A high pulse with low blood pressure (BP) can happen after standing up or due to a medical condition—like congestive heart failure.

Low blood pressure—also called hypotension—may not be a medical concern unless it causes symptoms. A high heart rate—called tachycardia—is one way the heart resolves hypotension.

This article will discuss the benign and serious causes of when tachycardia and hypotension occur together. It will also cover when to contact a healthcare provider and potential treatments.

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Benign Causes of High Pulse With Low BP

A normal heart rate is 60 to 100 beats per minute (BPM) for an adult. Heart rates over 100 are considered high. A low blood pressure is considered 90/60 millimeters of mercury (mmHg) or less.

A person's blood pressure and heart rate should correlate with their actions. If someone is resting, their heart rate and blood pressure should be on the lower end of normal. When someone exercises, both their heart rate and blood pressure should be raised. This is a normal body process.

However, a high pulse and low blood pressure can indicate an underlying condition. There are benign causes that resolve with simple treatments. Learn more about these below.

Postural Orthostatic Tachycardia Syndrome (POTS)

Postural orthostatic tachycardia syndrome (POTS) is a condition in which the autonomic nervous system does not function properly. The autonomic nervous system regulates involuntary physical processes like heart rate, blood pressure, breathing, and digestion.

When someone with POTS stands up from lying down, their heart rate increases, and in some people, their blood pressure goes down.

POTS symptoms can include:

  • Light-headedness
  • Fatigue
  • Headache
  • Brain fog
  • Palpitations

POTS can change a person's life, but it is not life-threatening. The most significant risk associated with POTS is fainting and falling.

POTS treatment varies and is based on underlying conditions and symptoms. There is no cure but it is treated with diet, medications, and exercise.

Orthostatic Hypotension

Orthostatic hypotension is a condition where blood pressure decreases when standing up from a seated or lying position. Heart rate slightly increases, but not as significantly as in those with POTS.

It is normal for a slight blood pressure drop when moving to a standing position. Blood pools in the legs, and there is less blood for the heart to pump throughout the body. This causes a temporary drop in blood pressure and most people will not even notice it.

However, when someone has orthostatic hypotension, the blood pressure drops low enough that it causes symptoms like light-headedness, dizziness, blurred vision, and confusion. The heart will beat faster to bring blood pressure back up to normal.


Another benign cause of low blood pressure and high heart rate is dehydration.

Dehydration is when there is not enough fluid in the body. Illness, sweating, diarrhea, vomiting, or not drinking enough can cause it.

When there isn't enough fluid in the body, blood pressure can decrease and heart rate can increase. The heart rate increases in response to the lowered blood pressure, which is one way the body tries to bring low blood pressure back to normal levels.

When dehydration is mild, it can be treated by consuming additional fluids. People with moderate to severe dehydration will need to see a healthcare provider to receive intravenous (IV) fluids.


During the first 24 weeks of pregnancy, it is common to have lower blood pressure. This is due to the expanding maternal circulation and changes in hormones.

The heart will beat faster to compensate for the decreased blood pressure. This will help return the blood pressure to normal.

Serious Causes of High Pulse With Low BP

A combination of high pulse and low blood pressure can be caused by a serious medical condition, which are listed below.


Shock is a life-threatening condition characterized by a decreased amount of blood volume moving through the blood vessels. This results in less oxygen and fewer nutrients reaching the organs and tissues, leading to decreased organ function. If shock is not quickly treated it can lead to death.

The dangerously low volume in the blood vessels causes low blood pressure. In response, the heart will increase its rate to circulate more blood volume throughout the body to carry oxygen and nutrients to the organs.

There are several types of shock:

Irregular Heart Rhythm

Also known as an arrhythmia, an irregular heart rhythm is when an electrical signal does not move properly through the heart. This can cause the heart to pump blood throughout the body ineffectively.

One type of arrhythmia, atrial fibrillation, is when the heart's upper chambers beat very fast and irregularly. When this occurs, the heart's lower chambers are unable to fill up with blood, which does not allow enough blood to get pumped through the body.

There are no specific causes of atrial fibrillation, but risk factors include being over 50, male gender, high blood pressure, alcohol use, and heart failure.

Congestive Heart Failure

Congestive heart failure (CHF) is a condition in which the heart muscle becomes less effective at pumping blood throughout the body. There is decreased blood flow to organs, which can cause many serious problems.

With the heart unable to pump effectively, blood pressure decreases, and the heart rate can increase to compensate for the lower blood pressure.

CHF can be caused by other medical conditions or by injury to the heart muscle. Some medical conditions that can cause CHF include:

  • Irregular heartbeats
  • Diabetes
  • Cardiomyopathy
  • Coronary artery disease
  • Heart attack

When to Call 911

A high pulse with low blood pressure can require a call to a healthcare provider or be a medical emergency. Anytime someone suspects that they are having these changes along with dizziness, light-headedness, or nausea, they should contact their healthcare provider. However, call 911 if someone is experiencing difficulty breathing, chest pain, or becomes unconscious.

What to Do With a High Pulse and Low BP

Increasing the heartbeat is the body's normal response to low blood pressure. It is one of the ways the body works to bring the blood pressure back up to normal.

However, when the pulse is very high or stays high, and the blood pressure remains low, it is a problem. If someone is light-headed or dizzy when moving from a lying or seated position to a standing position, they should sit or lay back down until they feel better.

If medical conditions cause the high pulse and low blood pressure, a healthcare provider must treat the underlying cause.

Working With a Provider to Treat Both Symptoms

Treatments a healthcare provider provides will vary based on the underlying cause of high heart rate and low blood pressure. In mild cases, treatment can be done at home. However, those with moderate to severe symptoms will likely need to be hospitalized for treatment.

Treatments for mild cases of low blood pressure:

Treatments for moderate to serious cases of low blood pressure:

  • IV fluids
  • IV medicines to increase blood pressure
  • Antibiotics

Treatments for high heart rates will vary significantly based on the cause, the heart rhythm, and the symptoms it causes. Some people will recover with no treatment, whereas others will need to be in the hospital for treatment. Treatments can include:


A high pulse and low blood pressure can be caused by many different medical conditions or injuries. Some conditions can be treated with at-home treatments such as increased fluid intake and rest. Other conditions like irregular heart rates are very serious and will need immediate medical attention.

Contact a healthcare provider if a high pulse and low blood pressure are suspected. They will be able to evaluate and provide prompt, effective treatment.

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