Robin Backlund, BHSc
A blood pressure of 49/46 indicates that you have SEVERE HYPOTENSION, or extremely low blood pressure, although it is not officially classified by American Heart Association.
Such a critical reading necessitates immediate medical attention or possibly hospitalization, applicable to all—children, adults, the elderly, and pregnant individuals.
If left untreated, it can lead to serious health repercussions like organ failure or impaired oxygen delivery to the body.
It’s important to note that ‘ideal’ blood pressure may vary, influenced by age, gender, weight, and overall health, and individual medical history and current health conditions must be considered.
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What does a 49 over 46 (49/46) blood pressure mean?
A blood pressure reading of 49/46 mmHg signifies the presence of severe hypotension, a critical medical condition requiring immediate attention.
Clinically, this state is managed by administering medication that diminishes the contractility of blood vessels, aiding in the restoration of stable blood pressure.
Severe hypotension is diagnosed when blood pressure readings fall below 80/60, posing a life-threatening risk if it further decreases to below 50/35.
Here is a blood pressure chart according to the latest guidelines of American Heart Association (AHA).
mm Hg [upper #]
mm Hg [lower #]
Less than 80
Less than 50
Less than 90
Less than 60
Less than 120
Less than 80
Less than 80
Hypertension STAGE 1
Hypertension STAGE 2
140 or higher
90 or higher
Consult your doctor immediately
Higher than 180
Higher than 120
A study published in Aging Mental Health reported that approximately 30% of the senior population may be experiencing hypotension.1
The optimal blood pressure range for an individual is between [90/60] and [120/80]. A reading below this range typically indicates hypotension.
In instances of severe hypotension, the heart struggles to circulate blood throughout the body. While some organs can withstand this temporary deprivation, the human brain is particularly vulnerable, unable to survive without oxygen for more than four minutes.
It is imperative to understand that while low blood pressure is concerning, severe hypotension is a medical emergency that necessitates immediate reporting to a healthcare professional.
In some scenarios, severe low blood pressure may also indicate additional clinical complications such as organ damage or internal bleeding, underscoring the importance of prompt medical intervention.
Individuals experiencing severe hypotension will likely encounter distinct physiological symptoms, prompting them to seek medical assistance. If your blood pressure is at 49/46 mm/Hg, you may experience the following symptoms:
- Profound confusion
- Loss of balance
- Nausea, dizziness, and fainting
- Weak pulse
- Blurred vision
- Pallor and cool skin
- Impaired concentration or peripheral awareness
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What should you do if you have 49 over 46 (49/46) blood pressure?
Here is a set-by-step procedure to follow when you figure out you have a blood pressure of 49/46.
1. Consult your doctor for accurate blood pressure reading
If your blood is 49/46 and you have checked the same in your home setup, it is highly recommended to get it checked at your doctor’s office.
A trained professional has to clinically assess your condition and confirm that your 49/46 is, in fact, clinically valid.
There are instances when your reading at home setup might give you a reading which is incorrectly reported. It could be because of an error in reading it, damage to your device, your physical or mental condition on that particular day, etc.
Therefore, a doctor has to assess it over the course of 7 – 30 days periodically before he/she can confirm the accurate stage of your blood pressure.
In a study from the Aristotle University of Thessaloniki, researchers found something interesting about blood pressure readings.
Sometimes, when people are at the doctor’s office, their blood pressure reads high, but it’s normal when they check it elsewhere. They call this white coat hypertension.
On the flip side, some folks show normal readings at the doctor’s but have high readings at home or other places. This is known as masked hypertension. 2
All these conditions are linked to physiology and psychology and, therefore, better to be validated by a doctor.
2. Adopt these lifestyle changes to regulate your blood pressure
If you think you have severe hypotension, the first and foremost thing is to get in touch with your local medical care facility.
Since confusion and vertigo may happen, it is advised not to drive yourself to the hospital.
Unless your blood pressure hasn’t dipped to dangerous levels, you may make reasonable changes in your lifestyle to improve your blood pressure to a significant level.
According to a review from P&T Journal, here are some of the changes that you can bring into your lifestyle to improve your health and your blood pressure level 3:
- Increase the consumption of sodium salts.
