High Diastolic Blood Pressure

Introduction

High diastolic blood pressure (DBP) is a condition where the lower number in a blood pressure reading is elevated. This can indicate increased resistance in the smaller arteries, which can contribute to cardiovascular disease over time.

Understanding Blood Pressure

Blood pressure is measured as two values: - Systolic pressure (top number): The pressure in your arteries when the heart beats. - Diastolic pressure (bottom number): The pressure in your arteries when the heart rests between beats.

Normal diastolic pressure is typically between 60-80 mmHg. A diastolic reading above 80-90 mmHg may suggest an early stage of hypertension, while above 90 mmHg is often considered high.

Causes of High Diastolic Blood Pressure

Several factors can cause high DBP, including: - Unhealthy lifestyle choices: Poor diet, high sodium intake, lack of exercise. - Stress and anxiety: Chronic stress leads to sustained blood pressure elevation. - Obesity and metabolic syndrome: Increased fat deposition affects vascular resistance. - Kidney disease: The kidneys regulate fluid balance and blood pressure. - Endocrine disorders: Examples include thyroid dysfunction and adrenal gland disturbances. - Genetic predisposition: Family history plays a role in hypertension. - Medications and stimulants: Certain drugs, caffeine, and alcohol can increase blood pressure.

Potential Risks and Complications

High diastolic blood pressure increases the risk of many health issues: - Heart disease: A higher DBP puts more strain on the heart. - Stroke: Elevated pressure can damage blood vessels in the brain. - Kidney problems: Hypertension is a major cause of kidney failure. - Aneurysms: Persistent high pressure can cause arteries to weaken and bulge.

Management and Treatment

1. Lifestyle Changes

  • Reduce sodium intake: Aim for less than 2,300 mg/day, ideally 1,500 mg/day.
  • Increase potassium intake: Found in bananas, spinach, potatoes.
  • Exercise regularly: At least 150 minutes per week of moderate activity.
  • Maintain a healthy weight: Even a small weight loss can help.
  • Reduce alcohol intake and quit smoking.
  • Manage stress: Yoga, meditation, deep breathing exercises.

2. Medical Treatment

  • Diuretics: Help remove excess fluid and reduce pressure.
  • ACE inhibitors & ARBs: Relax blood vessels.
  • Beta and calcium channel blockers: Help control heart rate and vessel resistance.
  • Monitor blood pressure regularly: Ensuring medication effectiveness and lifestyle improvement.

Conclusion

High diastolic blood pressure is a serious health condition that requires attention. Taking proactive steps through lifestyle changes and, if necessary, medical intervention can significantly reduce risks and improve overall well-being.

Source recommendations

1. American College of Cardiology/American Heart Association (ACC/AHA) Hypertension Guidelines

  1. https://www.ahajournals.org/doi/10.1161/hyp.0000000000000065
  2. https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/05/11/43/2023-ESH-Hypertension-Guideline-Update
  3. https://www.aafp.org/pubs/afp/issues/2018/0315/p413.html
  4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2017/11/09/11/41/2017-Guideline-for-High-Blood-Pressure-in-Adults
  5. https://pubmed.ncbi.nlm.nih.gov/29133354/

2. European Society of Hypertension/European Society of Cardiology (ESH/ESC) Guidelines

  1. https://pubmed.ncbi.nlm.nih.gov/37345492/
  2. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension
  3. https://pubmed.ncbi.nlm.nih.gov/23771844/
  4. https://academic.oup.com/eurheartj/article/39/33/3021/5079119
  5. https://www.ejinme.com/article/S0953-6205(24)00238-3/fulltext

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