Blood pressure is a measurement of the force exerted by blood against the walls of your arteries as it circulates through your body. It is expressed as two numbers: systolic pressure, the top number, and diastolic pressure, the bottom number. Systolic pressure reflects the force when your heart beats and pumps blood, while diastolic pressure measures the force when your heart rests between beats. Understanding why the bottom number, or diastolic pressure, might remain elevated is important for maintaining cardiovascular health.
What Diastolic Pressure Represents
Diastolic blood pressure specifically indicates the pressure within your arteries during the period when your heart is relaxed and refilling with blood between beats. A healthy diastolic pressure is generally considered to be less than 80 millimeters of mercury (mm Hg). Readings consistently at 80 mm Hg or higher are categorized as elevated or high blood pressure.
For instance, a diastolic reading between 80 and 89 mm Hg is classified as Stage 1 hypertension, while 90 mm Hg or higher indicates Stage 2 hypertension. Monitoring both systolic and diastolic readings provides a comprehensive picture of your cardiovascular health, as both numbers contribute to the overall assessment of blood pressure and associated risks.
Primary Contributors to Elevated Diastolic Readings
Several factors can contribute to persistently high diastolic pressure, ranging from daily habits to underlying health conditions. A diet high in sodium, for example, can lead to increased fluid retention and higher blood pressure. A lack of regular physical activity and excessive alcohol consumption can contribute to elevated readings. Chronic stress and smoking also play a role in increasing blood pressure.
Beyond lifestyle, certain medical conditions can directly affect diastolic pressure. Kidney disease, for instance, can impair the body’s ability to regulate fluid and blood pressure. Thyroid disorders, such as hypothyroidism (underactive thyroid), are also linked to higher diastolic readings.
Obstructive sleep apnea, a condition where breathing repeatedly stops and starts during sleep, can also lead to elevated blood pressure. Arterial stiffness, often associated with aging, can impact diastolic pressure by reducing the elasticity of blood vessels. Additionally, primary or essential hypertension, where no specific cause is identifiable, often involves a combination of genetic predispositions and environmental factors. Certain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, and some antidepressants, can also elevate blood pressure as a side effect.
Addressing Persistent High Diastolic Pressure
When faced with consistently high diastolic readings, seeking medical attention is a recommended first step. This is especially true if readings are consistently 80 mm Hg or higher, or if you experience accompanying symptoms like headaches or shortness of breath.
The diagnostic process typically involves repeated blood pressure measurements to confirm consistent elevation. Your doctor may also order blood tests, urine tests, or an electrocardiogram (EKG) to assess organ function and rule out underlying medical conditions. A thorough discussion of your medical history and lifestyle habits will also inform the diagnosis.
Management approaches often begin with lifestyle modifications. Adopting a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, and whole grains while limiting sodium, can be beneficial. Engaging in at least 150 minutes of moderate-intensity aerobic exercise per week, managing stress through techniques like meditation, maintaining a healthy weight, and limiting alcohol intake are also important strategies. If lifestyle changes are insufficient, a healthcare professional might prescribe medications such as diuretics, ACE inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, or calcium channel blockers to lower blood pressure.
Long-Term Health Considerations
Leaving persistently high diastolic pressure unaddressed can lead to serious health complications. The constant strain on your arteries can weaken blood vessels and accelerate the hardening of arteries. This increases the risk of cardiovascular and cerebrovascular events.
Potential long-term consequences include an increased risk of heart attack, stroke, and heart failure. High diastolic pressure can also contribute to kidney damage, leading to chronic kidney disease. It may also result in vision problems due to damage to the small blood vessels in the eyes. Managing diastolic pressure effectively is therefore important for preventing these serious complications and improving health outcomes.