Low blood pressure, also known as hypotension, is usually considered a sign of good health and low risk for cardiovascular disease. However, there are times when persistently low blood pressure or a sudden drop can be a sign of an underlying health issue that needs medical attention. Knowing when low blood pressure becomes a problem can help ensure timely intervention and proper care.

Blood pressure readings consist of two numbers:

Systolic pressure (the top number) indicates the pressure in your arteries when your heart pumps blood. Diastolic pressure (the bottom number) reflects the pressure in your arteries while your heart is resting between beats.

The normal reading is usually 120/80 mmHg or less. Hypotension is clinically defined as having blood pressure readings less than 90/60 mmHg. In some patients, low blood pressure will have no adverse health consequences and therefore does not need to be treated. In extreme cases, however, it can limit the flow of oxygen and nutrients to vital organs, resulting in potentially life-threatening complications, such as shock.

Causes of Low Blood Pressure

Hypotension can result from many factors. Some of the factors that cause hypotension are as follows:

• Insufficient fluid intake or excessive fluid loss can lead to decreased blood volume and hence hypotension.
• An injury or internal bleeding may result in hypotension. This happens because blood pressure becomes significantly reduced.
• Some hormonal changes along with the increased blood requirement during pregnancy also causes hypotension.
• Issues like heart failure or arrhythmias can impair blood circulation and result in low blood pressure.
• Certain drugs, including diuretics, antidepressants, and blood-pressure-lowering medications, can induce hypotension.

Symptoms of Hypotension

While low blood pressure may not always cause symptoms, it can sometimes be associated with:

- Dizziness or fainting

- Fatigue and weakness

- Blurred vision

- Nausea

- Confusion or difficulty concentrating

- Shallow breathing

- Palpitations

If the person experiences these symptoms, with the recorded blood pressure reading, the medical services have to be consulted.

Types of Low Blood Pressure

1. Orthostatic Hypotension: This is a kind of hypotension that appears as a result of decreased blood pressure when a person is standing up from lying down or sitting position and primarily affects elderly people.

2. Postprandial Hypotension: This is a drop in blood pressure after eating, more common in older people.

3. Neurally Mediated Hypotension: It is triggered by standing for long periods. This type can affect younger people and is associated with miscommunication between the brain and heart.

When Is Low Blood Pressure Dangerous?

There is no such thing as a universal threshold for very low blood pressure, but a blood pressure reading below 90/60 mmHg can be dangerous and require prompt medical assessment if accompanied by symptoms of fainting, confusion, or shortness of breath. Sudden falls in blood pressure may point to potentially serious underlying causes, which can include:

• Internal bleeding
• Sepsis (severe infection)
• Allergic reactions

Management and Treatment

Treatment of hypotension depends on its cause:

• Hydration Drinking more water can help against dehydration-related hypotension.
• Compression Stockings: These can improve circulation and reduce blood pooling in the lower limbs.
• Dietary Changes: Increasing salt intake under supervision can help increase blood pressure
• Medication Changes: The physician may need to reduce dosages of some medications or replace prescriptions.

For more severe cases, physicians might also administer fludrocortisone or midodrine to increase blood pressure. Shock from hypotension should be treated promptly to ensure proper function of organs.

Can Hypotension Cause Fatigue?

Chronic fatigue syndrome has also been associated with low blood pressure. Prolonged tiredness, despite adequate rest, may require reassessment of blood pressure levels. Fatigue secondary to hypotension will impact functionality and thus requires assessment and treatment of the cause.

When to Seek Medical Care

If your blood pressure readings are low consistently and without symptoms, you probably have nothing to worry about. If you do have symptoms like dizziness, fainting, or confusion, you need to go to the doctor. Blood pressure checks are usually conducted regularly. Once you are aware of your own normal baseline, you will know right away when there is something wrong.

Lifestyle Tips That Support Normal Blood Pressure

1. Other than directly treating hypotension, a healthy lifestyle overall would promote balanced blood pressure levels.
2. Exercise regularly; it promotes cardiovascular health and can help regulate blood pressure.
3. Focus on nutrient-dense foods rich in iron, B vitamins, and electrolytes to support circulatory health.
4. Excessive alcohol consumption dehydrates the body and lowers blood pressure.
5. Practices like yoga and meditation can help maintain a healthy blood pressure range.

Metformin has remained the safe and most effective first-line treatment for Type 2 diabetes for the last 60 years. The anti-diabetic drug has been known to work through the liver and gut to lower blood sugar levels and improve the way the body handles insulin.

