Low blood pressure, generally defined as a reading below 90/60 mmHg, can be managed with a combination of dietary changes, physical strategies, and in some cases prescription medications. What works best depends on the type and severity of your symptoms, but most people start with simple, non-drug approaches before moving to prescriptions.
Salt and Fluids: The First-Line Approach
Increasing your salt and water intake is typically the first thing recommended for chronic low blood pressure. Salt helps your body retain fluid, which expands your blood volume and raises pressure. For people with orthostatic hypotension (the kind where you get dizzy standing up), medical guidelines suggest significantly more sodium than the average person consumes. The American Society of Hypertension recommends 2,400 to 4,000 mg of sodium per day for these patients, while some specialists push that range to 4,000 to 8,000 mg daily depending on the severity. For context, most general health guidelines tell the average person to stay under 2,300 mg.
A practical way to increase sodium is adding 1,000 to 2,000 mg to your diet three times per day through salty foods, broth, or salt tablets. One study found that patients who added roughly 2,400 mg of supplemental sodium per day for two months showed meaningful improvements in their ability to tolerate standing and in blood flow to the brain. Your doctor can check your sodium excretion through a urine test to see whether you’re actually getting enough.
Water matters just as much. Fluids directly increase blood volume, which is one of the core problems in hypotension. There’s no single magic number, but drinking consistently throughout the day and limiting alcohol (which is dehydrating and lowers blood pressure even in moderation) makes a real difference.
Caffeine for a Short-Term Boost
Caffeine constricts blood vessels and can raise blood pressure by about 5 to 10 points in people who don’t drink it regularly. One or two strong cups of coffee or tea with breakfast is a common recommendation. The effect kicks in within 30 minutes and can last a couple of hours. If you want to know how much caffeine affects your blood pressure specifically, check your reading before a cup of coffee and again 30 to 120 minutes afterward.
The catch: caffeine itself is a mild diuretic, so it can contribute to dehydration if you’re not drinking enough water alongside it. And if you already drink coffee daily, you’ve likely built up enough tolerance that the blood pressure effect is minimal.
Compression Garments
Compression stockings work by applying graduated pressure to your legs, with the tightest compression at the ankles. This prevents blood from pooling in your lower body when you stand up, pushing more of it back toward your heart and brain. Research confirms that compression stockings effectively raise resting blood pressure in people with low readings and reduce the drop that happens when standing.
Waist-high stockings or abdominal binders tend to work better than knee-high socks because a large portion of blood pools in the abdomen, not just the legs. Many people find compression uncomfortable, especially in warm weather, but wearing them during the times of day when your symptoms are worst (often mornings) can help you get by with less medication.
Prescription Medications
When lifestyle measures aren’t enough, two medications are most commonly prescribed for orthostatic hypotension.
Midodrine
Midodrine works by stimulating nerve endings in blood vessels, causing them to tighten and raising blood pressure. It’s taken three times a day at roughly four-hour intervals: upon waking, at midday, and in the late afternoon. Timing matters with this one. The last dose should not be taken after 6 p.m. or within three to four hours of bedtime, because it can cause dangerously high blood pressure when you’re lying down. You should also avoid taking it before napping or any period of lying flat.
This risk of elevated pressure while lying down (called supine hypertension) is the most important safety concern. According to an American Heart Association review, midodrine actually raises blood pressure more when you’re lying down than when you’re standing, which is the opposite of what you want at night. Supine hypertension over time can strain the heart and kidneys, so blood pressure monitoring while on this medication is essential.
Fludrocortisone
Fludrocortisone takes a different approach. Instead of tightening blood vessels, it helps your kidneys retain sodium and water, expanding your blood volume. It’s typically started at a low dose in the morning and can be gradually increased over several weeks based on how your standing and lying blood pressure readings respond. The most common side effects are fluid retention, swelling, low potassium levels, headache, and (like midodrine) elevated blood pressure when lying down.
Droxidopa for Neurogenic Causes
If low blood pressure is caused by nerve damage from conditions like Parkinson’s disease, multiple system atrophy, or autonomic neuropathy, there’s a more targeted option. Droxidopa is a synthetic compound that your body converts directly into norepinephrine, the chemical messenger that tells blood vessels to constrict. It’s FDA-approved specifically for dizziness, lightheadedness, and near-fainting in people with neurogenic orthostatic hypotension. One notable limitation: its proven effectiveness is based on studies lasting only two weeks, so doctors are advised to periodically reassess whether it’s still working.
Physical Countermeasures That Work Quickly
Simple body movements can raise your blood pressure within seconds when you feel symptoms coming on. Crossing your legs and squeezing your thighs together, squatting, or tensing your abdominal muscles all push blood from your lower body upward. These maneuvers are especially useful first thing in the morning (when blood pressure tends to be lowest) or after meals, which naturally divert blood to your digestive tract.
Other practical habits that help: standing up slowly rather than jumping out of bed or a chair, sleeping with the head of your bed elevated a few inches (this reduces nighttime fluid loss through the kidneys and can improve morning blood pressure), and eating smaller, more frequent meals to avoid the post-meal blood pressure dip that large portions cause.
Managing the Nighttime Trade-Off
One of the trickiest parts of treating low blood pressure is that many of the things that raise it during the day (salt, medications, fluids) can push it too high at night when you’re lying flat. This isn’t just uncomfortable. Over time, high nighttime blood pressure can thicken the heart muscle and impair kidney function. It also triggers your kidneys to flush out extra sodium and water overnight, which means you wake up with even lower blood volume in the morning.
Newer approaches are showing promise for managing this cycle. Research has found that sleeping with continuous positive airway pressure or applying local heat to the skin at night can lower nighttime blood pressure as effectively as medications, with the added benefit of reducing overnight fluid loss and improving daytime symptoms. Elevating the head of the bed by 10 to 15 degrees is a simpler version of the same principle: it keeps gravity working in your favor even while you sleep, discouraging the kidney from dumping excess fluid overnight.