<s>[INST] my mother in laws blood pressure is bottoming out like 60/40. what could be causing it. she has been on same meds.for over a year. it has just started last week. she has been in and out of hospital and there not telling us any answers. can you please [/INST] Hello! Welcome and thank you for asking on Chat Doctor! I understand your concern and would explain that there are different factors contributing to this clinical situation: - deny Chat Doctor.  I would recommend consulting as soon as possible with her attending physician for a careful physical exam and some tests: - a resting ECG and cardiac ultrasound to examine her cardiac function-some blood lab tests (complete blood count, total protein, NT Pro BNP levels, blood electrolytes, kidney and liver function tests). Furthermore, I would recommend avoiding intake of antihypertensive  </s>