What Does It Mean When the Diastolic Number is High?

In practice, systolic blood pressure (equal to or more than 160 mmHg) should be regarded as more important than diastolic blood pressure. Systolic blood pressure is the force generated on the inside of the blood vessels called the arteries when the heart contracts. According to a recent study, having a high systolic reading increased the risk of heart attacks and heart disease.

Systolic blood pressure is linked not only with heart disease and heart failure but also with kidney disease and overall mortality. Research favored high systolic readings as the most predictive of a harmful cardiovascular outcome. As a result, these readings were given more weightage in cardiology guidelines and risk estimation.

Blood pressure is the force exerted by the blood column against the walls of arteries, which function to carry blood to different parts of the body.

Blood pressure is measured in the following two variables:

1. Systolic (the number on top): The pressure produced when the heart pumps blood all through the body.
2. Diastolic (the number at the base): The pressure produced when the heart relaxes and refills with blood.

Hypertension is when both systolic and diastolic blood pressures are raised. However, high diastolic blood pressure or isolated diastolic hypertension (IDH) happens when the systolic pulse is in the normal range and only the diastolic blood pressure is elevated (over 80 mmHg). 

Any blood pressure reading that is equal to and more than 180/120 mmHg is usually considered a hypertensive crisis. At this range of blood pressure, the blood vessels may rupture, and a person may get a hemorrhagic stroke.

High blood pressure (hypertension) is the leading cause of strokes in the United States. However, it’s also one of the common risk factors that can be prevented. High blood pressure can damage or weaken the brain arteries, increasing a person’s risk of a stroke. Below are a few readings that everyone should know.

• Healthy blood pressure is less than 120/80 mmHg.
• Pre-hypertension is 120/80-139/89 mmHg.
• Hypertension is higher than 140/90 mmHg.
• Blood pressure readings above 180/120 are dangerously high and require immediate medical attention.

Hypothyroidism is one of the common causes of IDH. The raised diastolic pressure is the consequence of excessive arteriolar narrowing.

In the vast majority with isolated diastolic hypertension (IDH), no specific cause has been identified. Some possible reasons for IDH are:

• Primary hypertension
  • Here the blood pressure is raised because small arteries, called arterioles, in the body are narrower than normal.
  • This compresses the blood moving through the arterioles with greater force, thus bringing up the pressure.
• Endocrine and kidney conditions
  • Hypothyroidism is one of the common causes of IDH. The raised diastolic pressure is the consequence of excessive arteriolar narrowing.
  • Endocrine diseases producing significant degrees of aldosterone, parathyroid hormone, or corticosteroids can cause IDH.
  • A damaged kidney can prompt IDH by decreasing the capacity of the kidneys to remove fluids from the body or by increasing the production of angiotensin. 
  • Renovascular hypertension, because of the narrowing of the principal artery leading to the kidneys, is another cause of IDH.
• Sleep apnea
  • Sleep apnea is the episodic pauses in breathing during sleep. This may lead to IDH due to excessive arteriolar narrowing and decreased fluid excretion by the kidneys.
• Some other possible causes of IDH
  • High-sodium diet, obesity, lack of physical activity, excessive alcohol consumption, stress, and anxiety, etc.

The goal of treatment is to reduce blood pressure so that a person may have a lower risk of health problems caused by high blood pressure.

• Prehypertension: If blood pressure is between 120/80 and 130/80 mmHg, doctors may recommend lifestyle changes to bring blood pressure down to a normal range. Medicines are rarely used at this stage.
• Stage I hypertension: If blood pressure is higher than 130/80 mmHg but lower than 140/90 mmHg
  • Lifestyle changes with a single hypertensive drug
• Stage II hypertension: If blood pressure is higher than 140/90 mmHg, doctors may recommend starting rigorous medications and following strict lifestyle changes.
  • Most of the time, a single drug may be used at first. Two drugs may be started if a person has stage II hypertension or consistent readings above 160/90 mmHg.
  • Diuretics (water pills): They help the kidneys remove some sodium (salt) from the body. As a result, the blood vessels do not have to hold as much fluid and blood pressure may be maintained.
  • Beta-blockers: These drugs slow down the heart rate and reduce the heat load.
  • Angiotensin-converting enzyme inhibitors (ACE inhibitors): These work on the kidneys and reduce sodium retention in the body. They also have a direct action on the blood vessels causing them to relax.
  • Angiotensin II receptor blockers (ARBs): They work in about the same way as ACE inhibitors.
  • Calcium channel blockers: These relax the blood vessels by reducing calcium entering the cells.
  • Alpha-blockers: These help lower blood pressure by a central action (blood pressure center in the brain).
  • Renin-inhibitors: These are newer types of medicines for treating high blood pressure. They act by reducing the number of angiotensin precursors, thereby relaxing the blood vessels.

Some common side effects of high blood pressure medicines include

• Cough
• Low blood pressure causing giddiness
• Diarrhea or constipation
• Dizziness or light-headedness
• Erection problems
• Feeling nervous
• Feeling tired, weak, drowsy, or a lack of energy
• Headache
• Nausea or vomiting
• Skin rash
• Weight loss or gain without trying

Whatever the cause may be, isolated diastolic hypertension (IDH) should not be ignored because the systolic pressure will also elevate over time. IDH can be managed with some simple lifestyle changes, dietary enhancements, and medications.

A few ways that aid in lowering IDH are:

• Reduce sodium in the diet: Sodium can increase blood pressure, so limiting sodium consumption can prevent IDH.
• Get more potassium: Potassium can counteract the effects sodium has on blood pressure. So, potassium utilization can help decrease IDH.
• Avoid caffeine: Caffeine acts as a stimulant that can raise blood pressure.
• Cut back on alcohol: Drinking liquor can raise blood pressure. Thus, avoiding alcohol can help prevent and treat IDH.
• Stop smoking: The nicotine in cigarettes is a stimulant that can raise blood pressure. It can likewise prompt injury of the walls of arteries. Thus, avoiding smoking can help bring down IDH.
• Dietary supplements: They might help lower blood pressure.
  • Minerals, such as magnesium, calcium, and potassium
  • Cocoa, coenzyme Q10, L-arginine, garlic, and omega-3 unsaturated fats widen blood vessels