A reading of 113/60 is not dangerous, but it sits in a zone that deserves a closer look. The systolic number (113) is comfortably within a healthy range, but the diastolic number (60) is right at the threshold where several large studies have found increased cardiovascular risk. Whether this reading is “normal” for you depends on context: your age, fitness level, medications, symptoms, and how the reading was taken all factor in.
Where 113/60 Falls on the Standard Scale
Most clinical guidelines classify blood pressure as normal when systolic is below 120 and diastolic is below 80. By that measure, 113/60 looks fine on paper. But the guidelines focus primarily on defining hypertension, the upper end of the spectrum. They say less about how low is too low, particularly for the bottom number. There is no universally agreed-upon cutoff for “hypotension” the way there is for high blood pressure. Textbooks sometimes cite 90/60 as the threshold for low blood pressure, but that number is more of a clinical shorthand than a carefully evidence-based boundary.
The real story with 113/60 is less about the systolic number and more about the diastolic one. A systolic reading of 113 raises no flags. But a diastolic of 60 lands exactly at the edge of a range that researchers have increasingly flagged as worth investigating, especially in certain populations.
Why the Diastolic Number Draws Attention
Diastolic pressure reflects what is happening in your arteries between heartbeats, during the moment of relaxation. It matters because the coronary arteries that supply blood to the heart muscle are mostly filled during this phase. When diastolic pressure drops too low, the concern is that the heart itself may not get enough blood flow during each resting interval.
A large study using U.S. national health survey data found that people with diastolic pressure below 60, even when their systolic pressure was normal, had a roughly 30% higher risk of dying from any cause compared to people with diastolic readings between 70 and 80. Among those not on blood pressure medication, the risk was even more pronounced, about 46% higher.1PubMed Central. Association of low diastolic blood pressure with all-cause death among US adults with normal systolic blood pressure Another study in JAMA Network Open, looking specifically at treated patients with systolic blood pressure under 130, found that diastolic values below 60 were associated with higher rates of heart attack, stroke, and a composite of serious cardiovascular events.2JAMA Network Open. Evaluation of Optimal Diastolic Blood Pressure Range Among Adults With Treated Systolic Blood Pressure Less Than 130 mm Hg
These numbers do not mean that everyone with a diastolic of 60 is in trouble. The studies are observational, they identify patterns in populations rather than predicting what will happen to any one person. But they do suggest that diastolic readings below 60 are not simply “better” than higher ones, which is a common assumption people make when they see a low blood pressure reading.
Isolated Low Diastolic Pressure and Heart Risk
Cardiologists use the term “isolated diastolic hypotension” to describe a situation where the bottom number is low while the top number stays in the normal or elevated range. This is distinct from the kind of low blood pressure where both numbers drop together, which is more familiar from scenarios like dehydration or blood loss.
A study of community-dwelling older adults followed for over twelve years found that isolated diastolic hypotension was an independent risk factor for developing heart failure, increasing the risk by about 29% to 33% after adjusting for other variables.3PubMed Central. Isolated diastolic hypotension and incident heart failure in older adults A secondary analysis of the landmark SPRINT trial reinforced this picture, finding that treated patients whose diastolic pressure fell below 60 had about a 32% higher risk of major adverse cardiovascular events compared to those in the 60-to-79 range.4PubMed Central. Cardiovascular Risk in Patients With Treated Isolated Diastolic Hypertension and Isolated Low Diastolic Blood Pressure
There is also emerging evidence that low diastolic readings in people with wide pulse pressure (the gap between the top and bottom numbers) may be linked to kidney function decline. A Japanese study found a U-shaped association: both very low and very high diastolic readings were tied to worse kidney outcomes when pulse pressure was elevated.5PubMed Central. Pulse pressure modifies the association between diastolic blood pressure and decrease in kidney function: the Japan Specific Health Checkups Study With 113/60, the pulse pressure is 53, which is slightly above the typical range of 40 to 50 and worth mentioning to a doctor if it’s a persistent pattern.
When a Low Diastolic Reading Is Expected and Fine
Not every 113/60 reading signals a problem. Several common situations produce naturally low diastolic pressures without any underlying concern.
Regular endurance exercise is probably the most common one. Runners, cyclists, swimmers, and other endurance athletes tend to have lower resting blood pressure across the board, with diastolic readings in the low 60s or even upper 50s being routine. Research on elite athletes has confirmed that endurance-trained individuals exhibit lower blood pressure and less arterial stiffness compared to other athlete categories.6PubMed Central. Brachial and central blood pressure and arterial stiffness in adult elite athletes In a fit 30-year-old who runs five days a week and feels fine, 113/60 is about what you would expect.