- Increase the consumption of water, and keep yourself hydrated at all times.
- Eat low-carb healthy meals and exercise daily.
- Maintain a healthy body weight.
- Ensure a good emotional atmosphere around you (no stress and anxiety).
- Quit smoking and limit the consumption of alcohol.
3. Consider using medications for blood pressure management
Undoubtedly, at this point, you may want to use some medications for the good of your health. However, based on the diagnosis, it should be prescribed by your doctor.
According to a clinical review by U.S. Pharmacist, the following medicines are highly beneficial for individuals experiencing low blood pressure. 4
- Corticosteroids: These are the types of medicines that control the amount of sodium present in our blood. By regulating that particular concentration of sodium in blood, they raise the blood pressure of the individual.
- Alpha-adrenergic Agonists: These are the types of medicines that promote the contraction of blood vessels. As a result of this contraction, the pressure of blood over the vessels increases, and the body supports an ideal blood pressure.
- Angiotensin II: This type of medicine increases the extent of retention of sodium in the kidneys, and that contributes to the rise of blood pressure in the body of a person.
- Decongestants: These medicines help reduce the size of the swollen blood vessels and result in the contraction of the said blood vessels. This, as a result, leads to an increase in blood pressure.
- Immunosuppressants: These medicines promote the solubility of the sodium ions in your blood, as a result increasing its concentration. This contributes to rising in the BP of the individual.
4. Plan a diet specifically for 49/46 blood pressure
Like how you would be managing your diet for hypertension, even hypotension patients need to have a check on their dietary habits. Some of the foods are a big no-no, while certain foods need to be included on a strict note.
According to a report in Harvard Health Letters, incorporating the following items into your diet can help bring your blood pressure to healthy levels. 5
- Drink more: Hydration is key for all health conditions, so you should drink lots of fluids to increase blood volume.
- Sodium: Table salts are rich in sodium, a necessary component that helps retain water in the blood to increase its volume.
- Vitamin B12: When you are deficient in this vitamin, you may experience anemia and hypotension. Try adding eggs, cereals, meats, etc., into your diet.
- Caffeine: Caffeinated beverages are good stimulants that temporarily cause a surge in blood pressure and adrenalin levels.
- Say no to junk food: you should avoid the consumption of foods that are rich in carbs. Take small meals multiple times a day for the best of benefits.
5. Be aware of the underlying causes and risks of 49/46 blood pressure
Some of the comorbidities associated with low blood pressure include heart attack, cardiac arrest, heart valve disorder, bradycardia, and hormonal imbalance.
When you have 49/46, then you may want to rectify the root cause by visiting your physician.
Age is one of the major risk factors, and people older than 65 may have a sudden drop in blood pressure after eating food or while standing up.
In some cases, neural, mediated blood pressure decrease is noted in children and young adults as well.
A study from The American Geriatrics Society reports that depression is one of the significant causes that lead to hypotension, and vice versa. 6
Even stress is linked to hypotension in some patients. Since the human body reacts differently to different situations, not necessarily depression and anxiety lead to hypertension, but hypotension too.
Some of the medications that you might be using can cause severe hypotension. Therefore, it is important to inform your doctor about your pre-existing medical conditions when getting a new prescription.
6. Try natural supplements to support healthy blood pressure level
Sometimes managing blood pressure is all about supplementing your body with the right diet. Food is undoubtedly the best primary source to supplement your body.
However, in the current scenarios, we all know how much adultered our foodstuff is, and most of us are pushed towards processed foods to feed ourselves in this fast-paced world.
All these food are high in sugar and sodium and doesn’t contain any vital nutrients that are important for a healthy heart.
This is where some of the nutraceutical-based blood pressure supplements come in handy. These products combine all critical nutrients your heart craves, thereby assisting the better function of your cardiovascular system.
A team of researchers from Shahrekord University of Medical Sciences in Iran compiled a list of medicinal botanicals with anti-hypotensive capabilities. Today, most nutraceutical blood pressure supplements are made using these botanicals as their major ingredients. 7
Generally, these supplements are a concoction of herbs, plant-based products, dairy products, and some animal products. They are 100% organic and natural and don’t contain any harmful chemicals.
