less than 60 mm Hg) and a normal systolic pressure (above 100 mm Hg). Older adults who fit those conditions are at increased risk for developing new-onset heart failure, the researchers found.
“High blood pressure is a problem, but low blood pressure is also a problem,” Guichard said. That realization helped drive a 2014 decision by the panel members appointed to the Eighth Joint National Committee (JNC 8) to relax target blood pressure guidelines for those over 60 years old. [Read Guichard's take on "ideal blood pressure" and the new guidelines in this blog post.]

REPLY

Hello i am going on 54 & i have SVT & POTS along with low blood pressure, hoping for it not to go to heart failure ever, sorry to hear u deal with heart failure, best wishes for u to get better!!

REPLY
Please sign in or register to post a reply.
  Request Appointment