Younger adults in general tend to have lower diastolic pressures than older adults. Diastolic blood pressure naturally rises with age through roughly the 50s and then begins to decline, a pattern driven by progressive stiffening of the large central arteries.7PubMed. Influence of age, risk factors, and cardiovascular and renal disease on arterial stiffness: clinical applications This stiffening pushes systolic pressure up while actually pulling diastolic pressure down, widening the pulse pressure over time.8PubMed Central. Arterial Stiffness and Hypertension in the Elderly So a diastolic of 60 in a healthy 25-year-old is a very different finding than the same number in a 75-year-old. In the younger person, the arteries are flexible and the number reflects that. In the older person, it may reflect arteries that have stiffened enough to alter the normal pressure dynamics, which is a red flag for cardiovascular events.
Pregnancy and Diastolic Pressure Drops
Pregnant women commonly see their diastolic blood pressure dip during the second trimester. A systematic review and meta-analysis of blood pressure trends in normal pregnancies found that mean diastolic pressure hit its lowest point around 21 weeks of gestation, dropping to about 66, before climbing again toward delivery.9PubMed Central. Trends of blood pressure and heart rate in normal pregnancies: a systematic review and meta-analysis This dip is driven by hormonal changes that relax blood vessel walls and increase blood volume. A reading like 113/60 during the second trimester would be entirely typical and expected. The concern during pregnancy is more about blood pressure going too high (preeclampsia) than going modestly low.
Medications That Can Push the Bottom Number Down
If you take blood pressure medication, the diastolic number of 60 raises a practical question. Some drugs lower diastolic pressure disproportionately, and the controversial “J curve” hypothesis suggests that pushing diastolic blood pressure too far down with treatment, especially in people with coronary artery disease, could actually increase cardiovascular risk rather than reduce it.10PubMed. The diastolic blood pressure in systolic hypertension The concern is straightforward: the heart muscle depends on diastolic-phase blood flow, so medication that drops the bottom number below a useful threshold may be counterproductive even while bringing the top number to target.
Heart failure medications in particular can intensify this effect. When patients are started on or have doses increased of drugs like ACE inhibitors, angiotensin receptor blockers, or beta-blockers, the frequency of low diastolic blood pressure episodes during the day and night has been shown to increase significantly.11Journal of Cardiac Failure. Impact of Additional Neurohumoral Modulating Agents on Ambulatory Blood Pressure Control in Patients With Heart Failure If you are on any of these medications and seeing diastolic readings at 60 or below, your prescriber may want to review the dose.
Symptoms That Separate “Low but Fine” From “Low and Concerning”
The single most useful question to ask about a blood pressure reading of 113/60 is whether it comes with symptoms. A population-based study found a clear association between lower systolic blood pressure and self-reported tiredness and feeling faint, particularly in women under 50.12British Medical Journal. Symptoms of low blood pressure: a population study The key symptoms to pay attention to include:
- Lightheadedness: Especially upon standing, which can indicate orthostatic changes.
- Persistent fatigue: Beyond ordinary tiredness, a sense that energy is chronically low.
- Feeling faint: Brief episodes where vision dims or narrows.
- Difficulty concentrating: Feeling mentally foggy, particularly in the morning or after meals.
If none of these apply and you feel well, a single reading of 113/60 is almost certainly not a problem. If you are experiencing several of them, the reading provides useful context for a medical conversation even though 113/60 does not cross the classic “low blood pressure” threshold of 90/60.
Standing up quickly and feeling a head rush is a related but distinct phenomenon. Initial orthostatic hypotension involves a sharp, transient blood pressure drop within the first 15 seconds of standing, typically over 40 points systolic or over 20 diastolic, followed by rapid recovery. It is common in adolescents and young adults and is generally benign.13PubMed Central. “He’s dizzy when he stands up”: an introduction to initial orthostatic hypotension If your dizziness only happens in that narrow window and resolves in seconds, it likely reflects this transient mismatch rather than a sustained blood pressure problem.
Could the Reading Be Wrong?
Before worrying about a diastolic of 60, consider whether the measurement itself was accurate. Blood pressure cuffs are surprisingly sensitive to fit, and using the wrong size cuff is one of the most common sources of error in outpatient readings.
A randomized crossover trial published in JAMA Internal Medicine found that using a regular-sized cuff on someone who needed a small cuff lowered the systolic reading by about 3 to 4 points. Using a regular cuff on someone who needed a large cuff inflated the reading by about 5 points, and using it on someone who needed an extra-large cuff added nearly 20 points.14PubMed Central. Effects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial A separate study confirmed similar patterns for diastolic pressure, with the wrong cuff size shifting diastolic readings by 2 to 4 points in either direction.15PubMed. Influence of cuff size on the accuracy of supine blood pressure measurement If you have slender arms and were measured with a standard adult cuff, the actual diastolic pressure could be a few points higher than 60, putting it comfortably in unremarkable territory.
Body position matters too. Being measured while lying down versus sitting can shift readings. Crossing your legs, talking during the reading, or having a full bladder all add small biases. A single reading in a clinic is a snapshot, not a verdict. If 113/60 shows up consistently across multiple properly taken readings at home, it carries more weight.