If you are hearing about these segments of products for the first time, to start with, you may blindly go for Blood Pressure Support from Vita Balance Inc, Blood Pressure Optimizer from HFL, or Corsanum, marketed by PLT Group.
Blood Pressure Support
Blood Pressure Optimizer
Blood Pressure Support combines hawthorn berry, olive leaf, hibiscus, and some vitamins like C, B6, B12, niacin, and folate alongside a bunch of other medicinal herbs to support the healthy working of the heart.
Blood Pressure Optimizer has MegaNatural®-BP grape seed extract and Celery3nB™ celery seed extract alongside common vitamins and minerals, which can help increase your cardiovascular elasticity.
Corsanum is a refined combination of olive, iron, and grapevine alongside regular products like coriander, hawthorn, and oregano, all of which are foods known to maintain cardiovascular health.
The only one thing to keep in mind is that choose the best blood pressure supplements that lower blood pressure, because when it comes to the heart, there is no taking of risk!
Severe hypotension might look scary, but consistent monitoring and timely medical care can easily be handled.
If you are someone suffering from hypotension for quite some time, it is better to inform your kin, peers, and colleagues about the condition so that, in the unlikely event, people can make a smart choice.
If you follow your diet correctly, use some supplementation, and exercise daily, then hypotension can slowly be eliminated from your life.
What should you do when your blood pressure is 49/46 mmHg during pregnancy?
A blood pressure of 49 over 46 mmHg during pregnancy is critically low and warrants immediate emergency medical attention.
Such a low reading could lead to insufficient blood supply to the placenta, which can pose severe risks for both mother and baby.
A study from the National Institutes of Health suggests that parental hypotension during pregnancy might be a causative factor for poor development of the child, and further research is currently underway to explore this connection. 8
This is a medical emergency that requires rapid intervention to safeguard the well-being of both you and your unborn child.
Is blood pressure 49/46 mmHg too low for a men?
For men, a blood pressure reading of 49/46 is dangerously low and requires immediate medical intervention.
Such a level is not just “too low”—it is critical and could be life-threatening. It could lead to dizziness, fainting, shock, or even organ failure.
Immediate emergency care is strongly advised.
Is blood pressure 49/46 mmHg too low for a women?
For women, a blood pressure of 49 over 46 mmHg is critically low.
Immediate medical intervention is absolutely necessary as this could indicate a severe underlying condition or even trigger life-threatening issues such as shock or organ failure.
You should seek emergency medical care right away.
Is blood pressure 49/46 mmHg too low for an elderly?
For elderly individuals, a blood pressure of 49/46 is dangerously low and requires immediate medical attention.
Given the increased risk factors and potential for complications at an older age, such low blood pressure could be life-threatening.
Immediate emergency care is imperative.
Is blood pressure 49/46 mmHg too low for a children?
In children, a blood pressure reading of 49 over 46 mmHg is critically low and should be treated as a medical emergency.
Blood pressure this low could result in severe consequences, including loss of consciousness and insufficient blood flow to the organs, potentially leading to irreversible damage. It could be life-threatening and poses a significant risk to the child’s overall health and well-being.
According to a study published in BMC Pediatr, the pediatric hypotension limit is identified as 90/50 mmHg, below which posses a significant risk in children. 8Immediate medical attention is crucial to address the underlying causes and to stabilize the child’s condition.
Timely intervention can significantly improve the prognosis and prevent further complications. Parents and caregivers should be vigilant and seek help promptly.
Is blood pressure 49/46 mmHg too low for an adult?
For an adult, a blood pressure of 49/46 is extremely low and constitutes a medical emergency.
Such a low reading could lead to severe symptoms like fainting, shock, and inadequate blood flow to the organs. Immediate medical intervention is essential to prevent life-threatening complications.
This is an emergency condition in all cases, and you should seek medical help immediately if you or someone you know has a blood pressure reading this low.
FAQ (Frequently Asked Questions)
What is the blood pressure?
Blood pressure is a measure of the force exerted by blood against the walls of the arteries as it is pumped by the heart.
