Heart failure and low blood pressure (hypotension) have a complex relationship. Heart failure is a progressive condition, which means it worsens over time. As heart failure worsens, it may cause low blood pressure.

Low blood pressure may worsen heart failure by limiting the amount of blood that can flow to the heart and causing it to work harder to pump blood to the body.

In heart failure, the heart becomes increasingly less efficient at pumping blood. As a lower volume of blood is pumped out of the heart, blood pressure drops.

Normal blood pressure is diastolic (the top number) between 90 mmHg and 120 mmHg and systolic (the bottom number) between 60 mmHg and 80 mmHg. If your systolic blood pressure is below 90 mmHg, your diastolic blood pressure is below 60 mmHg, or both, it’s considered low blood pressure.

If you have low blood pressure, your blood moves more slowly through your blood vessels, and there is less pressure available to move it. In some cases, you may also have a reduced volume of blood (hypovolemia). The risk from low blood pressure is that your vital organs, like your kidneys and brain, may not get enough oxygen.

Having low blood pressure can make your heart work harder to pump blood to your body. If this continues long enough, it can cause your heart to become less efficient and contribute to or worsen heart failure.

While heart failure can cause low blood pressure, especially in later stages, low blood pressure can also contribute to heart failure. Individuals who have both conditions will need to work closely with their healthcare team.

Lifestyle choices like eating a heart-healthy diet and staying active may help. Your doctor can help you develop and maintain a treatment plan to manage your conditions and feel better.