Blood Pressure Changes Throughout the Day
Blood pressure follows a daily rhythm. It is typically lowest during deep sleep and rises in the hours before waking. Nighttime values are normally about 10% to 20% lower than daytime values, a pattern called “dipping.”16American Journal of Medicine. Out-of-Office Blood Pressure Phenotypes and Cardiovascular Risk For someone whose daytime blood pressure averages around 120/70, a nighttime reading of 113/60 would be completely normal and expected.17PubMed. Nighttime blood pressure and nocturnal dipping are associated with daytime urinary sodium excretion in African subjects
This is relevant if you took your reading early in the morning, late at night, or right after waking. A reading that would be mildly low at 2 p.m. might be unremarkable at 6 a.m. If you are doing home monitoring, taking readings at roughly the same time each day gives a more meaningful picture than comparing numbers from different times.
Hydration, Dehydration, and Blood Pressure
The relationship between hydration and blood pressure is more nuanced than “drink more water, raise your blood pressure.” Acute dehydration can reduce your ability to tolerate standing upright without a blood pressure drop, and it may impair blood vessel function.18PubMed Central. Hydration Status and Cardiovascular Function But in controlled experiments, short-term water deprivation in healthy young adults did not meaningfully shift resting blood pressure or its variability.19PubMed Central. Short-term water deprivation does not increase blood pressure variability or impair neurovascular function in healthy young adults A study on dehydration’s effects on central blood pressure found a modest link between fluid loss and lower central systolic pressure, but no significant change in central diastolic pressure.20PubMed. Effects of dehydration on central blood pressure in young healthy adults
In practice, this means that mild dehydration is unlikely to be the sole explanation for a diastolic of 60 in someone who is otherwise healthy. Severe dehydration from illness, heat exposure, or prolonged exertion is a different story and would usually be accompanied by obvious symptoms like rapid heart rate, dark urine, and marked fatigue. If you just want to know whether drinking a glass of water will fix your reading, the honest answer is probably not by much.
Vitamin B12 Deficiency as a Sneaky Cause
One lesser-known contributor to low blood pressure that is worth mentioning is vitamin B12 deficiency. Case reports have documented people presenting with unexplained low blood pressure, including orthostatic hypotension, whose readings normalized after B12 supplementation.21PubMed Central. Orthostatic hypotension as a manifestation of vitamin B12 deficiency22PubMed Central. Hypotension: an unusual presentation of vitamin B12 deficiency, with complete recovery following cyanocobalamin therapy Research on the mechanism suggests that B12 deficiency can impair the autonomic nervous system’s ability to maintain blood vessel tone, essentially blunting the reflexes that are supposed to keep blood pressure from dropping when you change position.23PubMed. Autonomic dysfunction and hemodynamics in vitamin B12 deficiency
This is not the most common cause of a reading like 113/60, but it is particularly relevant for vegetarians, vegans, older adults with absorption issues, and anyone who has had gastric surgery. If low blood pressure readings are accompanied by tingling in the hands or feet, fatigue, or balance problems, B12 is worth checking.
The Overtreating Problem
There is a long, slightly embarrassing medical history of treating low blood pressure as a disease when it usually is not. A study from the 1980s screened over a thousand people and found that more than a quarter had been diagnosed as hypotensive by their doctors, with nearly 10% receiving treatments including veal liver extract capsules, iron capsules, tonics, and vitamin B12 injections. The study found little meaningful difference in actual blood pressure readings between those diagnosed and treated, those diagnosed but untreated, and those never diagnosed at all.24ScienceDirect. Treatment for a nondisease: The case of low blood pressure
The broader point holds up decades later. For the majority of people, low blood pressure is not a disease requiring treatment. It becomes a medical issue only when it causes symptoms, when it reflects an underlying condition, or when the specific pattern of the numbers (like an unusually low diastolic in someone over 65) places someone in a higher-risk statistical category. A reading of 113/60 with no symptoms in a younger, active person is almost certainly in the “leave it alone” camp. The same reading in a 70-year-old on multiple blood pressure medications who feels dizzy when standing warrants a conversation with their doctor about whether the treatment plan needs adjusting.
Vasovagal Episodes and Sudden Drops
Some people with resting readings around 113/60 find that their blood pressure drops more dramatically in certain situations: standing in line for a long time, getting blood drawn, experiencing sudden pain, or even just watching something distressing. These are vasovagal episodes, triggered when the brain’s reflex pathways override normal blood pressure regulation. In a vasovagal response, the parasympathetic nervous system ramps up while the sympathetic system dials down, causing blood pressure and heart rate to fall together, sometimes sharply enough to cause fainting.25PubMed Central. The Role of the Autonomic Nervous System in Vasovagal Syncope
People who start from a lower baseline may reach the threshold for symptoms more quickly during a vasovagal event. If your resting diastolic is already 60, a vagal-triggered drop does not have as far to fall before it hits the range where you feel lightheaded or faint. This does not make 113/60 abnormal on its own, but it does explain why some people with modestly low resting pressures seem more prone to passing out in certain circumstances. Staying hydrated, avoiding prolonged standing, and tensing the leg muscles when you feel a spell coming on are all practical countermeasures.