Palpitations can occur when blood pressure is high, low or completely normal. Understanding the difference between blood pressure and heart rate can help you interpret your numbers without assuming that one abnormal reading explains the heartbeat sensation.
Heart palpitations do not automatically mean your blood pressure is high. Blood pressure measures the force of blood against artery walls, while heart rate measures how many times your heart beats each minute. High blood pressure often causes no symptoms at all. Low blood pressure — commonly below 90/60 mm Hg — may cause dizziness, weakness, fainting and sometimes palpitations, especially when circulation falls suddenly. An arrhythmia can also change blood pressure if it makes the heart pump less effectively. The combination of the blood-pressure reading, heart rhythm and associated symptoms is more important than either number alone.
Blood Pressure and Palpitations: When It May Be an Emergency
Seek urgent or emergency medical care for palpitations accompanied by:
- significant chest pain or pressure;
- severe or sudden shortness of breath;
- fainting or loss of consciousness;
- severe dizziness or near-fainting;
- collapse;
- confusion or signs of shock;
- new weakness or numbness on one side;
- new difficulty speaking;
- a sudden major change in vision; or
- rapidly worsening symptoms.
A blood pressure above 180/120 mm Hg together with symptoms suggesting acute organ injury — such as chest pain, severe breathlessness, neurological symptoms or vision change — is a medical emergency.
Extremely low blood pressure with fainting, confusion, cold clammy skin, rapid shallow breathing or a weak rapid pulse may indicate shock and also requires emergency care.
Blood Pressure and Heart Rate Are Not the Same Thing
This distinction is essential.
Heart rate is the number of times your heart beats each minute.
Blood pressure is the pressure created by circulating blood against the walls of your arteries.
The blood-pressure measurement contains two numbers:
- Systolic pressure — the top number, representing arterial pressure when the heart contracts.
- Diastolic pressure — the bottom number, representing pressure while the heart relaxes between beats.
The two measurements influence one another, but they do not always move together.
Your heart rate can increase considerably during exercise while blood pressure rises only moderately. Conversely, a person may have high blood pressure while the resting heart rate remains completely normal.
If your heart suddenly feels fast or irregular, measuring both pulse and blood pressure can provide useful information when it is safe to do so. Neither reading, however, tells you the exact cardiac rhythm.
Can High Blood Pressure Cause Heart Palpitations?
High blood pressure and palpitations can occur together, but uncomplicated hypertension is usually not experienced as a pounding or irregular heartbeat.
In fact, hypertension is often called a “silent” condition because many people have no obvious symptoms.
Palpitations in someone with high blood pressure may instead result from:
- stress or anxiety;
- caffeine or nicotine;
- medication effects;
- premature beats;
- atrial fibrillation or another arrhythmia;
- thyroid disease;
- sleep apnea;
- alcohol; or
- another cardiovascular condition.
High Blood Pressure Can Increase Long-Term Arrhythmia Risk
Although hypertension does not necessarily produce immediate palpitations, long-standing high blood pressure can change the structure of the heart and is associated with a higher risk of conditions such as atrial fibrillation.
This is another reason good long-term blood-pressure control matters even when high blood pressure itself causes no symptoms.
What Blood Pressure Is Considered High?
Current U.S. guidelines classify adult blood pressure approximately as follows:
| Category | Systolic | Diastolic |
|---|---|---|
| Normal | Less than 120 | Less than 80 |
| Elevated | 120–129 | Less than 80 |
| Hypertension | Consistent readings beginning at 130 or higher | and/or 80 or higher |
| Severe hypertension | Higher than 180 | and/or higher than 120 |
A diagnosis of hypertension is generally based on repeated appropriately measured readings rather than one elevated measurement during stress, pain, exercise or a palpitation episode.
What If My Blood Pressure Is Over 180/120 During Palpitations?
If you obtain a reading higher than 180 systolic and/or 120 diastolic while otherwise stable, sit quietly and repeat the measurement after at least one minute.
If it remains severely elevated, contact a healthcare professional promptly.
Very High Blood Pressure Plus Warning Symptoms Is an Emergency
Seek emergency medical care if blood pressure remains above 180/120 mm Hg and you also have symptoms such as:
- chest pain;
- shortness of breath;
- back pain;
- new numbness or weakness;
- vision change;
- difficulty speaking;
- confusion; or
- another symptom suggesting acute organ injury.
Do not try to rapidly lower severely elevated blood pressure with extra doses of prescription medication unless a clinician has specifically given you such an emergency plan.
Can Low Blood Pressure Cause Heart Palpitations?