When the heart beats, usually 60 to 100 times a minute, it sends blood through arteries that distribute oxygen and nutrients to the entire body.
These arteries transport blood from the heart to various body parts, and the pressure within them naturally fluctuates throughout the day.
What do the numbers on blood pressure readings chart mean?
The numbers on the blood pressure chart are a metric that helps you determine the health of your heart.
A quick, concise and accurate judgement about your heart can be drawn based on the range, difference, and intensity of these numbers.
They are often divided into two numbers, called systolic (force of blood in your arteries when your heart beats) and diastolic (force exerted when the heart is resting between betas) measurements.
Based on these pair of numbers, the blood pressure reading is classified into seven stages.
- Very Low Blood Pressure (Severe Hypotension): Below 80/50
- Low Blood Pressure (Hypotension): 80/50 – 90/60
- Normal Blood Pressure: 91/61 – 119/79
- Pre-Hypertension (Elevated Blood Pressure): 120/80 – 139/89
- High Blood Pressure (Stage 1 Hypertension): 140/90 – 159/99
- High Blood Pressure (Stage 2 Hypertension): 160/100 – 180/120
- Hypertensive Crisis: Above 180/120
What is a normal blood pressure?
Normal blood pressure, as recommended by the American Heart Association and cited by the National Institutes of Health, falls between 90 mmHg systolic, 60 mmHg diastolic and 120 mmHg systolic, 80 mmHg diastolic.
Perfect blood pressure is a measure that indicates the optimal force of blood against the walls of our arteries, ensuring efficient circulation without undue stress on the cardiovascular system.
It’s a balance that signifies good heart health and is a benchmark against which deviations, either high or low, are gauged.
What is a severe hypotension?
Severe hypotension is a medical condition characterized by dangerously low blood pressure levels, which can have serious consequences for the body.
A blood pressure reading of 90/60 is generally considered low, but when it drops by 10 points to 80/50, it is classified as severe hypotension.
What do systolic and diastolic numbers mean in severe hypotension?
In severe hypotension, the systolic and diastolic numbers in a blood pressure reading take on specific meanings related to the condition.
These values provide essential insights into cardiovascular health.
Systolic Number (the higher of the two)
- Reflects the pressure in your arteries during each heartbeat.
- In hypotension, a low systolic reading indicates reduced force exerted by the heart when pumping blood.
- This can lead to inadequate blood flow to vital organs, causing symptoms like dizziness and fainting.
Diastolic Number (the lower of the two)
- Represents the arterial pressure when the heart rests between beats.
- In hypotension, a low diastolic reading may indicate that the heart is not effectively refilling or that there’s insufficient blood volume.
- This can result in inadequate oxygen delivery to tissues and may contribute to symptoms such as fatigue and weakness.
How does severe hypotension affect blood pressure?
Severe hypotension has a profound impact on blood pressure, leading to a significant drop in the circulatory force vital for proper bodily function.
This condition affects blood pressure in several ways.
- Sharp Decrease: Severe hypotension causes a rapid reduction in both systolic and diastolic blood pressure readings.
- Reduced Organ Perfusion: Inadequate blood supply to vital organs can result in organ dysfunction or failure.
- Symptoms: It often leads to symptoms like dizziness, fainting, and weakness due to insufficient blood flow.
- Increased Health Risks: Prolonged severe hypotension can increase the risk of complications, such as shock or organ damage.
What are the symptoms of a severe hypotension?
Symptoms of severe hypotension, a condition characterized by dangerously low blood pressure, can manifest in various ways, often causing significant discomfort and potential health risks.
When blood pressure drops to critically low levels, individuals may experience the following.
- Profound Dizziness and Lightheadedness
- Blurred Vision
- Nausea and Potential Vomiting
- Cold, Clammy Skin
- Rapid or Weak Pulse
- Overwhelming Fatigue and Weakness
- Fainting or Loss of Consciousness
These symptoms reflect the body’s struggle to maintain adequate blood flow to vital organs and should be treated as a medical emergency, necessitating immediate attention.
What are the risk factors of severe hypotension?
The risk factors associated with severe hypotension comprise a vast array of diverse elements that hold the potential to substantially contribute to the development of this potentially debilitating condition.
