D20 Call of Cthulu applies the massive damage fortitude save any time you take more than 10 damage from a single hit, and has great magic and sanity systems.
Black Company RPG applies that save for any damage taken in the surprise round.
If death is too much, you could use a critical hit chart or deck instead, or adjust the threshold as desired. Even when it's a 1 check, having to make the save is scary.
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Here is some advice from someone that has been in a lot of terrible low-magic games.
First off, if you are doing a low-magic item, no caster campaign, please Please PLEASE watch what you throw at the players from the Bestiary. Really look at what they are going up against, especially if they have powerful special abilities that would require magic to cure. It can get very annoying when you are a group going against shadow demons. Or beholders. Or wraiths. In fact, the game I was in was less DnD and more "Run the f#!& away from everything and get nothing accomplished". Very frustrating. Mind you, I'm not saying the occasional magic creature is bad, but you have to really calibrate what your players can handle.
Secondly, the variant rules for wounds and vigor, in my opinion, work pretty well. I've used them in a campaign for two months before the campaign ended and they were good. There should be some other ones here by Evil Lincoln that he made up. Armor as DR I haven't used, but I feel that it favors platemail too much over agile characters. Everyone becomes easier to hit, but the armor at least gives good DR to the armor wearers. I've thought about putting in a dodge or parry mechanic for the agile fighters to use.
Thirdly, look at the rules for E6. It might be up your alley for some lower style adventures. They are free, easy to find, and even easier to convert. Some people play E8 for Pathfinder, since many classes come into their own at level 8. E6 stops at 6 because it barricades things like divination.
Fourthly, please, don't make every single fight one for their lives. Much like stories, roleplaying games have a certain pacing to them. If you are constantly throwing APL+3 every encounter, or your players are always being ambushed or always fighting against tactically superior foes, there will be a time where encounter fatigue sets in. Players will be out of resources after two fights. Many players might get discouraged that despite their tactics, their characters are always on the brink of dying or worse, always dying. It'll come to a point where instead of "playing more tactically" and "fearing death", the complete opposite happens and your players become apathetic to the story and their character's well-being. Some people might just make a min-maxed beefcake just for survival and to spite both the story and the GM, instead of making the more well-rounded characters you are looking for.
I was in a low magic campaign once where every game, someone died. Sometimes it was poor tactics, but mostly, it was monsters with powers beyond our scope that we couldn't escape from. The GM LOVED this gritty, no-hope, Arkham Horror-type game, but after awhile, we got really sick of it. Despite our complaints, things only got worse, until finally, we all just made twinked out characters and just became a murderous band of adventurers. That campaigned crashed and burned and it took a long time before anyone played with that GM again.
Of course, the opposite is true. Making every encounter a cakewalk makes the game dull and players a bit too cocky. I was once in a game where the final boss was a level 10 aristocrat solo encounter... I think we killed him in one hit before escape. Was very anticlimactic and terrible. Point is, it's okay to have some easy fighters here and there, mixed in with a couple hard ones. Remember that your players don't know the encounter is easy going in; you do. In addition, all of your bad guys will have all of their resources at their disposal. HP, Spells, etc. Meanwhile, the players will probably have used some ammunition, spells, or might be damaged from a previous fight, making each subsequent fight harder and harder. Keep that in mind when designing encounters.
And lastly, make sure your players know ahead of time what kind of game they are getting into. This style of gaming isn't for everyone, so you at least want them to know so they can prepare for it, express concerns, or simply not play. I know for me, as much as I love Lovecraft, I'd probably not want to play in a Call of Cthulhu game.
Good luck and remember, calibrate the expectations of your players.
An addendum to the Armor as DR, what I have considered doing is allowing players to dodge with Acrobatics (applying armor penalty). Roll acrobatics as an immediate action against an attack and what you roll is your AC for that attack. Sometihng pretty much like Snake Style.
Corpsefinder: more gritty, not more unfair
Grittier IS more unfair, as Odraude said, you will have to scale thing up and/or down, find some solution for healing, etc...
Luke Crane swears that however much time you spend writing house rules, you should have spent that time finding an alternate game to play.
But since you're here...
Wounds and vitality are a good move
Try banning certain spells, the one's you hate, and not the whole magic system.
+1 be careful with monsters. Low magic usually works well with several bad guys, not one super monster
+1 for E6
Take a look at Sanity rules from Freeport, or the whole setting.
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Luke Crane swears that however much time you spend writing house rules, you should have spent that time finding an alternate game to play.
Yes, you want to run GURPS. Maybe Fantasy Hero. Even Runequest/BRP without the magic overlays would work. These systems cater to what you're looking for much more easily than Pathfinder.
And they're all pretty interesting systems in their own right.
GURPS has a Steampunk Sourcebook, Chaosium has A supplement that could be useful for BRP.
Making Pathfinder grittier requires reworking Hit Points, and, as a result, damage output.
The best method for this at present is the wounds and vigor system, where critical hits, sneak attack, etc. can mess you up.
Wounds and Vigor also make resource management in regards to healing a bit "grittier". You can (and do) recover Vigor pretty easily, but wounds take awhile to heal.
Another option for grittier combat would be to create condition chains and have wounds (or crits) inflict conditions as well as HP loss.
Stealing from Mutants and Masterminds 3e and using their conditions would be the best way to keep things on an even playing field.