<s>[INST] My husband has a history of heart disease. He has an ICD . His blood pressure is running 90/66 to 88/57. He is feeling tired and sorta lazy like. Normally BP runs 108/68 to 100/59. His pulse rate fluxes from 70 to 71. I feel his BP of 90/57 is too low. How can I safely raise is a little. JAK [/INST] Hello! Thank you for asking on Chat Doctor! I understand your concern, and would like to explain that when facing with low blood pressure values, the two main points to investigate are: (1) cardiac performance (is there a severe left ventricular ejection fraction compromise?); (2) excessive therapy implications (probably, a dose modulation of possible vasodilators and diuretics should be done). Facing the fact that your husband has an ICD implantation, seems that both the above-mentioned point have serious implications on the matter. As I lack more specific information about actual medical status, cardiac performance and current therapy, I recommend discussing with his doctor about the above options, and find an optimal strategy to deal with. Hope to have been helpful to you. Greetings!  </s>