These encompass a wide spectrum of circumstances and health-related aspects, reflecting the intricate interplay of various factors.
- Dehydration: Insufficient fluid intake can lead to reduced blood volume.
- Medications: Certain drugs like antihypertensives or diuretics may lower blood pressure excessively.
- Medical Conditions: Conditions such as heart problems, endocrine disorders, or neurological issues can affect blood pressure regulation.
- Infections: Septic shock can cause severe hypotension.
- Allergic Reactions: Anaphylaxis can lead to a sudden drop in blood pressure.
- Age: Older adults are more vulnerable.
- Pregnancy: Hypotension may occur during pregnancy.
What are the causes of severe hypotension?
The causes of severe hypotension are remarkably diverse and multifaceted, originating from a complex interplay of various underlying factors.
These encompass a broad spectrum of circumstances and health-related aspects that contribute to the development of this serious condition. Some of the key contributing factors are the ones listed below.
- Dehydration: Inadequate fluid intake leading to reduced blood volume.
- Medications: Certain drugs, like antihypertensives or diuretics, may excessively lower blood pressure.
- Medical Conditions: Heart problems, endocrine disorders, or neurological issues affecting blood pressure regulation.
- Infections: Septic shock resulting from severe infections.
- Allergic Reactions: Anaphylaxis causing a sudden drop in blood pressure.
- Age: Older adults may be more vulnerable.
- Pregnancy: Hypotension can occur during pregnancy due to hormonal changes and increased circulation demands.
How is a severe hypotension diagnosed?
Diagnosing severe hypotension involves a combination of clinical assessment, medical history, and specific diagnostic tests.
- Medical History: Gathering information about the patient’s symptoms, medications, and underlying health conditions.
- Physical Examination: Checking vital signs, such as blood pressure, heart rate, and temperature, along with assessing signs like skin color, moisture, and the presence of edema.
- Blood Pressure Measurement: Repeated measurements to confirm low blood pressure.
- Blood Tests: Assessing electrolyte levels, organ function, and markers of infection.
- Electrocardiogram (ECG or EKG): To evaluate heart rhythm and function.
- Echocardiogram: An ultrasound of the heart to assess its structure and function.
- Holter Monitor: Continuous heart rhythm monitoring over 24 hours.
- Tilt Table Test: Assessing blood pressure changes in response to position changes.
- Imaging: Depending on the suspected cause, imaging tests like CT scans or MRIs may be used.
Combining these diagnostic tools helps healthcare professionals identify the underlying causes of severe hypotension and guide treatment accordingly.
How to take blood pressure at home?
Taking your blood pressure at home can be a simple procedure when you have the appropriate equipment and follow the correct technique.
Consistently monitoring your blood pressure offers valuable insights into your cardiovascular health and aids in the early detection of potential health issues.
Here are the steps to follow.
- Obtain a digital blood pressure monitor from a reputable brand.
- Sit comfortably in a quiet room, resting for approximately five minutes before taking a measurement.
- Position the cuff on your upper arm, ensuring it’s neither too tight nor too loose.
- Keep your arm at heart level, placing it on a table or armrest.
- Activate the monitor and adhere to the device’s instructions to initiate the measurement.
- Remain still and silent throughout the process.
- Record the reading, making note of both the systolic (top number) and diastolic (bottom number) values.
- It’s recommended to measure your blood pressure at the same time each day and maintain a log for reference during medical consultations.
Which are the best and accurate blood pressure monitors to use at home?
Finding the best blood pressure monitor for home use in today’s internet market flooded with technology is a challenging task.
While you may find cheap options online, the reproducibility of results is a big question mark. This could sometimes mean life or death, and that’s why you need a clinically valid product that is no less than smart!
The three best recommendations from the internet are below.
The Oxiline Pressure X Pro is an accurate at-home blood pressure monitor powered by a superior VIBRA TX sensor and boasts a user-friendly interface. It logs readings automatically, syncs with Apple and Android devices, and offers a lifetime warranty.
The CheckMe BP2 is a compact blood pressure monitor with EKG capabilities. It pairs with the ViHealth App, offering BP and EKG readings in 30 seconds. Features include an OLED screen, Bluetooth, and AI-ECG detection of irregular heart conditions. A reliable and efficient heart health tool.
