December 4, 2020
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Low Blood Pressure in the Elderly

Low blood pressure in the elderly: Definition, causes, symptoms and how to prevent.

Model of human heart and textbook describing low blood pressure in the elderly


Low blood pressure, also known as hypotension is defined as a blood pressure below 90/60 mm Hg. If either systolic blood pressure (top number) is below 90 mm Hg or the diastolic (bottom number) blood pressure is below 60 mm Hg, it is considered a low blood pressure. This does not change with age, although risk of hypotension increases with age. Check out the chart for normal blood pressure by age and to learn about causes of and how to prevent hypertension with age. The Cleveland Clinic also has a good description of blood pressure, here.


  • Dehydration: The body loses water as a metabolic necessity. This water must be replaced. If not, you have a negative ratio that will lead to dehydration. Refer to these symptoms and causes of dehydration and how to combat this issue.
  • Medication: A side effect of medications that treat cardiac conditions including hypertension or high blood pressure is often low blood pressure. Be sure to let you physician know if you are experiencing low blood pressure while taking medications for hypertension.
  • Prolonged standing: As we age, venous return of blood to the heart becomes less efficient. This can result in hypotension with prolonged standing as gravity causes fluid to build up in the lower extremities. This will result in swelling of the feet and ankles.
  • Quick changes of position: Going from lying down to sitting up or sitting to standing can result in orthostatic hypotension or postural hypotension. This gets worse with age as our heart and arteries are less able to keep up with quick movements. This can be dangerous and lead to dizziness or even fainting. 
  • Medical complications: This includes thyroid issues, internal bleeding, severe infections or heart conditions.
  • Trauma: Significant bleeding or extensive burns will lead to loss of fluid in the body.
woman displaying confusion and blurry vision due to low blood pressure in the elderly


If you have low blood pressure, but do not have any of the symptoms listed below, you have asymptomatic hypotension. This is usually not treated because if the blood pressure was too low to get oxygen to the needed tissues such as brain cells and muscles, you would be having symptoms. Symptoms associated with low blood pressure include:

  • Dizziness, or feeling lightheaded or faint
  • Blurry vision
  • Increased thirst
  • Feeling weak
  • Increased fatigue
  • Nausea or vomiting
  • Confusion
  • Cold, clammy skin
  • Rapid breathing

If you or a loved one are having any of these symptoms, along with a systolic blood pressure below 90 mm Hg or a diastolic blood pressure below 60 mm Hg, contact your physician.


Often symptoms of hypotension appear with rapid movements from sitting to standing or laying to sitting. This orthostatic hypotension can often be prevented by taking a few deep breaths prior to movement, changing position slowly, and then taking a couple deep breaths once in the new position. This gives your vascular system enough time to catch up and sustain the blood flow to your brain preventing the dizziness or faintness that could otherwise occur. Another way to reduce symptoms of low blood pressure in the elderly is to drink more water and decrease alcohol and caffeine intake. Both alcohol and caffeine have a net negative effect on total hydration status. This is because your kidneys use water to flush them out of your system. Drinking water is the best way to improve hydration status. Eating fruits and veggies is another less effective but healthy way to improve dehydration.

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