If your blood pressure drops below 115, is it too low, should you reduce the dosage?

Mondo Health Updated on 2024-01-31

A friend who suffers from high blood pressure told Huazi that his recent blood pressure has been around 115 65mmHg, is it too low?He wanted to reduce the dosage of the medicine, but he couldn't make up his mind.

Huazi's advice to him was that if he did not have symptoms of low blood pressure such as dizziness, palpitations, or blackness in front of his eyes, he did not need to reduce the dosage. Because long-term maintenance of lower blood pressure has a good impact on health, and the prevention of cardiovascular and cerebrovascular diseases will be better.

1. What should be normal blood pressure?

Many people with high blood pressure think that it is enough to control the blood pressure below 140 90mmHg, and the blood pressure should not be lower than this value too much, otherwise it will affect the blood supply to the organs. But in fact, 140 90mmHg is only the diagnostic standard for hypertension in China, not a normal blood pressure value.

In the Chinese Guidelines for the Prevention and Treatment of Hypertension, normal blood pressure is defined as systolic blood pressure (hypertension) less than 120 mmHg and diastolic blood pressure (low pressure) less than 80 mmHg.

A systolic blood pressure of 120 139 mmHg and a diastolic blood pressure of 80 89 mmHg are the normal high values of blood pressure, and although it is not considered high blood pressure, it still increases the risk of disease.

Second, lower blood pressure is better.

In related studies, people with a blood pressure control of 135 85 mmHg had a double higher risk of cardiovascular and cerebrovascular disease after 10 years than those with a blood pressure control of 115 75 mmHg. In other words, as long as the blood supply to important organs such as the heart, brain, and kidneys can be maintained, then the blood pressure is as low as possible, and the protection of these organs will be better.

However, if the systolic blood pressure is less than 110mmHg, the diastolic blood pressure is less than 60mmHg, or if there is dizziness, fatigue, palpitations, blackness and other hypotension, it is recommended to reduce the dosage of antihypertensive drugs, maintain a slightly higher blood pressure, and avoid dysfunction of vital organs due to insufficient blood supply.

Third, the control of blood pressure in the elderly should be individualized.

Older people have a high degree of arteriosclerosis, so blood pressure is characterized by an increase in systolic blood pressure, a constant or decrease in diastolic blood pressure, and an increase in pulse pressure. In several studies, the vast majority of older adults tolerate lower diastolic blood pressure well, so for older adults, as long as the diastolic blood pressure is above 50 mmHg, there is generally no need to reduce medications.

The effect of antihypertensive drugs on low blood pressure is weak, so there is still a view that the elderly can ignore diastolic blood pressure and only control systolic blood pressure to reach the standard, and if there are no symptoms of hypotension, they should maintain medication and keep blood pressure low for a long time.

However, most older people have underlying medical conditions and varying degrees of arterial stenosis, so blood pressure needs to be individualized. Ideally, the goal is to control systolic blood pressure below 130 mmHgIf it can be tolerated, it should be controlled to less than 120mmHg;If it is not tolerated, then 140 mmHg or 150 mmHg is acceptable.

Fourth, things to pay attention to when lowering blood pressure**.

Start with small, low-intensity antihypertensive drugs** and gradually adjust the intensity**. The rush to lower blood pressure and achieve the target is the main cause of ** failure and adverse drug reactions. The vast majority of hypertensive patients, as long as they have enough patience to gradually adjust their medications, can basically achieve the control target of 130 80mmHg.

Orthostatic hypotension is at risk at the beginning of antihypertensive drugs and when the antihypertensive drugs are adjusted, especially in older people. Therefore, when using antihypertensive drugs, pay attention to slow movements when switching from lying down, sitting, squatting and other postures to a standing position to prevent orthostatic hypotension from causing falls.

Many antihypertensive drugs can affect electrolyte metabolism, and the elderly are also prone to electrolyte disorders, so pay attention to electrolyte levels during medication. When using drugs such as pril, sartan, and diuretics, special attention should be paid to the condition of potassium in the blood.

To sum up, if your blood pressure drops below 115mmHg, as long as you don't have symptoms of low blood pressure such as dizziness, fatigue, palpitations, and blackness in front of your eyes, it is not too low. Slightly lower blood pressure has a stronger preventive effect on cardiovascular and cerebrovascular diseases, but it is not recommended for the elderly to have blood pressure lower than 110mmHg.

Antihypertensive drugs should be used under the guidance of a doctor, and if you have any doubts about the medication, please consult a doctor or pharmacist. I am Pharmacist Huazi, welcome to follow me and share more health knowledge.

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