Low Blood Pressure (Hypotension)

Do you know the feeling of having trouble getting going in the morning and not feeling rested despite a good night's sleep? During the day you feel weak, sometimes you get dizzy after standing for a long time and you tend to have cold hands and feet. All of these complaints can point to low blood pressure. A blood pressure measurement provides clarity: if it shows a value below 100/60 mmHg in women or below 110/70 mmHg in men, this is considered low blood pressure. Low blood pressure, also known by the medical term hypotension, is usually not dangerous. In Germany about five percent of the population is thought to have low blood pressure. Because hypotension is seen as a separate condition mainly in Germany, it is sometimes jokingly called the "German disease" abroad. That shouldn't distract from the fact that low blood pressure can be a sign of another illness.

In medicine, the different forms of low blood pressure are classified first according to how long they last as chronic or acute hypotension. Secondly, a distinction is made between primary and secondary hypotension. The primary form has no clear cause. Young, slim people, particularly women, are most commonly affected, so physical constitution may be a possible cause. A hereditary predisposition also plays a role, but infections can temporarily cause low blood pressure as well. Medications, severe fluid loss or lack of salt can also be responsible. By contrast, secondary hypotension is always caused by an underlying disease, for example a cardiovascular disease or an underactive thyroid.

Orthostatic hypotension

Orthostatic hypotension refers to a drop in blood pressure when changing position to an upright, standing posture. Because of gravity, when you stand up, blood briefly pools in the legs and trunk, blood return to the heart through the veins is reduced and blood pressure falls. This process is normal and is usually corrected by the body very quickly, so it is not noticed at all. If orthostatic hypotension is present, however, blood pressure drops rapidly. It is defined as a drop in systolic blood pressure of more than 20 mmHg, diastolic blood pressure of more than 10 mmHg, or both. The affected person looks pale, feels dizzy or light-headed and may, for example, have blurred vision. Syncope, meaning a brief loss of consciousness, is possible and can lead to falls. Lying down and, if necessary, elevating the legs quickly improves the symptoms.
Orthostatic hypotension occurs in both acute and chronic forms, especially in older people who have not had enough fluids or who have been on bed rest for a long time. Medications can also be the cause, as can age-related changes in blood pressure regulation or diseases such as a disorder of the autonomic nervous system known as autonomic dysfunction. A meal that is perhaps too large can also be a cause, because after eating, blood flow to the digestive tract increases and blood may effectively be "missing" elsewhere. It is, of course, not completely gone, but is, so to speak, being used for another purpose.

Orthostatic hypertension in people with high blood pressure

It is very interesting that orthostatic hypotension, as well as low blood pressure while standing, can also occur in people with high blood pressure. Until now, this has often led to blood pressure tablets being discontinued even when the affected person had no symptoms. However, a new analysis of several studies on this subject shows that these patients also benefit from treatment for high blood pressure, even from more intensive treatment, because it reduces their risk, due to high blood pressure, of developing cardiovascular disease or even dying.

Symptoms of low blood pressure (hypotension)

The symptoms that occur with low blood pressure can vary from person to person. In general, they are caused by the brain receiving too little blood. This can show up as difficulty concentrating, tiredness, exhaustion and depressive moods. You may also feel unusually cold, have reduced performance and trouble sleeping. More often, the reduced blood supply to the brain causes episodes of dizziness - especially after standing for a long time or after a sudden change of position. Sometimes this can even lead to fainting or loss of consciousness. Sultry, warm weather can also worsen the symptoms. Unlike high blood pressure, low blood pressure does not have a negative effect on the vascular system. In fact, the opposite is true: with hypotension the arteries and veins stay younger in the long run, helping to prevent stroke, heart attack or atherosclerosis. Despite this positive balance, the symptoms caused by low blood pressure can still be unpleasant for those affected. If there is no underlying disease, the symptoms can often be effectively relieved by some lifestyle changes.

What can I do myself about low blood pressure?

The most important tip-especially if you get dizzy or have symptoms when you stand up-is to do it slowly. While still lying in bed in the morning, do some movement exercises such as pointing and flexing your toes, circling your feet, and straightening and bending your legs to get the muscle pump going. Sit up in bed or on the edge of the bed for a while before you stand up. Also, when you straighten up from a bent-over or crouching position, do so slowly.
Keeping the head of the bed slightly elevated (about 20 percent) helps reduce blood flow to the kidneys and urine output at night, which in turn leads to fewer blood pressure fluctuations in the morning.
Alternating hot and cold showers in the morning get the circulation going and train the venous system. If the idea of a cold shower is too daunting, simply alternate warm and cold water on your legs up to your buttocks. Caution: If you have heart or venous disease, please ask your doctor whether alternating hot and cold showers are suitable for you.
Massages, such as brush massages, also increase circulation and thus help relieve symptoms.
If you have varicose veins, wearing compression stockings helps.
Exercise also helps with symptoms of low blood pressure. Walk more often or use a bike for errands. Although this does not raise blood pressure in the long term, it can help improve symptoms.
To ensure sufficient blood volume in the circulatory system and keep blood pressure stable, make sure you drink enough. Two to three liters of sodium-rich mineral water, tea, or juice spritzers are recommended. Caffeine or sparkling wine, as sometimes recommended, only raises blood pressure for a short time.
Diet also plays an important role. Large meals should be avoided because they draw blood into the abdomen at the expense of the brain. Instead, several small portions spread throughout the day are preferable. Contrary to the recommendation for high blood pressure, people with low blood pressure may consume a little more salt, since salt helps the body retain water and can thus raise blood pressure.

Only in a few cases is it necessary to prescribe medications that raise blood pressure. Options include drugs that constrict the blood vessels or medications that increase the fluid volume in the circulation.

Note: At Tensana.app, we always use the cutoff of 105/65 for low blood pressure (hypotension) when needed. Otherwise, we would have to label low values as "optimal" according to the hypertension scale.

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This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.

Low Blood Pressure (Hypotension)

Orthostatic hypotension

What can I do myself about low blood pressure?

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