The QardioArm is an intuitive at-home blood pressure monitor compatible with iOS and Android. It is a sleek and lightweight product with superior energy efficiency. It offers clear readings, visualizes data on a color-coded app graph, and stores historical data.
What are the treatments for severe hypotension?
Treatment for severe hypotension depends on its underlying cause and the severity of the condition.
Several approaches can be employed to address this medical issue.
- Fluid Replacement: Intravenous (IV) fluids, like saline, are administered to increase blood volume.
- Medications: Certain drugs, such as vasopressors or inotropes, can help raise blood pressure.
- Treatment of Underlying Causes: Managing conditions like infections or heart problems.
- Lifestyle Adjustments: Increasing salt intake, wearing compression stockings, and maintaining proper hydration.
- Tilt Training: A supervised program to improve blood pressure regulation.
- Dietary Changes: Consuming smaller, more frequent meals and avoiding alcohol.
- Avoiding Triggers: Identifying and avoiding factors that worsen symptoms.
- Implantable Devices: In rare cases, devices like pacemakers may be considered.
The specific treatment plan is determined by healthcare professionals based on the individual’s unique circumstances.
How to treat severe hypotension at home?
Treating severe hypotension at home can be challenging, as it often requires immediate medical attention. However, some measures can help manage milder cases or complement medical treatment under a doctor’s guidance.
Here are steps to consider.
- Hydration: Drink plenty of fluids, particularly water and oral rehydration solutions.
- Increase Salt Intake: Under a healthcare provider’s guidance, slightly increase salt intake.
- Avoid Triggers: Identify and avoid situations or activities that worsen symptoms.
- Wear Compression Stockings: These can help improve blood flow in the legs.
- Lifestyle Modifications: Lie down with your legs elevated to boost blood flow to vital organs.
- Small, Frequent Meals: Eating smaller, more frequent meals can prevent blood pressure drops after eating.
- Monitor Blood Pressure: Keep track of your blood pressure at home if advised by a doctor.
Always consult a healthcare professional for guidance on managing severe hypotension, as self-treatment may not be appropriate or safe in all cases.
What are the dangers of severe hypotension?
Dangers of severe hypotension can have profound and sometimes life-threatening effects on the body.
These complications encompass various aspects of health and well-being.
- Organ Damage: Insufficient blood flow can lead to organ damage, affecting the heart, brain, kidneys, and other vital organs.
- Shock: Severe hypotension can progress to shock, where organs and tissues don’t receive enough oxygen and nutrients.
- Stroke: Insufficient blood supply to the brain can cause a stroke, leading to neurological deficits.
- Heart Attack: Reduced blood flow to the heart may result in a heart attack.
- Kidney Dysfunction: Decreased blood pressure can impair kidney function and lead to acute kidney injury.
- Loss of Consciousness: Fainting or loss of consciousness is common, posing injury risks.
- Permanent Disability or Death: If not promptly treated, severe hypotension can result in permanent disability or, in severe cases, death.
Timely medical attention is essential to prevent these complications.
How to prevent a severe hypotension?
Preventing severe hypotension involves adopting lifestyle measures and managing underlying conditions to maintain healthy blood pressure levels.
Here are key strategies.
- Hydration: Ensure adequate fluid intake to prevent dehydration.
- Balanced Diet: Consume a diet rich in fruits, vegetables, and whole grains while limiting sodium intake.
- Regular Exercise: Engage in regular physical activity to support cardiovascular health.
- Medication Management: If on medications that affect blood pressure, take them as prescribed.
- Monitor Blood Pressure: Regularly check blood pressure levels and follow medical advice.
- Manage Underlying Conditions: Control conditions like diabetes, heart problems, or neurological disorders.
- Avoid Triggers: Identify and avoid situations or substances that trigger low blood pressure, such as prolonged standing or excessive alcohol consumption.
- Compression Garments: Consider compression stockings under medical guidance.
- Gradual Position Changes: When rising from sitting or lying positions, do so slowly to prevent sudden drops in blood pressure.
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