A diastolic blood pressure reading of 140 mm Hg (millimeters of mercury) or higher is considered dangerously high. The diastolic number represents the pressure in your blood vessels between heartbeats, when your heart is at rest. A normal diastolic blood pressure is less than 80 mm Hg. A reading of 140 mm Hg or higher indicates stage 2 hypertension and requires immediate medical attention.
What do the diastolic and systolic blood pressure numbers mean?
Blood pressure consists of two numbers – the systolic and diastolic pressures. The systolic reading represents the pressure in the arteries when the heart contracts and pumps blood through the body. The diastolic reading represents the pressure in the arteries between heartbeats, when the heart is relaxed and refilling with blood.
For example, a blood pressure of 120/80 mm Hg means:
- Systolic pressure: 120 mm Hg
- Diastolic pressure: 80 mm Hg
The systolic number comes before the diastolic number, like a fraction. A normal blood pressure is less than 120/80 mm Hg.
What is considered a high diastolic blood pressure?
Here are the general blood pressure ranges for diastolic pressure, according to the American Heart Association:
| Diastolic Pressure | Category |
|---|---|
| Less than 80 mm Hg | Normal |
| 80-89 mm Hg | Elevated |
| 90-99 mm Hg | Stage 1 Hypertension |
| 100-109 mm Hg | Stage 2 Hypertension |
| 110 mm Hg or higher | Hypertensive crisis (consult doctor immediately) |
As the table shows, a diastolic pressure of 140 mm Hg is considered dangerously high. It falls into the hypertensive crisis range, meaning there is a medical emergency requiring immediate treatment.
What are the risks of a very high diastolic pressure?
An extremely high diastolic pressure, such as 140 mm Hg, can damage the blood vessels, heart, brain, eyes and kidneys if left untreated. Specific risks include:
- Heart attack or stroke – Excessive pressure can cause arteries to fat and plaque to rupture, blocking blood flow.
- Aneurysm – Increased pressure can cause artery walls to weaken and bulge, forming dangerous aneurysms.
- Heart failure – The heart has to work harder to pump against high pressure, which can cause it to weaken and fail.
- Kidney damage – The kidneys filter blood; high pressure damages the blood vessels in the kidneys.
- Vision loss – High pressure strains the blood vessels in the eyes.
- Cognitive impairment – Hypertension impacts circulation in the brain, increasing dementia risk.
The higher the diastolic pressure, the greater the health risks. A reading of 140 mm Hg requires emergency medical care to lower blood pressure and prevent complications.
What are the symptoms of very high diastolic pressure?
A diastolic pressure of 140 mm Hg is typically asymptomatic. Most people will not experience any symptoms with chronically elevated blood pressure. However, symptoms that may develop include:
- Headaches
- Shortness of breath
- Nosebleeds
- Dizziness
- Vision changes
- Chest pain
Once the diastolic pressure reaches hypertensive crisis levels above 110 mm Hg, more severe symptoms can develop such as confusion, nausea, vomiting, chest pain, numbness, or sudden vision changes. These require immediate medical treatment.
What causes very high diastolic pressure?
There are a few potential underlying causes of severely elevated diastolic pressure:
- Chronic hypertension – Also known as high blood pressure, this is the most common cause. It develops over many years and has no identifiable cause in 95% of cases.
- Undiagnosed secondary hypertension – This type has an identifiable cause, such as kidney disease, certain tumors, or obstructive sleep apnea.
- Pregnancy – Pre-eclampsia and other complications can cause high blood pressure in pregnant women.
- Medication side effects – Certain medications like steroids, birth control pills, decongestants, and NSAIDs can raise blood pressure.
- Illegal drugs – The use of stimulants like cocaine and amphetamines is associated with hypertension.
- Alcohol abuse – Excessive drinking is linked to elevated blood pressure.
- Endocrine disorders – Conditions like Cushing’s disease, hyperthyroidism, and pheochromocytoma can cause hypertension.
Regardless of the cause, a diastolic pressure reading of 140 mm Hg or higher constitutes a hypertensive crisis requiring prompt medical treatment to prevent complications.
How is very high diastolic pressure treated?
Treating severely elevated diastolic blood pressure involves a combination of lifestyle changes and medications. Treatment focuses on rapidly lowering blood pressure to safe levels and preventing organ damage.
Emergency diastolic pressure treatment may include:
- Oral medications like nifedipine, labetalol, or intravenous nitroprusside to quickly lower blood pressure.
- Lifestyle changes like starting a low-sodium diet, getting regular exercise, losing weight if overweight, quitting smoking, and limiting alcohol.
- Further testing to identify any underlying secondary causes contributing to hypertension.
- Monitoring blood pressure at home daily or several times per week.
- Long-term medications to control hypertension, like diuretics, ACE inhibitors, ARBs, beta-blockers, or calcium channel blockers.
In severe cases, intravenous medications may be administered in an emergency room or hospital setting to lower blood pressure. The goal is to reduce diastolic pressure to below 100 mm Hg within the first hour.
How can very high diastolic pressure be prevented?
You can take the following preventative steps to maintain normal diastolic blood pressure:
- Get blood pressure checked regularly – This allows early detection of elevated pressure.
- Follow a healthy diet – Eat lots of fruits, vegetables, whole grains, and lean protein. Limit sodium, fat, and sugar.
- Exercise regularly – Aim for at least 30 minutes per day of moderate activity.
- Maintain a healthy weight – Lose weight if overweight or obese.
- Limit alcohol – No more than 1 drink per day for women or 2 for men.
- Don’t smoke – Cigarette smoking raises blood pressure.
- Reduce stress – Try relaxation techniques and get good sleep.
- Take medications as prescribed – Follow your doctor’s medication instructions.
Following a heart-healthy lifestyle and taking any prescribed medications can help prevent blood pressure from reaching dangerously high levels.
When to see a doctor
Consult your doctor promptly if you have any of the following:
- Diastolic pressure consistently above 90 mm Hg
- Systolic pressure consistently above 140 mm Hg
- Other signs of hypertension, like headaches, dizziness, or nosebleeds
- A single diastolic reading over 120 mm Hg
You should seek emergency medical care right away if you experience:
- Diastolic pressure over 130 mm Hg
- Confusion, chest pain, trouble breathing, or loss of vision
- Other symptoms of a hypertensive emergency
Proper treatment can help bring severely elevated blood pressure back down to a safe range and prevent damage to your health.
Key takeaways
- A diastolic pressure of 140 mm Hg or higher is dangerously high and requires immediate medical treatment.
- Chronically elevated diastolic pressure increases the risks of heart attack, stroke, aneurysm, heart failure, kidney damage, vision loss, and cognitive impairment.
- High diastolic pressure is usually asymptomatic but may cause headaches, shortness of breath, nosebleeds, dizziness, vision changes, or chest pain.
- Causes include chronic hypertension, secondary hypertension, pregnancy complications, medications, illegal drugs, alcohol abuse, and some endocrine disorders.
- Treatment focuses on rapidly lowering blood pressure through medications, lifestyle changes, and identifying any underlying causes.
- Prevention involves following a heart-healthy lifestyle with a balanced diet, exercise, stress management, medication adherence, and avoiding smoking and excess alcohol.
A diastolic pressure of 140 mm Hg is a medical emergency. Prompt treatment is vital to prevent permanent organ damage and serious complications. Ongoing management of hypertension can successfully minimize health risks. Monitoring your blood pressure is important to detect any elevation before it reaches dangerous levels.
