Scope of Care · B
Primary hypotension
Last updated: 2026-09-20 · Prepared by licensed TCM physicians · Updated 2026-09
Key Points
Primary hypotension is blood pressure consistently below 90/60 mmHg on separate-day readings, after excluding treatable secondary causes (anemia, dehydration, arrhythmia, endocrine or drug-related). It ranges from no symptoms to chronic fatigue and dizziness.
- Common in slender young women; often noticeable on standing
- Most have no symptoms; some feel fatigue, dizziness, blurred vision or feel cold
- Linked in TCM to "qi and blood deficiency" and "yang deficiency"; positioned as lifestyle and constitution support
- Rule out secondary causes first; never stop prescribed drugs on your own
First, what cannot wait
- Fainting with head injury, confusion or seizures — call emergency
- Fainting during exercise with chest pain, palpitations or breathlessness — emergency now
- Brief slurred speech or limb weakness — possible stroke, call emergency
- Severe dehydration (ongoing vomiting/diarrhea, little urine) with lethargy — seek care now
- Low pressure is new and steadily worsening
- Night urination and marked thirst — check endocrine (thyroid, adrenal)
- Pregnancy or planning pregnancy with marked low pressure and dizziness
Understanding the Condition
Low pressure is like low water pressure in a building — the top-floor "shower" (your brain) gets less supply, so standing up brings dizziness or blackening of vision.
The word "primary" means no clear cause is found: anemia, thyroid disease, arrhythmias and certain drugs are ruled out first, leaving a chronic low-pressure state.
Why It Keeps Coming Back
It is easy to dismiss as "just poor constitution," yet blackouts on standing and fatigue genuinely disrupt life and can lead to falls.
Extra salt water alone does not fix the root. People who run constitutionally low do better with regular routine, graded exercise and pattern-based care that slowly rebuilds the base.
Our Pattern-Based Approach
A clinically common adjunctive approach warms yang and tonifies qi and blood, and lifts the clear: yang deficiency (cold limbs, fatigue); qi-blood deficiency (pale face, palpitations); sinking middle qi (worse after prolonged sitting or standing).
Acupuncture often uses Baihui (GV20), Zusanli (ST36), Qihai (CV6) and Guanyuan (CV4) to raise yang and nourish qi-blood, with warmth and regular meals. This remains adjunctive — if you take blood-pressure or antidepressant drugs, discuss with your prescriber first.
Common patterns and treatment directions
| Pattern | Typical presentation | Approach |
|---|---|---|
| Yang deficiency | Cold limbs, chilliness, low spirits, easy fatigue | Warm yang and tonify qi: Guanyuan (CV4), Qihai (CV6), Zusanli (ST36), keep warm |
| Qi and blood deficiency | Pale face, dizziness, palpitations, short breath | Tonify qi and blood: Zusanli (ST36), Baihui (GV20), Pishu (BL20), gentle tonifying |
| Sinking middle qi | Dizziness worse after long sitting/standing, fatigue, tendency to prolapse | Raise yang and lift: Baihui (GV20), Qihai (CV6), lifting points |
| Heart-spleen deficiency | Palpitations, poor memory, insomnia, poor appetite | Tonify heart and spleen: Xinshu (BL15), Pishu (BL20), Zusanli (ST36) |
| Liver stagnation with blood deficiency | Low mood, period-related dizziness, wiry-thin pulse | Course liver and nourish blood: Taichong (LR3), Sanyinjiao (SP6), Xuehai (SP10) |
Patterns are determined in person. This list is for orientation only and is not a self-diagnosis tool.
What to expect: first visit to follow-up
- First visit · about 40 minutesBring recent BP logs and medication list. We take history, pulse, tongue and pattern, checking red flags and referring to internal medicine first if a secondary cause is suspected.
- Plan discussion · same dayWe explain the pattern, points and frequency, state the adjunctive role, and note when to coordinate with your prescriber.
- Weeks 1-4One to two sessions per week, focused on dizziness, fatigue and circulation; you keep logging at home.
- Week 4-8 · first reviewCompare diary and symptoms before and after; decide to continue, adjust points or move to maintenance.
Course of care and follow-up
- Assessment usually runs in 4-8 week cycles
- Once stable, care may shift to maintenance every 2-4 weeks
- Pattern is re-assessed yearly or with constitutional/seasonal change
- We work with your physician throughout: never stop or reduce prescribed drugs alone
When to Seek Care
Before your visit:
- Change position slowly; rise in stages and consider raising the bed head to ease morning dizziness
- Keep hydrated and eat regular meals; modestly increase salt and protein if not contraindicated
- Graded aerobic and lower-limb strengthening to improve venous return
Consider an in-person consultation if:
- Recurrent dizziness/blackout or a fall caused by it
- Marked fatigue, palpitations, sudden weight loss or menstrual changes
- A medicine you take may lower pressure (some BP or antidepressant drugs) — ask your doctor
Supportive Care
- Routine: sit up first, pause at bedside, then stand; avoid long standing and sudden rises after hot baths
- Diet: regular meals, adequate fluids, slightly more salt and protein if allowed
- Exercise: gradual aerobic plus leg-contraction training to aid return flow
- Warmth: those with cold limbs especially avoid cold; warming yang is daily care
FAQ
Do I need medication to raise my pressure?
Most primary hypotension needs no specific drug and is managed by lifestyle. If a medicine or illness causes it, treat the cause. Our role is adjunctive; any medication change is your doctor’s decision.
Can acupuncture "raise my blood pressure"?
We do not promise to "raise pressure." Acupuncture aims to warm yang, tonify qi-blood and improve dizziness, fatigue and circulation, with lifestyle — assessed by your logs and reviews, not a one-off fix.
Want your situation assessed? Book a consultation.
Prepared by licensed TCM physicians · Updated 2026-09