Variety of factors can cause low blood pressure

My blood pressure drops to 111/49. I am 89 years of age. Should I be concerned?
- William
Like everything else in medicine, it depends. Assuming a patient is otherwise healthy and not having symptoms, no one would recommend treatment just to raise a number.
Many young or thin people, especially women, have quite low blood pressures which are perfectly normal for them.
But if you're feeling dizzy or have other symptoms that's a different story. Your doctor would then work out the cause of your low blood pressure, which could include anaemia, dehydration, infection or heart disease.
Among older patients, hypotension is frequently due to medication side effects, most often from blood-pressure pills working overtime.
If this is the case, your doctor can adjust your dose or even change medications. Often the first symptom is lightheadedness upon standing, caused by a transient drop in blood pressure.
Orthostatic, or postural, hypotension occurs because your body suddenly has to work much harder to deliver blood to the brain against the force of gravity. If this compensation takes your heart and blood vessels a moment too long, you'll get lightheaded from a lack of oxygen.
This is one process that can occur in young, perfectly healthy people as well as older people with significant medical conditions.
Of the younger healthy ones, most will never need any treatment beyond staying well hydrated and avoiding standing up too quickly.
As you can see, low blood pressure runs the gamut from completely benign to harbinger of serious disease.
It's not the low number that matters so much as what's causing it.
Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)