A diastolic blood pressure reading refers to the pressure in the arteries when the heart rests between beats. It is one of two numbers recorded when measuring blood pressure, with the other being the systolic pressure. Diastolic pressure readings can provide important information about a person’s heart health. An elevated diastolic reading may be a sign of issues that require medical attention. This article will examine what constitutes an alarming diastolic blood pressure number that should prompt further evaluation and treatment.
What is diastolic blood pressure?
Blood pressure is recorded as two numbers and is expressed as a ratio. For example, a blood pressure reading of 120/80 mm Hg (millimeters of mercury) consists of a systolic pressure of 120 and a diastolic pressure of 80.
The systolic pressure represents the pressure in the arteries when the heart contracts and pushes blood through the circulatory system. In contrast, the diastolic pressure is the pressure between heartbeats when the heart is at rest.
To measure blood pressure, an inflatable arm cuff is placed around the upper arm and inflated to temporarily block blood flow. As air is slowly released from the cuff, the first sound heard through a stethoscope over the artery at the bend of the elbow is the systolic pressure. The point at which the sound disappears is recorded as the diastolic pressure.
What is considered a normal diastolic reading?
Normal blood pressure is a systolic pressure below 120 mm Hg and a diastolic pressure below 80 mm Hg. This is expressed as 120/80 mm Hg. However, optimal blood pressure is thought to be closer to 110/70 mm Hg.
According to American Heart Association guidelines:
| Blood Pressure Category | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Normal | Less than 120 | And less than 80 |
| Elevated | 120-129 | And less than 80 |
| Stage 1 Hypertension | 130-139 | Or 80-89 |
| Stage 2 Hypertension | 140 or higher | Or 90 or higher |
Therefore, according to medical guidelines, a normal diastolic reading is considered anything less than 80 mm Hg.
When is a diastolic reading considered too high?
Diastolic pressure between 80-89 mm Hg is classified as stage 1 hypertension. A diastolic pressure of 90 mm Hg or higher is considered stage 2 hypertension.
Doctors generally agree diastolic readings at or over 90 mm Hg are considered high and in the danger zone for developing complications. A diastolic pressure over 100 mm Hg requires prompt medical intervention to reduce pressure and protect against organ damage.
In addition to the numerical diastolic reading, factors like age, medical history and overall health are taken into account when evaluating blood pressure. For example, a diastolic pressure over 80 mm Hg may be concerning for a teenager or young adult without additional heart disease risk factors.
Prehypertensive Range
Diastolic readings between 80-89 mm Hg are not considered optimal. They fall into a prehypertensive range associated with developing high blood pressure in the future without lifestyle changes and treatment as needed.
Stage 1 Hypertension
A diastolic reading of 90-99 mm Hg is classified as stage 1 hypertension. This range is alarming as hypertension is a major risk factor for heart attack, stroke, kidney disease and congestive heart failure. Prompt lifestyle changes and medication is recommended to lower blood pressure.
Stage 2 Hypertension
A diastolic reading of 100 mm Hg or higher is classified as stage 2 hypertension and considered a medical emergency. Severely elevated pressure can damage organs like the heart, brain, kidneys and eyes if not immediately lowered. Lifestyle changes combined with multiple medications are typically initiated to prevent complications.
What health problems are associated with elevated diastolic pressure?
Chronically elevated diastolic pressure contributes to developing:
- Heart attack and heart failure – Consistently high diastolic pressure forces the heart to work harder, enlarging the heart muscle over time. This leads to congestive heart failure.
- Stroke – Pressure damages arteries in the brain, causing them to harden and burst.
- Kidney failure – Increased pressure damages the delicate blood vessels in the kidneys reducing their ability to function.
- Vision loss – High blood pressure stresses tiny blood vessels in the eyes.
- Peripheral artery disease – Restricted blood flow damages arteries in the legs.
- Erectile dysfunction – Men with hypertension are more likely to experience erectile dysfunction due to diminished blood flow.
In addition, higher diastolic pressure causes artery walls to lose elasticity. This increases resistance to blood flow and further exacerbates hypertension.
Who is at risk for elevated diastolic pressure?
A number of factors that increase the risk for developing high diastolic blood pressure include:
- Older age – The risk rises as you age with most people developing hypertension after age 35.
- Family history – Having close blood relatives with high blood pressure increases your risk.
- Obesity – Being significantly overweight places extra pressure on the heart.
- Diabetes – About 80% of diabetics eventually develop hypertension.
- High sodium diet – Eating foods high in salt causes fluid retention.
- Excess alcohol intake – Drinking more than moderate amounts of alcohol increases blood pressure.
- Stress – Chronic stress and anger contribute to hypertension.
- Smoking – Smoking and tobacco use impairs heart and artery function.
- Sedentary lifestyle – Lack of exercise causes blood pressure to rise.
- Chronic conditions – Diseases like kidney disease, sleep apnea and thyroid disorders increase risk.
High blood pressure risks also increase in women who are pregnant or taking birth control pills.
How can you tell if you have elevated diastolic pressure?
