A woman bites her nails while she takes her blood pressure with an arm cuff.

My Blood Pressure Is so Low! Am I Dying?

You just started meds and were told to take your vitals daily. Your meds include beta-blockers and ace inhibitors. Your blood pressure seems low at 80/60 – are you dying?

Why is it so low?

I’ll never forget the week after I had left the hospital after a frightening and unexpected heart attack at age 42. I had been discharged with a lot of medications and was told to make sure I took all of them. Also given to me were instructions to monitor all of my vitals every day. I didn’t even own a scale, much less a blood pressure cuff.

Every day I did as instructed – I obsessively took my blood pressure, heart rate, and weight. I immediately noticed that my blood pressure was dropping and dropping fast. With this drop, I felt exhausted, hardly able to move. I started to freak out when it hit 90/60. Was I dying? Why is it so low?

That was reassuring

Before my heart attack, I didn’t even have a primary care physician. Leaving the hospital, I felt alone – who do you call? Ghostbusters? No! So I called the after-hours number I was given by the interventional cardiologist who treated me the week prior. Someone called back, someone who wasn’t my doctor and someone who didn’t seem to care. As they were explaining everything, this ‘someone’ couldn’t understand why I was freaking out. He said, “well, just take half of your beta-blocker,” I said, “Is that ok, or will I die?” He said I’d be fine and hung up. That was reassuring. I freaked out, which luckily raised my numbers a bit.

A new cardiologist

Months later, I had switched cardiologists. At the end of our first visit, she asked how I was doing mentally. I responded, “not well,” and I told her I thought I was dying all the time because both my heart rate and blood pressure were so unusually low. She then took the time to explain the medications and her strategy in treating me.

She calmly and methodically explained the drugs I was taking and that she wanted to get my heart rate and blood pressure as low as possible while I could still function. My heart was weak, and this was the way to make it work less while optimizing the blood output with each beat. That made sense to me, and I finally got why my vitals were dropping as they were. It also explained why I felt awful – incredible and sometimes unbearable fatigue.

Working effects and side effects

We are all given a lot of information after diagnosis, and it can be incredibly overwhelming. While I learned about all the medications from the hospital and during cardiac rehab sessions, I never really understood the effects they would have on my body. I had confused “working effects” with “side effects.” The “working effect” was that my blood pressure and heart rate would drop. The “side effects” was that I’d feel lousy. Understanding both of these effects helped put my mind at ease.

It also helped when some medications are changed – I know that my vitals will drop again, and I’d have to take some time to acclimate. I now let my cardiologist understand how I am managing and feeling with my medications at each visit. Often she will change the dosage and or timing so that I can function better.

Tips for the newly diagnosed

Here are some tips for the newly diagnosed:

  1. Understand your medication and what “working effects" and what "side effects" they will have on you.
  2. Ask your doctor what their strategy is – most will try to reduce your heart rate and blood pressure as low as it can go while you can still function.  Everyone is different, so ask your doctor about your condition.
  3. Make sure you tell your doctor if you are not feeling well. Sometimes they can change the medication doses or timing to help you acclimate and lead a better quality life.

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