“It wasn’t a heart attack. It was low blood pressure.”
When 28-year-old architecture student, Aarti Arora fainted in a crowded Delhi metro station recently, commuters assumed it to be the result of dehydration or exhaustion. But doctors diagnosed chronic hypotension.
In India, over 220 million people live with hypertension, making it a public health priority. Awareness campaigns, screenings, and even insurance premiums are often tailored around it. But what about those who are always dizzy, faint when they stand up too fast, or feel unusually fatigued despite “being healthy”? That’s where hypotension, the “invisible dip”, creeps in.
“There’s an overemphasis on hypertension, which is justified, but the result is that hypotension often slips through the cracks. It happens especially in young or undernourished patients,” says Dr. Radhika Kulkarni, a senior internal medicine consultant at a private hospital in Gurgaon.
DO I HAVE LOW BP?
Hypotension is medically defined as BP that is below 90/60mmHg. In some cases, reduced blood flow may deprive the brain, heart, and organs of vital oxygen and nutrients. Key warning signs include persistent fatigue, light-headedness when standing, blurred vision, nausea, and blackouts.
Left unmanaged, hypotension risks falls, brain fog, organ damage, and even shock from extreme drops. In other cases, low BP can also result in cardiac arrest.
Not too long ago, we had the unfortunate incident of the passing of actress Shefali Jariwala at just 42. Following a day-long fast, the actress had administered her usual medications and an anti-ageing injection, despite being on an empty stomach.
Later, she suffered a severe drop in blood pressure, leading to cardiac arrest and collapse at home. Mumbai police reported that Jariwala “began shivering” before her collapse and “BP dropped drastically” shortly before being rushed to Bellevue Hospital, where she was pronounced dead.
Her passing is not just an entertainment headline — it’s a stark reminder that sudden hypotensive episodes, often overlooked, can strike hard and fast. Even in otherwise healthy individuals.
According to noted cardiologist Dr. Naresh Trehan, there are two major culprits for sudden heart attacks: hypertrophic cardiomyopathy or dilated cardiomyopathy and the other is inherited electrical irregularities, such as Brugada syndrome. This is where the heart’s electrical system is unstable and prone to dangerous arrhythmias.
In a healthy heart, a drop in blood pressure (systolic pressure falls below 100 mmHg) can compromise blood flow to the heart.
But can low BP result in a cardiac arrest that could kill? “Yes, critically low blood sugar (especially during fasting), may also play a role,” he tells us.
WHY HYPOTENSION IS MISDIAGNOSED
“I kept hearing it’s all in my head,” says Karan, 35, an ad executive in Chennai. It often takes a collapse or ER visit before anyone considers low BP.
Many patients are sent home with “just drink water” or “get more rest.” Matters are worse in rural India. Pulmonologist Dr. Sanjeev Kumar observes, “Young women report dizziness or extreme fatigue, but no one checks BP unless it’s high. In areas with high anaemia and dehydration, hypotension is often a quiet epidemic.”
The reason why it has become an epidemic in India is because hypotension is no longer restricted to elderly patients alone. Across India, low BP is commonly seen in young urbanites who regularly skip their meals, or are in a burnout regime. Women with anemia, PCOS, thyroid flaws, or rural communities grappling with malnutrition and heat, are also prone to such sudden dips in their blood pressure.
WHAT SHOULD YOU DO?
Experts advise an increase in routine BP checks. Building public awareness around hypotension is key. More health camps around the issue need to be organised, ABHA-enabled telemedicine, and corporate screenings must begin logging of low BP trends, not just high readings. AI-enabled BP monitors that trigger hydration nudges, and fire alerts for hypotensive dips in real time, can also go a long way in revolutionising early detection.
Including hypotension in heart-health campaigns — hashtags like #NotJustHighBP and #LowBPCanKill can drive social traction about the issue at hand.
“Hypotension is not always benign; integrated tracking in ABHA and telehealth could change outcomes,” adds Dr. Sheetal D’Souza, a digital health policy expert, Mumbai.
If you experience fatigue, light-headedness, chest unease, or fainting — don’t chalk it up to stress. These could be signs that your blood pressure is dangerously low.
Even a single episode shows how fast hypotension can turn fatal. Let’s shift the focus: pressure isn’t just about being high, even low can kill.
– Ends