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Does Aggressive Treatment of Hypertension Lead to Low BP?

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Blood pressure is the pressure applied by flowing blood against the arterial walls, and in an average, healthy adult, it is maintained at 120/80 mm Hg. When your blood pressure is higher than this value, it’s hypertension. Hypertension or high blood pressure is a widely prevalent lifestyle disease that affects nearly 2/3rds of adults living in low and middle-income countries. It is a primary risk factor for heart failure, stroke, and heart attacks. Since hypertension does not cause any signs and symptoms in the early stages, it is termed the ‘silent killer.’

There are plenty of options for the treatment of hypertension. But many doctors avoid or are hesitant about prescribing aggressive treatment options as they feel it could lead to a dangerous drop in blood pressure levels. But, can aggressive treatment of hypertension cause a significant drop in blood pressure levels, bordering danger? Let’s take a look!

Debunking the Myth: Aggressive Hypertension Treatment Leads to Extremely Low BP?

Why Doctors are Hesitant

Most doctors use routine hypertensive drugs to optimise blood pressure levels among hypertensive patients. However, many doctors fear that treating their patient’s hypertension aggressively can result in symptoms like lightheadedness, weakness, or fatigue. These may be more pronounced in older patients and increase their risk for injury or disability.

Many doctors also believe that aggressively treating hypertension aggravates orthostatic hypotension in people. Orthostatic hypotension is the sudden lowering of blood pressure when someone moves from a sleeping or sitting posture to a standing position. We may all have experienced this form of sudden, short-lived low blood pressure characterised by light dizziness or blacking out for a few seconds. But, it is never dangerous.

How Aggressive Treatment Can Prove Beneficial

Contrary to popular belief, aggressive treatment for hypertension can be beneficial for patients. A recent study published in the Annals of Internal Medicine studied over 18,000 participants to determine if aggressive hypertensive therapy can lead to a dangerous drop in blood pressure levels. The study found that intensive blood pressure lowering was not associated with orthostatic hypotension.

After evaluating multiple clinical trials, it was found that hypertension treatments that lower the systolic blood pressure between 120 and 124mm Hg provided the most significant benefits to patients compared to those which did not reduce the blood pressure this low.

One study found that people who achieved and maintained their blood pressure levels between 120mm and 124 mm Hg were 40% less likely to die than those who maintained a blood pressure range of 140-144 mm Hg. Therefore, based on the existing studies and research, it is recommended that hypertensive patients over the age of 60 should achieve and maintain their blood pressure levels below 150 mm Hg.

Maintaining Ideal Blood Pressure Levels

With a growing number of hypertensive cases, we must strive hard to reduce our risk of developing the condition, even among young adults. If you have been diagnosed with hypertension, you must work with your doctor to bring down your levels and maintain them within the normal range. One of the most important things to do to maintain ideal blood pressure levels is to monitor them regularly and treat the condition promptly.

Here are some ways that can help you maintain healthy blood pressure levels:

  • Weight loss and maintaining a healthy BMI
  • Regular exercises (include cardio and strength training)
  • Follow a DASH diet (Rich in fresh fruits, vegetables, whole grains, nuts, and seeds)
  • Reduce sodium consumption (sodium is known to increase water retention in the body, which raises blood pressure levels)
  • Limit alcohol intake
  • Work on portion control during each meal
  • Beat stress with meditation, yoga, mindfulness
  • Quit smoking (it can increase your risk for other cardiovascular diseases)

If you are on hypertensive medications, take them as prescribed by your doctor while making healthy lifestyle changes mentioned above.


Though hypertension can be a dangerous health condition that increases your risk for severe, potentially fatal cardiovascular diseases, it is possible to manage it with suitable measures. Also, studies have proved that treating hypertension aggressively is not one of the reasons for low BP.

Though there is sufficient data to prove this, researchers believe further studies are needed to establish the same. Your doctor will evaluate your hypertension and find the best possible medications to help you lower and maintain your blood pressure levels within normal limits without worrying about orthostatic hypotension. If you are experiencing random hypotension, your doctor will determine the reasons for your blood pressure drop.

Read more about hypertension and how to manage it on BPinControl!

Note of caution: This article is for information purposes only. Always consult your doctor before altering any diet plans, medications or in case of any other blood pressure-related troubles.

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Very useful information

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