Doctors define blood pressure using two numbers: systolic and diastolic. They offer a reading with the systolic number above the diastolic number. Systolic pressure is the pressure during the contraction of the heart, and diastolic pressure is the pressure between heartbeats.
The American Heart Association (AHA) Trusted Source states that although people place a lot of emphasis on the systolic number, every 10 millimeters of mercury (mm Hg) increase in diastolic pressure in people ages 40 to 89 doubles the risk of heart disease or heart disease. stroke.
In this article, we discuss common causes of high diastolic blood pressure, how to prevent high blood pressure.
High blood pressure statistics show that the condition is a growing problem in America. In fact, one in three adults in the United States — about 75 million people — has high blood pressure or hypertension, according to 2016 estimates from the Centers for Disease Control and Prevention (CDC).
In most people with high diastolic blood pressure, no specific cause has been identified. But less commonly, diastolic hypertension is secondary to another disorder, such as a thyroid problem, kidney disease, or sleep apnea.
What Qualifies as High Blood Pressure?
Blood pressure consists of two numbers – an upper (systolic) and a lower (diastolic) number. Therefore, there are three types of hypertension.
- High diastolic blood pressure, called diastolic hypertension, occurs when the bottom number is above 80 mmHg.
- High systolic blood pressure, called systolic hypertension, occurs when the highest number is above 130 mmHg.
- Mixed hypertension occurs when both numbers are high.
What causes diastolic blood pressure to be high?
Potential Causes of Diastolic Hypertension
Isolated diastolic hypertension (IDH) occurs primarily in young adults. Most people with IDH have no specific cause identified. This is known as primary or essential hypertension. Less commonly, IDH is secondary to another disorder such as a thyroid problem, kidney disease, or sleep apnea.
1. Primary Hypertension
Diastolic pressure is the force that blood exerts on artery walls as it flows through these blood vessels between heartbeats. Diastolic pressure is usually elevated in IDH because small arteries in the body, called arterioles, are narrower than normal. This compresses the blood flowing through the arterioles, raising the pressure.
The underlying cause of arteriolar narrowing in IDH caused by primary hypertension is not well understood. Unusually high levels of certain substances that increase blood pressure, such as angiotensin, or improper contraction of the small muscles in the arterial walls are two possible causes. Genetic factors may also contribute.
2. Endocrine and Kidney Conditions
An underactive thyroid or hypothyroidism is one of the more common secondary causes of IDH. As with primary hypertension, high diastolic pressure is the result of excessive arteriolar narrowing.
Hypothyroidism may be suspected in a person with weight gain, fatigue, and intolerance to cold, but blood tests are required to confirm the diagnosis. Endocrine diseases that produce high levels of aldosterone, parathyroid hormone, or corticosteroids can also cause IDH.
Most diseases that damage the kidney can lead to IDH by reducing the kidneys’ ability to remove fluids from the body or by increasing the production of angiotensin. Renovascular hypertension due to narrowing of the main artery to the kidneys is another possible cause of IDH.
3. Sleep apnea
Sleep apnea – episodic pauses in breathing during sleep – can also cause IDH with excessive arteriolar narrowing and reduced renal fluid excretion.
The increased heart rate, which is often seen in people with the syndrome, may contribute to the shorter time between heartbeats, giving blood vessels more time to be exposed to the extra blood flow that accompanies each heartbeat. Excessive daytime sleepiness is suggestive of sleep apnea syndrome, but a sleep study is required to diagnose the disorder.
4. Other Causes
Chronic excessive alcohol consumption can also lead to IDH. Since angiotensin is usually broken down in the liver, this may be especially likely if liver damage has occurred. IDH can also be caused by medications such as oral contraceptives, corticosteroids, or non-steroidal anti-inflammatory drugs such as ibuprofen.
Risk Factors for High Diastolic Blood Pressure
Certain risk factors for IDH have been identified. They are not a direct cause, but their presence increases the likelihood of developing IDH. Risk factors identified in the large Framingham Heart Study, published in Circulation in March 2005, were younger age, being male, and overweight or obesity.
Indeed, this and other research suggest that IDH is more common in adults under 40 than systolic or mixed hypertension. Additional risk factors for IDH were reported in studies published in the July 2012 issue of the Indian Heart Journal and the December 2015 issue of PLoS One. were:
- Sedentary lifestyle
- Too smoke
- High total cholesterol level
- High coffee or tea consumption
Lowering High Diastolic Blood Pressure
Whatever the cause, IDH should not be ignored. In many individuals, systolic pressure will also rise over time. In the Framingham Heart Study, 83 percent of people with IDH developed mixed hypertension within the next 10 years.
Even if it does not progress, IDH itself increases the likelihood of serious cardiovascular complications. A study published in the March 2014 issue of the Journal of Hypertension noted that adults with IDH have twice the risk of cardiovascular complications, including heart attack, stroke, or heart-related death, compared to adults with normal pressure.
Updated 2017 guidelines from the American College of Cardiology and the American Heart Association recommend treating all individuals with a diastolic pressure of 80 mmHg or higher, regardless of whether the person has IDH or mixed hypertension.
Strategies to lower blood pressure may include weight loss, dietary changes, exercise, and medications. It is also important to reduce other risk factors for cardiovascular disease by controlling blood sugar and cholesterol levels.
IDH itself usually causes no symptoms. Headaches, nosebleeds, and other symptoms are sometimes attributed to high blood pressure, but they are just as likely to occur in people with normal blood pressure.
Seek immediate medical attention if you develop chest pain, shortness of breath, or lightheadedness, or develop sudden weakness, change in speech, or decreased level of consciousness. These may indicate the presence of a life-threatening complication of IDH, such as a heart attack or stroke.
Diastolic pressure is the bottom number of a blood pressure reading. When a person has high blood pressure, doctors often focus on the systolic number, but the diastolic number can and often does rise as blood pressure rises.
High blood pressure is a serious, often symptomless condition that a person must take steps to reduce. Lifestyle changes, such as achieving or maintaining a moderate weight and getting regular exercise, can help.
A person should talk to their doctor if their blood pressure does not drop in response to making healthy lifestyle changes.
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- What are the symptoms of high blood pressure? (2016).