Low blood pressure can occur with palpitations, particularly when the body responds to reduced circulation by increasing heart rate.
A blood-pressure reading below about 90/60 mm Hg is commonly described as hypotension.
However, the number alone does not determine whether it is dangerous. Some healthy people naturally have blood pressures around this range and feel completely well.
Symptoms matter.
Symptoms That May Accompany Low Blood Pressure
- dizziness or lightheadedness;
- blurred or fading vision;
- weakness;
- fatigue;
- nausea;
- difficulty concentrating;
- palpitations; and
- fainting.
A sudden fall from your usual pressure may cause symptoms even when the final reading is not dramatically low.
What Can Cause Low Blood Pressure With Palpitations?
Dehydration
Vomiting, diarrhea, fever, heavy sweating or poor fluid intake can reduce circulating volume. The heart may compensate by beating faster.
Blood loss
Significant bleeding can lower circulating volume and blood pressure. A rapid pulse, weakness, pallor or faintness may develop.
Medication effects
Diuretics, beta-blockers, alpha-blockers and other blood-pressure medicines may lower pressure excessively in some people.
Arrhythmia
Very rapid, very slow or poorly coordinated rhythms can reduce cardiac output and cause low blood pressure, dizziness or fainting.
Severe infection
Serious infection can cause dangerous vasodilation and low blood pressure. Fever, rapid breathing, confusion or severe illness may occur.
Severe allergic reaction
Anaphylaxis can cause a sudden dangerous fall in blood pressure, often with difficulty breathing, swelling, rash or collapse.
Anemia
Significant anemia may produce a faster heartbeat, fatigue, weakness, dizziness and sometimes lower blood pressure.
Pregnancy
Blood pressure can fall during pregnancy because of normal circulatory changes. Palpitations are also common, although significant symptoms deserve appropriate pregnancy-specific evaluation.
Can a Heart Arrhythmia Make Blood Pressure High or Low?
Yes.
An arrhythmia can alter how effectively the heart fills and pumps blood. The blood-pressure response depends on the rhythm, heart rate, duration and underlying heart function.
For example:
- a very fast rhythm can reduce the amount of blood pumped with each beat;
- a very slow rhythm may not provide enough cardiac output;
- atrial fibrillation can produce variable pulse strength and blood-pressure readings;
- premature beats may temporarily produce weaker pulse waves; and
- anxiety during palpitations may temporarily increase blood pressure.
A 12-lead ECG or ambulatory rhythm monitor is needed when clinicians need to determine whether AF, SVT, premature beats, bradycardia or another rhythm is responsible.
What If Palpitations and Low Blood Pressure Happen When I Stand Up?
Symptoms that appear after standing may suggest orthostatic hypotension.
This occurs when blood pressure falls after moving from lying or sitting to an upright position.
Symptoms may include:
- lightheadedness;
- dizziness;
- blurred vision;
- weakness;
- palpitations or a compensatory faster pulse; and
- fainting.
Possible contributors include dehydration, prolonged bed rest, medications and disorders affecting the autonomic nervous system.
Blood Pressure and Heart Rate Should Be Considered Together
When recurrent symptoms occur after standing, clinicians may compare blood pressure and heart rate while lying down and after standing. In selected patients, a tilt-table test may be used to examine how both measurements respond to gravity.
What If Blood Pressure Is Low and the Heart Is Racing?
A fast heartbeat with low blood pressure deserves particular attention because the rapid pulse may represent the body’s attempt to maintain circulation — or the fast rhythm itself may be causing the pressure to fall.
Possible causes include:
- dehydration;
- blood loss;
- fever or severe infection;
- anemia;
- SVT or another tachyarrhythmia;
- atrial fibrillation with a rapid ventricular rate;
- medication effects;
- severe allergic reaction; or
- other forms of circulatory shock.
Low Blood Pressure Plus Signs of Poor Circulation Needs Urgent Care
Seek emergency care if low blood pressure is associated with:
- fainting or collapse;
- confusion;
- cold clammy skin;
- rapid shallow breathing;
- a weak rapid pulse;
- severe shortness of breath;
- significant chest pain; or
- rapidly worsening weakness.
These findings may indicate inadequate circulation or shock rather than simply a person’s naturally low blood-pressure baseline.
Can Blood Pressure Medicine Cause Heart Palpitations?
Sometimes symptoms appear after starting or changing cardiovascular medicines, but the mechanism depends on the drug.
Beta-blockers
Beta-blockers usually slow heart rate and lower blood pressure. An excessive effect can cause bradycardia, low blood pressure, dizziness or weakness.