However, a new study has, for the first time, shown that metformin probably works through the brain, and neurons in a specific region boost its anti-diabetic effects.

The findings open up potential for more targeted and effective diabetes therapies as well as for improving brain health.

The international team of researchers led by those at Baylor College of Medicine, in the US, decoded a brain-based pathway involved in metformin's ability to lower blood sugar.

They found that the widely used diabetes medication switches off a key protein and activates specific neurons, and lowers blood sugar through a previously hidden pathway.

"Metformin is not just working in the liver or the gut, it's also acting in the brain. We found that while the liver and intestines need high concentrations of the drug to respond, the brain reacts to much lower levels," said corresponding author Dr. Makoto Fukuda, associate professor of pediatrics - nutrition at Baylor.

Metformin: New Brain Pathway

The new study, published in Science Advances, targeted a small protein called Rap1 -- located in a brain region known as the ventromedial hypothalamus (VMH).

Mice studies proved that metformin fights blood sugar by suppressing the activity of Rap1 in VMH.

To prove the findings, the team deployed genetically engineered mice without Rap1 in the brain.

In mice with a high-fat diet that models type 2 diabetes, low doses of metformin did not improve their blood sugar levels.

On the contrary, when metformin was delivered in very small amounts directly into the brains of diabetic mice, it effectively lowered blood sugar levels.

Further, the team found that SF1 neurons located in the VMH are helping metformin to fight diabetes.

When the team measured the electrical activity of these neurons, they found that metformin’s activity increased only when Rap1 was present

The findings demonstrated that Rap1 is required for metformin to activate these brain cells and regulate blood sugar.

"This discovery changes how we think about metformin," Dr. Fukuda said.

Also read: Indian Drug Regulator Flagged 90 Combination Medicines Sold Without Approval

Metformin: Other benefits

Metformin has also shown potential to boost fertility levels in people with polycystic ovary syndrome (PCOS) -- a condition that affects how the ovaries work.

Metformin treats PCOS by lowering insulin and blood sugar levels. This can also improve ovulation and encourage regular periods.

Metformin has previously shown its potential for slowing brain aging and improve lifespan.

While metformin is safe for most adults and children aged 10 years and older, the drug may not suitable for some people. this includes people who:

• have ever had an allergic reaction to metformin or other medicine
• have uncontrolled diabetes
• have liver or kidney problems
• have a severe infection
• are being treated for heart failure or have recently had a heart attack.

Indians are facing an increasing burden of heart diseases, and mortality is rising faster compared to other countries. A top US cardiologist has now shared the major risk factors that range from genetics to obesity to pollution.

Cardiovascular diseases (CVDs) cause nearly 31 per cent of all deaths in India, according to the latest Sample Registration Survey (SRS) 2021-2023 data from the Registrar General of India, released in September 2025.

The SRS report highlighted cardiovascular diseases as the leading cause of death, especially among adults over 30.

Speaking exclusively to HealthandMe, Dr. Sripal Bangalore, Professor of Medicine at New York University School of Medicine, highlighted the key reasons why India is seeing a huge burden of heart diseases.

"I think it’s a combination of traditional and non-traditional risk factors. Globally, we are seeing the burden of obesity increasing, and specifically in India, genetic factors and non-traditional risk factors also play a role," Dr. Sripal said.

"There is a growing investigation into lipoprotein(a) and other causes of cardiovascular disease (in India). Obesity is a major risk factor, and I’m sure stress and pollution also add to it, with more and more data supporting these links," he added.

Data from the World Heart Federation showed that heart disease kills 28.6 lakh Indians every year. In the recent past, India has also been seeing a significantly higher rate of heart attacks and related deaths, even in children as young as 12 years old.

Also read: AHA’s New Dyslipidemia Guidelines Stress Early Screening, Lifestyle Management

What Factors Are Driving This Trend

"I think we need to know that part of it tends to be non-traditional, because in the Western world most of it is explainable by traditional risk factors like hypertension, diabetes, and hypercholesterolemia," Dr. Sripal said.

"What we see in India is that it is less about those risk factors, but more about non-traditional ones, including potentially genetic factors and lipoprotein(a)," the doctor added.

The Indian-origin interventional cardiologist also cited lifestyle factors such as stress and pollution that are significantly adding to the increased risk of cardiovascular events in the country.

AHA 2026 Cholesterol Guidelines: Relevance For India

Recently, the American Heart Association (AHA) released cholesterol guidelines, which stressed the importance of early screening, starting with teenagers.