The only way to detect elevated diastolic pressure is to have your blood pressure tested. Hypertension is known as the “silent killer” because it often has no obvious symptoms that would alert you to a problem. Some people with prehypertension or stage 1 hypertension may experience:
- Dull headaches
- Dizziness
- Ringing in the ears
- Facial flushing
- Fatigue
- Nosebleeds
However, by the time symptoms occur, significant organ damage may have already happened. This underscores the importance of having regular wellness checkups that include blood pressure screening. If your readings are nearing the upper limits of normal, your doctor may recommend more frequent monitoring.
Home blood pressure monitoring has also become an easy way to watch for increases in diastolic pressure. Choosing a well-rated, validated home monitor provides additional blood pressure data points for you and your doctor to identify issues before they become severe.
What do doctors recommend if diastolic pressure is too high?
Treatment for elevated diastolic pressure centers around lifestyle changes and medications to lower blood pressure into a healthy range.
Lifestyle Changes
Doctors will advise adopting healthy lifestyle habits to reduce blood pressure including:
- Following a heart-healthy diet low in sodium, fat and sugar like the Mediterranean diet or DASH (Dietary Approaches to Stop Hypertension) diet.
- Exercising for 30-60 minutes most days of the week.
- Losing weight if overweight until reaching a healthy BMI (body mass index).
- Limiting alcohol intake to no more than 1 drink per day for women or 2 drinks for men.
- Quitting smoking and avoiding secondhand smoke.
- Reducing stress through techniques like meditation, yoga, tai chi, journaling, music, etc.
- Taking blood pressure medications as prescribed.
Making lifestyle modifications may be adequate to control blood pressure in people with mildly elevated diastolic readings. However, the majority of people will require medication to reach optimal levels.
Medications
If diastolic pressure remains high after implementing lifestyle changes for 3-6 months, blood pressure medication will be necessary. Often, treatment starts with one drug and increases to two or more if needed to lower pressure.
Types of medications used to treat high diastolic pressure include:
- ACE inhibitors – These widen and relax blood vessels to improve blood flow.
- ARBs – Similar to ACE inhibitors, these block angiotensin receptors to dilate blood vessels.
- Beta-blockers – Help the heart beat slower and less forcefully to reduce blood pressure.
- Calcium channel blockers – Prevent calcium from entering cells in arteries allowing blood vessels to dilate.
- Diuretics – Flush out excess sodium and water from the body to reduce blood volume.
In certain circumstances, medications to control heart rate or slow other heart functions may be used. The target is lowering diastolic pressure to at least under 90 mm Hg.
When is an immediate reduction in diastolic pressure required?
Extremely high diastolic readings above 110 or 115 mm Hg may require emergency medical treatment. Possible interventions include:
- Intravenous medications like sodium nitroprusside, nicardipine, labetalol or enalaprilat to rapidly relax blood vessels
- Oral emergency blood pressure pills like captropril, clonidine, prazosin or hydralazine
- Magnesium sulfate infusions to inhibit blood vessel constriction
Rapid reductions in diastolic pressure are critical in cases of:
- Hypertensive crisis – Pressure over 180/120 mm Hg with symptoms like severe headache, anxiety, shortness of breath, nosebleeds or dizziness.
- Malignant hypertension – Pressure above 200/130 mm Hg causing acute organ damage.
- Postoperative hypertension – Spikes in pressure following surgery.
- Eclampsia – Severely elevated blood pressure and protein in the urine during pregnancy.
- Use of stimulant drugs like cocaine.
Without emergency treatment, uncontrolled high diastolic pressure can lead to a stroke, heart attack, pulmonary edema, visual changes or seizures.
What steps should you take if diastolic pressure is high?
You should take the following steps if your diastolic pressure is elevated:
- Consult your doctor – Schedule a medical evaluation, even if you have no symptoms.
- Evaluate your heart disease risk – Undergo diagnostic tests like blood work, an EKG or echocardiogram as recommended.
- Check pressure frequently – Monitor at home and with your healthcare provider.
- Keep all medical visits – Don’t skip appointments to have your blood pressure monitored.
- Take medications as directed – Stay on your treatment plan.
- Adopt lifestyle changes – Follow your doctor’s advice for diet, exercise, sleep, etc.
- Avoid possible triggers – Steer clear of substances that may increase blood pressure.
- Reduce stress – Make time for healthy stress relief activities every day.
- See a specialist if needed – Get a referral to a cardiologist or nephrologist for high-risk cases.
Following your doctor’s treatment plan is vital to control elevated diastolic pressure before it leads to a life-threatening health crisis. Monitor your numbers closely and seek urgent medical care for any severe symptoms related to very high blood pressure.
Conclusion
Diastolic blood pressure, the bottom number in a reading, measures the pressure between heartbeats. Normal diastolic pressure should be below 80 mm Hg. Readings from 80-89 mm Hg are considered elevated. A diastolic pressure of 90 mm Hg and above is classified as hypertension.
Diastolic pressure is considered dangerously high if it reaches above 100 or 110 mm Hg. At these levels, immediate medical intervention is often required to prevent organ damage. Consistently high diastolic pressure significantly increases the risks of stroke, heart attack, heart failure, kidney disease, vision loss and more.
All adults should know their blood pressure numbers and undergo screening. If your diastolic pressure creeps upward, comprehensive lifestyle improvements and medication as prescribed can help regain control of your heart health. Prompt evaluation and treatment are critical, as high diastolic pressure typically causes no obvious symptoms until complications arise. By monitoring your levels and seeking care when needed, elevated diastolic readings can be effectively managed.
