April 2, 2010
Lowering Elevated Diastolic Blood Pressure Will Lessen Chance of Developing Elevated Systolic Blood Pressure
April 2, 2010
Dear Mayo Clinic:
I have normal systolic blood pressure, but my diastolic goes between 82 and 96 during the work day and goes down to normal at night or when there is no stress. Should I be concerned or is this normal?
Answer:
If you don't have other health issues that increase your risk of cardiovascular problems, the situation you describe — isolated diastolic hypertension — isn't dangerous now. But it's not normal, either. People with elevated diastolic blood pressure often develop elevated systolic blood pressure over time. You can help prevent that by taking steps to lower your diastolic blood pressure to a normal level.
A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in the arteries when the heart beats (systolic pressure). The second, or lower, number measures the pressure in the arteries between beats (diastolic pressure). Normal blood pressure is below 120/80 mm Hg.
Research regarding diastolic blood pressure has evolved considerably over the last several decades. During the 1970s and 1980s, many researchers and physicians believed the diastolic reading was the more important of the two blood pressure measurements. Now, we know they are both equally important.
Minimal elevations of diastolic blood pressure (less than 95 mm Hg) alone don't pose an immediate significant health risk. But that's assuming you're in good health otherwise and don't have any additional factors that put you at risk for cardiovascular problems. Those factors include diabetes, kidney disease, obesity, smoking, hardening of the arteries (atherosclerosis), or a history of heart disease or a heart attack.
If you don't have any additional risk factors, regularly monitoring your blood pressure and making lifestyle changes to decrease your diastolic blood pressure may be all that's necessary at this time. Taking steps to reduce your blood pressure to a normal level is important because an elevated diastolic pressure puts you at a higher-than-average risk of developing elevated systolic blood pressure as you age. Changes that can make a difference include eating a low-salt diet, avoiding alcohol, exercising regularly, not smoking and maintaining a healthy weight.
If you have other cardiovascular risk factors, any elevation in diastolic blood pressure — even if it's small — significantly increases your risk of cardiovascular problems. If that's the case for you, I strongly recommend you work with your physician to create a comprehensive treatment plan that addresses all your risk factors, including high blood pressure.
Effective management of high blood pressure is important because if left untreated it can have serious, long-term consequences. High blood pressure damages the lining of the blood vessels and accelerates hardening of the arteries throughout the body. This, in turn, can lead to a variety of health issues, such as cerebrovascular disease, heart attack and peripheral vascular disease, among others. These are cholesterol-related complications that people often think of when considering health problems associated with high blood pressure.
But there's another way high blood pressure is equally dangerous. The constant pounding of high blood pressure on blood vessels can also lead to serious health problems, including the type of stroke where there is bleeding in the area between the brain and the tissues that cover it (subarachnoid hemorrhage), congestive heart failure, kidney failure and abdominal aortic aneurysm.
In addition, increasing evidence suggests a correlation between high blood pressure and dementia. Research has shown that successful treatment of high blood pressure is associated with a reduced risk for dementia and Alzheimer's disease. So, to protect the brain, treat high blood pressure.
To effectively address your situation, I encourage you to make an appointment with your doctor to assess your elevated diastolic blood pressure and, based on your health history and other medical issues, develop a plan to manage it appropriately.
—John Graves, M.D., Nephrology and Hypertension, Mayo Clinic, Rochester, Minn.
Related articles
- What Is It?
- What is isolated diastolic hypertension?
-
Causes
- What causes high diastolic blood pressure?
- What causes your blood pressure to suddenly get high?
- Signs/Symptoms
- What are symptoms of high diastolic pressure?
- Types of Hypertension
- What are the main types of hypertension?
- Treatment
- How is high diastolic blood pressure treated?
- Blood Pressure Levels
- What are the different blood pressure levels?
- Risk Factors
- What are the risk factors of high blood pressure?
- Related Resources
- Related Resources - Why Is My Bottom Blood Pressure Number High?
Isolated diastolic hypertension (IDH) occurs when only your diastolic blood pressure is high
Blood pressure is the force of your blood pushing against the walls of your arteries, which carry blood to other parts of your body. Your blood pressure can be measured using two numbers:
- Systolic (the number on top): pressure exerted when the heart pumps blood throughout the body
- Diastolic (the number at the bottom): pressure exerted when the heart relaxes and refills with blood
When your blood pressure is consistently higher than 130/80 mm Hg, you are considered to have hypertension.
What is isolated diastolic hypertension?
With hypertension, typically both systolic and diastolic blood pressures are elevated. However, isolated diastolic hypertension (IDH) occurs when your systolic blood pressure is normal, and only your diastolic blood pressure is high (over 80 mm Hg).
IDH is an uncommon type of hypertension, accounting for less than 20% of all hypertension cases. Like other types of hypertension, IDH can increase the risk of stroke, heart disease, heart attack, heart failure, aneurysm, atrial fibrillation, peripheral arterial disease, vision loss and chronic kidney disease.
What causes high diastolic blood pressure?
Possible causes of isolated diastolic hypertension include:
- High-sodium diet
- Obesity
- Lack of physical activity
- Excessive alcohol consumption
- Stress and anxiety
- Medications including:
- Amphetamines
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Antidepressants
- Oral contraceptive pills
- Caffeine
- Decongestants
- Atypical antipsychotics
- Steroids
What causes your blood pressure to suddenly get high?
