Blood pressure pills are meant to protect you, but they can be overdone, especially as people get older and the list of medications grows. Dizziness, weakness and feeling washed out may be signs that pressure is running too low rather than just signs of aging. Here is how to check, and what to ask at home and in the hospital. (Based on the insights of Dr. Suneel Dhand)
Key Takeaways
- Do not stop blood pressure pills randomly. Changes to medicine should be made with your doctor.
- Older adults can end up in a cascade of pills, with readings in the low 100s or 90s and symptoms such as dizziness and weakness.
- A home blood pressure machine lets you compare your readings with the doctor’s office.
- In hospital, orders to hold medication only below a threshold such as 100 can still allow pressure to drop 30 to 45 minutes after a dose.
- Family members can ask the nurse about current readings, the medications being given and the hold parameters.
First, a Warning About Stopping Pills
Do not stop your blood pressure medication on your own. The concern here is not about abandoning treatment. It is about making sure the treatment is not overdone, and that is a conversation to have with your doctor.
Overtreatment at Home
Many people, especially those over 65 or 70, end up on a growing list of pills. One medication leads to a side effect, which leads to another medication, and so on in a cascade. Blood pressure can end up running too low, with readings in the low 100s or even the 90s, and the person feels dizzy, weak and washed out. It is easy to blame age when the cause may be the medication.
The practical step is simple: get a home blood pressure machine and check your readings, including at times when you feel unwell. Then compare them with the numbers in the doctor’s office and bring the log to your appointment. If your pressure is consistently low and you have symptoms, ask whether your doses should be reviewed.
Overtreatment in the Hospital
The same problem can happen in hospital. Orders often say to “hold” a blood pressure medication only if the top number is below a set threshold, such as 100. A patient whose reading is 103 may still be given medication, and pressure can drop 30 to 45 minutes after a medication pass. For a frail or older patient, that drop can cause dizziness, falls and weakness.
Family members can speak up. It is reasonable to ask the nurse what the current reading is, which medications are being given and what the hold parameters are, and to ask that the doctor review them if the pressure is already low.
The Bigger Picture on Blood Pressure
Much of high blood pressure is linked to insulin resistance, and many people may be able to lower their pressure through lifestyle changes. Those changes work best when guided by your doctor, who can reduce medications safely as your numbers improve rather than leaving you on the same doses indefinitely.
The Bottom Line
Blood pressure that is too low can be as unsafe as pressure that is too high. Keep taking your medication as prescribed, track your own readings, notice dizziness and weakness, and ask your doctor or nurse whether the doses still fit your numbers.
Frequently Asked Questions
Should I stop my blood pressure medication if my readings are low?
No. Do not stop on your own. Track your readings at home, bring the log to your doctor and ask whether your doses should be reviewed.
What are signs that blood pressure may be too low?
Readings in the low 100s or 90s on top, together with dizziness, weakness or feeling washed out, especially in people over 65 or 70.
Why can blood pressure drop in the hospital?
Orders may only hold medication when the top number falls under a set value such as 100, so a reading of 103 can still lead to a dose, and pressure can drop 30 to 45 minutes later.
What can families ask the nurse?
What the current reading is, which blood pressure medications are being given and what the hold parameters are, and whether the doctor can review them if pressure is already low.
Blood Pressure Checklist
- ☐ Never stop blood pressure pills on your own
- ☐ Get a home blood pressure machine
- ☐ Log readings, especially when you feel dizzy or weak
- ☐ Compare home readings with the doctor’s office
- ☐ Bring the log to your next appointment and ask about your doses
- ☐ In hospital, ask the nurse about readings and hold parameters
This article is for general educational purposes and is not a substitute for personalized medical advice. Never stop or change a blood pressure medication on your own. Any change to your medicines should be made only with your doctor.