Abruptly stopping some beta-blockers may also produce a rebound increase in heart rate or blood pressure.
Diuretics
Diuretics can lower blood pressure by reducing fluid volume. Excessive fluid or electrolyte loss may sometimes contribute to dizziness or palpitations.
Vasodilators and other antihypertensives
Medicines that lower vascular resistance can sometimes cause lightheadedness or compensatory increases in heart rate.
If your readings have changed substantially or symptoms began after a medication adjustment, contact the prescribing clinician. The dose, timing, hydration status, kidney function and other medicines may all need review.
See our broader guide to medicines and heart palpitations .
How Should You Measure Blood Pressure During Palpitations?
If you are otherwise stable and can measure your pressure safely, good technique makes the reading much more useful.
- Sit quietly for about five minutes first when possible.
- Keep your back supported.
- Place both feet flat on the floor.
- Keep your arm supported at heart level.
- Use the correct cuff size.
- Do not talk during the measurement.
- Take two readings about one minute apart.
- Record the pulse shown by the monitor as well.
- Write down what the palpitation felt like and how long it lasted.
Caffeine, exercise and nicotine shortly before the measurement can affect results, so routine blood-pressure monitoring is best performed under consistent resting conditions.
If repeated readings vary widely during an irregular heartbeat, show the measurements to your healthcare professional rather than trying to diagnose the rhythm from the blood-pressure monitor.
How Do Doctors Evaluate Palpitations With Abnormal Blood Pressure?
Evaluation depends on whether the concern is persistent hypertension, symptomatic hypotension, an arrhythmia or an underlying condition causing both.
Repeat blood-pressure measurements
A single reading may be misleading, particularly during stress, pain or an active palpitation episode.
Home or ambulatory blood-pressure monitoring may help establish the person’s usual pattern.
12-lead ECG
An ECG can identify atrial fibrillation, SVT, bradycardia, premature beats and other electrical abnormalities if they are present during the recording.
When symptoms come and go, a Holter, patch or event recorder may be needed to compare the rhythm with the blood-pressure and symptom episodes.
Blood tests
Depending on the history, testing may include:
- blood count for anemia or bleeding;
- electrolytes;
- kidney function;
- thyroid testing; and
- other tests suggested by the clinical situation.
Orthostatic blood pressure
If dizziness and palpitations occur when standing, blood pressure and pulse may be measured lying down and again after standing.
Echocardiogram
Echocardiography may be appropriate when structural heart disease, heart failure or long-standing hypertension-related heart changes are suspected.
What Should You Do at Home?
If there are no emergency warning signs:
- sit or lie down if you feel dizzy;
- avoid driving while lightheaded or near-fainting;
- record your blood pressure and pulse when safe;
- note whether the heartbeat feels regular or irregular;
- record how long the episode lasts;
- review recent caffeine, alcohol, nicotine and medications;
- drink fluids if mild dehydration is likely and you have no fluid restriction; and
- contact your clinician when symptoms recur or readings remain abnormal.
Do Not “Chase” Blood Pressure Numbers
Do not repeatedly take extra blood-pressure medication because one reading is high, and do not consume large amounts of salt, caffeine, electrolyte supplements or fluids merely because one reading is low.
Treatment should be based on the underlying cause, repeated measurements and your clinician’s individualized instructions.
See how to stop heart palpitations safely for general self-care guidance.
Dr. Albana’s Note
When a patient tells me, “My heart was racing and my blood pressure was high,” I do not automatically assume the high pressure caused the palpitation. Stress from feeling the abnormal heartbeat can raise blood pressure temporarily, while the underlying rhythm may be something quite separate. I take the same approach with a low reading. A person who normally feels well at 95/60 is very different from someone whose pressure suddenly falls to that level with weakness and near-fainting. I look at the blood pressure, pulse, rhythm, symptoms, medications and usual baseline together. That gives us a much more accurate picture than focusing on one number alone.
When Should You Make a Medical Appointment?
Arrange evaluation if:
- palpitations keep returning;
- blood-pressure readings are repeatedly high;
- you repeatedly have symptomatic readings below about 90/60 mm Hg;
- you frequently become dizzy when standing;
- your heartbeat feels persistently fast or irregular;
- you have recurrent weakness or exercise intolerance;
- symptoms began after starting or changing medication;
- you have known heart or kidney disease;
- you have fainted or nearly fainted; or
- your blood-pressure pattern has changed substantially from your usual baseline.
If dizziness is prominent, see dizziness and heart palpitations .
If unusual weakness accompanies the episodes, see heart palpitations and weakness .