Hypertension or high blood pressure (high BP) is a medical condition
Hypertension or high blood pressure (high BP) is a medical condition where the pressure in the arteries is persistently elevated. The heart pumps blood into the arteries, and it is circulated to all parts of the body. Hypertension develops when the heart constantly needs to exert higher force to deliver the blood to the organs through the arteries. Since a hypertensive heart must work harder to deliver blood, hypertension can increase the risk of cardiovascular disease, heart attack and heart failure. Also, the blood vessels in people with hypertension are narrower, putting them at risk of stroke, kidney disease and vision loss.
There are many reasons for high blood pressure. Some possible causes include
- caffeine,
- acute stress or anxiety,
- certain medications (such as nonsteroidal anti-inflammatory drugs),
- combinations of medications,
- recreational drugs,
- sudden or acute pain,
- dehydration and
- white coat effect (fear of being in a hospital or doctor’s clinic).
QUESTION
Salt and sodium are the same. See AnswerWhat are symptoms of high diastolic pressure?
Hypertension is generally considered a silent killer. Most people with hypertension do not have any symptoms.
It may take many years for the condition to become severe and for symptoms to appear. Many times, these symptoms may be attributed to other issues. The best way to know the blood pressure levels is through regular checkups.
Symptoms of severe hypertension include:
- Severe headaches
- Anxiety
- Nosebleeds
- Nervousness
- Sweating
- Fatigue or confusion
- Irregular heartbeat
- Facial flushing
- Dizziness
- Vision problems
- Chest pain
- Shortness of breath
- Sleeping problems
- Blood in the urine
- Black spots in eyes
- Pounding in chest, neck, or ears
What are the main types of hypertension?
There are two types of hypertension:
1. Primary or essential hypertension
Primary or essential hypertension is when the hypertension has no identifiable cause (for example, another disease or condition). It develops gradually over years.
This type of hypertension may be the result of multiple factors, including:
- Blood plasma volume
- Hormone activity
- Genes
- Physical changes in the body due to age
- Environmental factors, such as stress and lack of exercise
2. Secondary hypertension
In some people, hypertension is caused by an underlying health condition. This type of hypertension tends to appear suddenly. Secondary hypertension also generally causes higher blood pressure than primary hypertension.
Secondary hypertension is caused by specific conditions and their complications:
- Kidney disease
- Congenital heart defects
- Congenital defects in blood vessels
- Obstructive sleep apnea
- Certain endocrine tumors
- Adrenal gland tumors
- Cushing syndrome
- Congenital adrenal hyperplasia
- Thyroid problems
- Pregnancy
- Obesity
- Certain medications, such as birth control pills, cold remedies, decongestants, pain relievers and some prescription drugs
- Use of illegal drugs, such as cocaine and amphetamines
Health News
How is high diastolic blood pressure treated?
Isolated diastolic blood pressure can often be managed with lifestyle modifications, dietary supplements, and medications.
Lifestyle modifications
- Maintaining a healthy weight
- Eating a high-fiber diet rich in fruits and vegetables and low in saturated fat and dairy products
- Reducing sodium in the diet
- Exercising regularly
- Quitting smoking
- Limiting alcohol use
- Managing stress
- Getting adequate sleep
- Practicing slow deep breathing
- Monitoring blood pressure at home
Dietary supplements
Dietary supplements that may help lower blood pressure include:
- Minerals like magnesium, calcium and potassium
- Supplements that widen blood vessels, such as cocoa, coenzyme Q10, L-arginine and garlic
- Omega-3 fatty acids, found fish oil supplements and flaxseeds
Medications
If lifestyle and dietary changes are not enough to lower your blood pressure, your doctor may be able to prescribe medications for you.
SLIDESHOW
How to Lower Blood Pressure: Exercise and Tips See SlideshowWhat are the different blood pressure levels?
Table: Blood pressure levels| Less than 120 | Less than 80 |
| Between 120 to 129 | Less than 80 |
| Between 130 to 139 | Between 80 to 89 |
| 140 or higher | 90 or higher |
| Higher than 180 | Higher than 120 |
What are the risk factors of high blood pressure?
Factors that increase the risk of hypertension include:
- Being over the age of 60, when arteries stiffen and narrow due to plaque buildup
- Being overweight or obese
- Regular tobacco use
- Alcohol abuse
- Male gender
- Sedentary lifestyle
- Lack of exercise
- High fat intake
- High salt intake in the diet
- Low potassium intake diet
- Stress
- Family history of hypertension
- Existing health conditions:
- Cardiovascular disease
- Diabetes
- Chronic kidney disease
- Sleep apnea
- High cholesterol levels
Subscribe to MedicineNet's Heart Health Newsletter
By clicking "Submit," I agree to the MedicineNet Terms and Conditions and Privacy Policy. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time.
Medically Reviewed on 3/2/2022
References
Midha T, Lalchandani A, Nath B, Kumari R, Pandey U. Prevalence of isolated diastolic hypertension and associated risk factors among adults in Kanpur, India. Indian Heart J. 2012;64(4):374-379. //www.ncbi.nlm.nih.gov/pmc/articles/PMC3860613/
Mahajan S, Zhang D, He S, et al. Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project. J Am Heart Assoc. 2019; 8(19): e012954. //www.ahajournals.org/doi/10.1161/JAHA.119.012954
Alexander MR. Hypertension. Medscape. //emedicine.medscape.com/article/241381-overview
Medscape. New Hypertension Guidelines: JNC 7. Journal Watch. 2003;2(5). //www.medscape.com/viewarticle/457298
Benetos A, Petrovic M, Strandberg T. Hypertension Management in Older and Frail Older Patients. Circ Res. March 28, 2019;124:1045–1060. //www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313236
American Academy of Family Physicians. Hypertension in Adults Over 60. January 2017. //www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/hypertension-over-60.html