Low Blood Pressure Can Be a Sign of Heart Disease

Azadeh Beheshtian | May 30, 2023

Throughout recent history, the discussion surrounding blood pressure has consistently been regarding the high blood pressure epidemic. This is, in part, thanks to the dangerous health ramifications of hypertension (high blood pressure); “organs and blood vessels can be damaged.” In addition, hypertension can result in the “rupture of a blood vessel and lead to bleeding or other complications.”  It is a commonly accepted fact that “within certain limits, the lower your blood pressure reading is, the better.” However, dangerously low blood pressure is also a cause for concern, as it has the potential to result in long-lasting health issues — namely heart disease.

Spotting the Warning Signs of Critically Low Blood Pressure

For many individuals, hypotension (low blood pressure) is no reason to worry — desirable, even. But for others, abnormally low blood pressure can manifest in a variety of health issues. The majority of medical professionals “will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms”. For this reason, it is crucial that individuals familiarize themselves with the warning signs of low blood pressure — all ranging in their severity — so that it may be treated properly and in a timely manner. Such symptoms may include dizziness, lightheadedness, fainting, blurred or fading vision, fatigue, nausea, lack of concentration, etc. In patients with more dire cases, “low blood pressure can be life-threatening.” Patients’ bodies may go into shock as a result of extreme hypotension, causing a weak or rapid pulse; rapid, shallow breathing; cold, clammy, pale skin; and confusion, especially in older individuals. People who encounter signs of shock are advised to immediately “seek emergency medical help.” Although most instances of low blood pressure merely necessitate routine examination to monitor readings, “it’s important to see your doctor if you have signs or symptoms of low blood pressure because they can point to more serious problems.”

A blood pressure reading is a quantified report of “the pushing of the blood against the artery walls” that occurs in conjunction with each heartbeat. According to the Mayo Clinic, a blood pressure reading is typically considered low if it is “lower than 90 millimeters of mercury (mm Hg) for the top number (systolic) or 60 mm Hg for the bottom number (diastolic)”. The systolic measurement is “the measurement of your blood pumping through your arteries when the ventricles of the heart squeeze,” while the diastolic measurement is “the measurement for the periods of rest”.

Heart Disease & Hypotension

Although each and every individual will, at some point in their lives, experience a drop in blood pressure for one reason or another, “certain conditions can cause prolonged periods of hypotension that can become dangerous if left untreated.” Unfortunately, there are several types of heart problems that may cause low blood pressure, in addition to other more widely associated symptoms of heart disease.

Low blood pressure may be a potential complication of the following heart conditions:

• An “abnormally low heart rate,” or bradycardia; generally, “for adults, a resting heart rate of fewer than 60 beats per minute (BPM) qualifies as bradycardia.”
• Heart valve disease; depends on which heart valve disease persists and the connection is still being studied. Specifically, “orthostatic hypotension is a commonly unrecognized mechanism responsible for some of the symptoms of mitral valve prolapse, particularly in patients affected by recurrent lightheadedness, dizziness, or syncope.”
• Heart attack; as a result, “blood flow to your heart is blocked or cut off completely.” Due to this, “the tissues that make up your heart muscle” can become stunned or killed — eventually “reduc[ing] the amount of blood your heart can pump to the rest of your body.” Moreover, heart attacks have the ability to set off a vasovagal response in the nervous system, which is the body’s “reaction to a trigger like extreme stress or pain.” In turn, this may cause low blood pressure or even fainting. Furthermore, a heart attack may prompt the body’s parasympathetic nervous system (PNS) “to go into overdrive, decreasing… blood pressure.”
• Heart failure; specifically in cases of “low output heart failure[, as it] is usually a sign of very advanced heart failure and is associated with a very poor prognosis.” Heart failure is a common result of prolonged low blood pressure. In a recent study, it was found that patients experience dips in blood pressure “on a regular basis are about 50% more likely to go on to have heart failure.” Although the exact cause of this link is not entirely clear-cut, some medical researchers believe that “orthostatic hypotension could be a sign of a buildup of plaque in the arteries, called atherosclerosis, which can lead to heart failure.”

As a consequence of the aforementioned medical issues, a patient’s “heart may not be able to circulate enough blood to meet your body’s needs,” provoking low blood pressure.

Treatment Methods

It is important to note that “a single lower-than-normal reading is not [a] cause for alarm unless you are experiencing any other symptoms or problems.” However, if a patient confronts symptoms associated with hypotension on a consistent basis, it is crucial to pursue timely and thorough treatment. An individual’s prescribed course of treatment will depend on the route cause of their hypotension, and “could include medications for heart disease, diabetes, or infection.” Each form of hypotension requires a different path of treatment. For instance:

• Neurally mediated hypotension, which typically results after prolonged periods of standing, is often treated through maintaining hydration. Taking a break, sitting down, and drinking water will usually cause low blood pressure to subside.
• Orthostatic hypotension, which affects patients of all ages and “is the drop in blood pressure that occurs when you transition from sitting or lying down to standing,” is typically treated with slow, small, gradual movements and keeping the legs uncrossed when sitting.
• Shock-induced hypotension, which is the most severe kind of hypotension, must be treated as soon as possible. In the most serious cases, “emergency personnel will give you fluids and possibly blood products to increase your blood pressure and stabilize your vital signs.”

Patients don’t have to address their low blood pressure concerns all on their own. Dr. Beheshtian is an interventional cardiologist who has treated over 1000 patients, in New York and elsewhere. She is extremely knowledgeable about treatment paths for various types of cases, mild or complex. Please feel free to contact Avicenna Cardiology’s office with any questions. Schedule a telehealth appointment or come in soon to see Dr. Beheshtian, who will work with you to create a care plan.