Urgent Warning Signs
Seek urgent or emergency medical care for:
- blood pressure above 180/120 mm Hg with chest pain, breathlessness, neurological symptoms or vision change;
- very low blood pressure with fainting or collapse;
- confusion, cold clammy skin or signs of shock;
- significant chest pain or pressure;
- severe shortness of breath;
- severe dizziness or near-fainting;
- a sustained very rapid or markedly irregular heartbeat while feeling seriously unwell;
- new one-sided weakness or numbness;
- new difficulty speaking; or
- rapidly worsening symptoms.
For a broader triage guide, see when to worry about heart palpitations .
Most Asked Questions
Can high blood pressure cause heart palpitations?
High blood pressure and palpitations can occur together, but uncomplicated hypertension often causes no symptoms. Stress, stimulants, medication effects or an arrhythmia may explain the palpitation even when blood pressure is elevated.
Can low blood pressure cause heart palpitations?
Yes. Palpitations may occur with symptomatic low blood pressure, particularly when dehydration, blood loss, medication effects or another condition causes the heart to compensate by beating faster.
Is 90/60 blood pressure dangerous?
Not necessarily. Some healthy people normally have blood pressure around 90/60 and feel well. Low blood pressure becomes more concerning when it is new or accompanied by dizziness, fainting, confusion, weakness or signs of poor circulation.
Can my blood pressure be normal while I have palpitations?
Yes. Palpitations can occur with normal blood pressure. Premature beats, anxiety, caffeine and some arrhythmias may produce noticeable heartbeat sensations without causing a major change in blood pressure.
Does a racing heart always raise blood pressure?
No. Heart rate and blood pressure are separate measurements. Some rapid rhythms may raise pressure temporarily, while very rapid arrhythmias can actually lower blood pressure because the heart has less time to fill between beats.
Why is my blood pressure high when I have palpitations?
Anxiety, pain or adrenaline during the episode can temporarily raise blood pressure. The palpitation may also have an independent cause. Repeated resting readings and ECG evaluation can help separate the two.
Why does my blood pressure drop when my heart races?
A very rapid rhythm can reduce how much blood the heart pumps with each beat. Dehydration, blood loss or other causes of low circulating volume can also produce both a rapid pulse and low blood pressure.
Can blood pressure medicine cause palpitations?
Some blood-pressure medicines can affect heart rate, fluid volume or electrolytes. Excessive blood-pressure lowering may also cause dizziness or weakness. Do not stop or change prescribed medication without medical advice.
Can dehydration cause low blood pressure and palpitations?
Yes. Fluid loss can reduce circulating blood volume, lower blood pressure and trigger a compensatory faster pulse. Severe or persistent symptoms need medical evaluation.
What blood pressure is an emergency?
Blood pressure above 180/120 mm Hg accompanied by symptoms suggesting acute organ damage, such as chest pain, severe breathlessness, neurological symptoms or vision changes, is a medical emergency. Very low pressure causing shock symptoms is also an emergency.
Should I check my blood pressure during palpitations?
If you are otherwise stable and can do so safely, recording blood pressure and pulse may provide useful information. Do not delay emergency care to take repeated measurements when serious warning signs are present.
Can a normal blood-pressure reading rule out an arrhythmia?
No. Many arrhythmias can occur while blood pressure remains normal. An ECG or ambulatory rhythm monitor is needed to identify the electrical rhythm.
Related Heart Palpitation Guides
Medical References
- American Heart Association / American College of Cardiology. 2025 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.
- American Heart Association. Low Blood Pressure — When Blood Pressure Is Too Low. Reviewed 2024.
- American Heart Association. Blood Pressure Explained.
- American Heart Association. All About Heart Rate. Last reviewed May 13, 2024.
- American Heart Association. Symptoms, Diagnosis and Monitoring of Arrhythmia. Reviewed 2024.
- American Heart Association. Syncope (Fainting). Reviewed 2024.
- Mayo Clinic. Low Blood Pressure (Hypotension): Symptoms and Causes. Updated June 13, 2024.
- Mayo Clinic. Orthostatic Hypotension: Symptoms and Causes.
About the Medical Team
Dr. Albana Greca, MBBS, MMedSc
Family Physician / General Practitioner
Dr. Albana Greca has more than 20 years of experience in primary care, general medicine, chronic disease management, prevention, patient education and digital health.
Dr. Benard Shehu, MBBS, MS
Cardiologist
Dr. Benard Shehu has more than 19 years of cardiovascular experience, including clinical experience relevant to arrhythmias and cardiovascular disease.