It is better to have blood pressure that is too low than too high. But low blood pressure can be a sign of a serious illness, sometimes even triggering a heart attack. FOCUS Online spoke to an expert about important symptoms, self-treatment and why medication can even be harmful.

High blood pressure damages the blood vessels, there is no question about that. It should be different with low blood pressure. The common opinion is that blood pressure cannot actually be low enough because it protects blood vessels and organs.

But that’s not entirely true, because in the case of low blood pressure, medical hypotension or hypotension, a distinction must be made “whether a healthy, young person is affected or someone who is ill or much older,” explains Robert HG Schwinger, chief physician at the medical clinic II at the Klinikum Weiden, member of the Bavarian heart attack network.

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According to the WHO, the ideal blood pressure values ​​are 120 to 80 mmHg. Doctors speak of low blood pressure when these values ​​are:

There are no exact figures on how many people are affected. “However, it is clear that there are significantly fewer people with low blood pressure than with high blood pressure,” adds the expert.

Because low blood pressure is not considered a disease. Countermeasures usually only need to be taken when symptoms appear.

Dizziness is one of the main signs of low blood pressure. In addition, there may be:

“If symptoms occur, you should have them checked out, regardless of whether you are young, old, sick or healthy,” advises the cardiologist.

Depending on the cause, low blood pressure is medically divided into different forms.

1. The primary, constitutional low blood pressure is simply a matter of type: Young, tall and very slim women who do not do any sport are particularly affected. There is no clear trigger for primary hypotension.

2. The situation is different with secondary low blood pressure, which occurs as a result of certain circumstances or illnesses. It is primarily lifestyle and stimulants that drive blood pressure down. “Above all, drinking too little – a major risk for seniors – leads to a loss of volume in the vessels and thus a drop in blood pressure,” says Robert Schwinger, naming an important reason.

High-dose blood pressure lowering drugs such as ACE inhibitors, sartans, beta blockers or calcium antagonists are also often the cause of hypotension.

3. Orthostatic hypotension is also listed medically as the third form of hypotension. Symptoms such as dizziness appear when standing up. The systolic blood pressure falls by more than 20 mmHg and/or the diastolic blood pressure by more than 10 mmHg within three minutes. When sitting or lying down, the symptoms disappear immediately. Background: Blood pressure drops when you get up and does not regulate itself as it normally does. The causes for this largely coincide with those of secondary hypotension.

But how dangerous is low blood pressure really? For young, healthy people, low blood pressure is more likely to indicate a good health prognosis because it hardly puts a strain on the organism. In addition, according to the expert, the blood pressure in this age group usually normalizes itself as they grow up.

It is different with older people. With them, the vascular tone and vasoreactivity are already limited. If the blood pressure is then too low, symptoms such as severe dizziness can occur, which can lead to a dangerous situation. “If an elderly person gets dizzy and stands in front of a staircase, for example, they can fall,” warns the professor.

Low blood pressure can also be dangerous for people who already have a cardiovascular disease such as coronary heart disease (narrowing of the coronary arteries). In the past, the doctrine was that their blood pressure should be lowered as much as possible with medication in order to protect their heart and blood vessels. Medicine today takes a more differentiated approach.

“If the blood pressure in patients with borderline coronary stenosis falls below 120 or even 110 mmHg, a heart attack can be triggered,” warns the expert. Excessive blood pressure reduction is therefore unfavorable in the elderly and people with cardiovascular diseases, which is now known from recent large studies.

An exception, however, is heart failure, i.e. when the heart muscle is weakened, adds the expert. If the vessels are normal and healthy, the blood pressure must be reduced to a large extent in this case in order to relieve the muscle. “Some patients then have values ​​below 100 mmHg and are symptom-free, so they don’t have dizziness and the like, because the body compensates for it,” he reports from practice. So there is no such thing as low blood pressure in the case of cardiac insufficiency.

Depending on the cause, there are different ways to normalize blood pressure. If an illness triggers the hypotension and this is treated, the blood pressure rises again. If antihypertensive drugs have been dosed too high, a slow reduction in medication under medical supervision can help.

Otherwise healthy people, both young and old, advise the cardiologist to take the following measures against low blood pressure:

It could also be a good idea to consume a little more of the blood pressure drivers salt and caffeine. Here, however, Robert Schwinger warns. Although salt would increase blood pressure, it would trigger a number of unfavorable processes in the body, such as increasing the risk of water retention. In addition, there are no solid studies that show a positive effect of increased salt consumption on low blood pressure. Within reason, there is nothing wrong with coffee.

And what about medication for low blood pressure? In pharmacies and on the Internet, there are plenty of prescription-free options available. Many of them are based on alpha sympathetics such as etilefrine. These active ingredients constrict the vessels and thus raise blood pressure. “Especially if you are older, you should not take these drugs without medical advice because they can cause blood pressure and heart rate to rise sharply,” warns the cardiologist. If there are critical constrictions in the coronary arteries, this can ultimately lead to a heart attack.

He also advises against herbal medicines for low blood pressure. “The notion that phytopharmaceuticals are always good and harmless is not true.” These drugs often contain a lot of alcohol and, not least because of this, could be taken with pleasure.

Conclusion: Of course it is important for health that everyone, whether young or old, checks their blood pressure. Values ​​below 110 mmHg should be checked by a doctor, especially if symptoms such as dizziness and others occur. Because low blood pressure is not always harmless. It can be triggered by an illness that requires treatment, lead to falls in the elderly and, last but not least, increase the risk of a heart attack in people with certain cardiovascular diseases.