Hi Thanks for posting on HCM Low BP could be caused by many medical conditions.Some possible causes may include: -Pregnancy -Heart problems like bradycardia, heart valve problems, heart attack and heart failure -Endocrine problems like adrenal insufficiency hypoglycemia and, in some cases, diabetes can trigger low blood pressure -Dehydration -Severe allergic reaction -Anemia -Some medications like Diuretics, Alpha blockers, Beta blockers, Drugs for Parkinson s disease, tricyclic antidepressants, Sildenafil Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly.It may not directly manifest with low blood pressure. When low BP become symptomatic, the most appropriate treatment depends on the underlying cause.I will suggest you try the following: *Use more salt *Drink more water *Wear compression stockings *Continue with midodrine when you have symptoms *Follow a healthy diet *Go slowly when changing body positions If these measures do not help, you see your Cardiologist for evaluation and investigation.You will tests like full blood count, fasting blood sugar, serum electrolytes, ECG, Echocardiogram, Stress test, Valsalva maneuver, Tilt table test.From the results of the tests, better and objective treatment options may be discussed. Hope this will help Wish you good health