If you’ve ever been told your blood pressure is “low,” your first reaction might have been relief. After all, in a world where high blood pressure (hypertension) is linked to heart attacks, strokes, and kidney disease, low sounds like a good thing. And sometimes it is. Healthy, active people, especially young adults and athletes, often have resting blood pressures below 100/60 mm Hg with no symptoms or problems at all.

But low blood pressure, or hypotension, is not always benign. For some individuals, particularly older adults and people with chronic conditions, a low reading can spell trouble. The real risk isn’t the number itself but it’s how your body responds to it. If you feel fine, a reading of 90/60 mm Hg might be normal for you. But if you’re dizzy, weak, confused, or fainting, it could signal that your brain and other vital organs aren’t getting enough blood flow. That’s when low pressure becomes dangerous.

One of the most important clinical distinctions is whether your hypotension is symptomatic. Symptoms such as dizziness, blurred vision, lightheadedness when standing (known as orthostatic hypotension), and fainting are red flags that blood flow to the brain is inadequate. In older adults, this can lead to serious injuries from falls. In fact, orthostatic hypotension is not only common in aging but is also associated with an increased risk of death.

Even more concerning is the connection between very low diastolic blood pressure (the bottom number) and cardiovascular risk. Diastolic pressures under 60–70 mm Hg may impair blood flow to the heart, especially in people with stiffened arteries or heart failure. The Framingham Heart Study and subsequent trials confirm a U-shaped risk curve: the danger increases at both ends of the spectrum: very high and very low blood pressures alike. In patients with heart failure, especially those with preserved ejection fraction (HFpEF), low diastolic pressure is linked to worse outcomes.

So what should you watch for? If you experience symptoms like dizziness, fatigue, confusion, or fainting, especially if they happen when you stand up or after eating, pay attention. These might seem like minor annoyances, but they can indicate that your cardiovascular system is struggling to maintain adequate perfusion (blood supply) to key organs. For older adults, individuals with diabetes, and those on blood pressure medications, these signs deserve medical evaluation. In rare but critical situations, very low blood pressure can trigger shock, a life-threatening state that deprives tissues of oxygen and can quickly lead to organ failure. This is a 911 emergency.

The bottom line: if your blood pressure is low and you feel great, it’s probably nothing to worry about. But if you have persistent symptoms, particularly with systolic pressures under 90 mm Hg or diastolic under 60 mm Hg, don’t ignore them. It could be dehydration, medication side effects, heart issues, or an endocrine disorder like adrenal insufficiency or hypothyroidism. Talk to your doctor. A simple blood test or ECG might reveal a fixable cause.

In the quest for long-term health, the goal isn’t to have the lowest blood pressure possible; it’s to have a pressure that fits your physiology and keeps your brain, heart, and kidneys well perfused. For many, that’s somewhere in the range of 110–120 systolic and 70–80 diastolic. There’s no trophy for hitting 85/55 if it makes you faint.