The guidelines call for early intervention through early screening and healthy lifestyle changes, starting from childhood.

It recommends:

• Children (9-11 years): Cholesterol screening if never done before.
• Adults (30-79 years): Evaluate 10- and 30-year ASCVD risk to determine the need for early intervention

"India is a good example where LDL levels (bad cholesterol) may not be very high, like in the Western world. Many times, HDL cholesterol (good cholesterol) tends to be lower, and there are other risk factors, including lipoprotein(a), which seems to be elevated here," Dr. Sripal said.

How To Improve Heart Health

The doctor also explained whether overall diet quality matters more than just cholesterol intake.

"Diet adds to the totality of everything that we do, including increasing the risk of obesity. Cholesterol may explain some part of it, but having a heart-healthy diet is critically important," Dr. Sripal said.

The cardiologist highlighted the need to increase the intake of fruits and vegetables, as consuming natural foods is critically important.

Importantly, he also emphasized at least making sure that you have a lipid panel to check your cholesterol levels.

"We are assuming that you are staying healthy and not smoking. Checking blood pressure, it depends on your age, but at least once a year, checking your lipid panel would be critically important," Dr. Sripal told HealthandMe.

As a cardiologist, he shared that to boost heart health, the key is

• to make sure that you lead a healthy lifestyle,
• stay away from smoking,
• increase physical activity,
• reduce stress.

"Pollution is one factor, and I think we can all do our part to make sure that we don’t contribute more to environmental pollution," he noted.

While India’s Ministry of Environment, Forest, and Climate Change (MoEFCC) enforced a nationwide ban on identified single-use plastic (SUP) items from July 1, 2022, a new survey showed that violations continue to persist across major cities in the country, raising significant health and environmental risks.

The survey of 560 locations by Toxics Link -- an Indian environmental research and advocacy organization -- showed that 84 percent of sites across Delhi, Mumbai, Guwahati, and Bhubaneswar still use or sell banned plastic items.

Bhubaneswar recorded the highest availability of banned SUPs at 89 percent of survey locations, followed by Delhi at 86 percent, Mumbai at 85 percent, and Guwahati at 76 percent.

The survey noted that high use among street food vendors, juice shops, coconut water sellers, vegetable vendors, and ice cream parlours.

"The continued presence of banned plastic items in a majority of locations suggests that enforcement remains inconsistent,” said Ravi Agarwal, Director of Toxics Link.

“Unless implementation improves and the supply of these products is controlled, the ban will not effectively address plastic littering and pollution,” he added.

How Plastics Can Harm Your Body

Plastic carry bags, disposable plastic cutlery, cups, plates, and straws often contain chemicals like BPA and phthalates, which can interfere with the body’s hormonal balance.

BPA is an industrial chemical used to make certain plastics and resins, and its exposure has been linked to several health conditions, including an increased risk of high blood pressure.

Phthalates, another group of chemicals used to make plastics more flexible, have been found to disrupt the endocrine system, leading to potential health issues.

Also read: Your Kids’ Fast-fashion Clothing May Be Laced With High Levels of Toxic Lead

Studies have proven that BPA and phthalates can mimic the body’s hormones, particularly estrogen. This interference can disrupt the normal functioning of the cardiovascular system, leading to increased blood pressure.

Plastics also contain some highly toxic chemicals, such as flame retardants, per- and polyfluoroalkyl substances (PFAS), that can migrate into the environment and into human bodies.

According to a report by WWF, an average person could be ingesting approximately 5 grams of plastic every week.

Scientific studies have proven that the health effects of plastics include cancer or changing hormone activity (known as endocrine disruption), which can lead to reproductive, growth, and cognitive impairment.

Recent evidence also indicates that humans constantly inhale and ingest microplastics through contaminated seafood, including fish and shellfish.

In addition, microplastics have been found in tap water, bottled water, and even commonly consumed beverages, such as beer and salt.

How to Reduce the Disease Risks?

The UNDP urges individuals, organizations, and governments to work together to

• manage plastic waste,
• reduce plastic usage,
• transition to a more sustainable and resilient environment.

Other options include

• Opting for BPA-free and phthalate-free options
• Switching to reusable water bottles, plates, and cutlery made from glass, stainless steel, or other safe materials can significantly reduce exposure to harmful chemicals.
• Avoid exposing plastic bottles or lunch boxes to high temperatures, as heat can accelerate the leaching of chemicals into the water.