More than one billion adults globally have hypertension, or high blood pressure—a condition that affects nearly half of the adult population in some regions. In the United States, it is the leading cause of deaths related to the heart and the second most preventable cause of death overall, following smoking.
High blood pressure is diagnosed when either the systolic (top number) or diastolic (bottom number) reading is consistently elevated. A persistently high diastolic pressure significantly raises the risk of serious cardiovascular issues, such as heart attacks, strokes, and heart-related death.
While systolic pressure often receives more attention, diastolic blood pressure is increasingly recognized for its importance in heart health. Elevated diastolic pressure is associated with conditions like heart failure, atrial fibrillation (irregular heartbeat), and kidney disease.
What Do Blood Pressure Readings Mean?
Blood pressure is recorded using two numbers:
- Systolic pressure: The pressure when the heart beats and pumps blood through the arteries
- Diastolic pressure: The pressure when the heart rests between beats
According to current guidelines, a diastolic pressure of 80 mm Hg or more is considered high. Blood pressure is classified into categories to help assess health risks and inform treatment:
- Normal: Systolic less than 120 AND diastolic less than 80
- Elevated: Systolic 120–129 AND diastolic less than 80
- Stage 1 hypertension: Systolic 130–139 OR diastolic 80–89
- Stage 2 hypertension: Systolic 140 or higher OR diastolic 90 or higher
- Hypertensive crisis: Systolic over 180 AND/OR diastolic over 120
A hypertensive crisis is a medical emergency and requires immediate intervention to prevent damage to organs.
If your healthcare provider sees elevated readings over multiple visits, they may recommend lifestyle changes or medications. They'll also assess your risk for heart-related conditions.
High Diastolic Blood Pressure Symptoms
High blood pressure often has no noticeable symptoms, which is why it's called a "silent" condition. It may quietly cause damage to your body over time. The only reliable way to detect high blood pressure is by monitoring it regularly, which allows for early intervention and treatment.
In cases of very high blood pressure, possible symptoms include:
- Headaches
- Chest or back pain
- Shortness of breath
- Numbness or weakness
- Dizziness
- Changes in vision
- Irregular heart rhythm
Even if you feel fine, it's important to check your blood pressure regularly.
When to Seek Immediate Care
If your blood pressure is 180/120 or higher but you don’t have symptoms, retest after five minutes. If it remains high, contact your healthcare provider. If your blood pressure is 180/120 or higher and you have symptoms like those mentioned, seek emergency medical care immediately.
Causes of High Diastolic Blood Pressure
Most cases of high blood pressure have no identifiable cause, which is known as primary hypertension. When a cause is known, it's called secondary hypertension, and possible causes include:
- Obstructive sleep apnea: A disorder that causes breathing interruptions during sleep
- Renovascular disease: Narrowing of arteries affecting kidney blood flow
- Primary aldosteronism: Overproduction of the hormone aldosterone, which controls blood pressure
Excess salt intake is a well-known risk factor for high blood pressure, especially in individuals who are salt-sensitive. Genetic factors play a role in how salt affects blood pressure.
Risk Factors
Several factors increase the risk of high diastolic blood pressure. Some are genetic or age-related, while others are lifestyle-related and modifiable. Risk factors include:
- Family history of hypertension
- Age over 65
- Diet high in sodium and low in potassium
- Physical inactivity
- Smoking
- Regular alcohol consumption (more than 1–2 drinks daily)
- Obesity
Systolic pressure usually increases with age, while diastolic pressure may decline after age 50 due to stiffening arteries.
Diagnosing High Diastolic Blood Pressure
A blood pressure cuff is used during a routine exam to measure your blood pressure. If high blood pressure is found, your provider may recommend home monitoring. They will also assess for underlying conditions such as:
- Aortic narrowing
- Heart valve disease
- Kidney disease
- Thyroid disorders
- Renovascular issues
Treatment for High Diastolic Blood Pressure
Treatment includes both lifestyle changes and, when needed, medication.
Lifestyle Changes
Healthy lifestyle habits can significantly improve blood pressure control. Recommendations include:
- Reduce sodium intake to under 1,500 mg per day
- Eat more fruits, vegetables, and whole grains
- Avoid alcohol or drink in moderation
- Quit smoking
- Manage stress levels
- Sleep at least six hours per night
- Exercise regularly (at least 150 minutes of moderate activity per week)
Medications
When lifestyle changes aren’t enough, medications may be prescribed. Treatment is tailored to your health history and personal needs. Options include:
- ACE inhibitors
- ARBs (angiotensin receptor blockers)
- Diuretics
- Calcium channel blockers
- Beta blockers
Your healthcare provider may adjust your medications over time. It's important to follow your treatment plan to manage high blood pressure effectively.
Complications of High Diastolic Blood Pressure
If left untreated, high blood pressure can damage blood vessels and lead to serious conditions, including:
- Heart attack
- Stroke
- Heart failure
- Kidney disease
- Vision problems
- Sexual dysfunction
- Chest pain
- Peripheral artery disease (PAD)
Over time, elevated pressure can cause small tears in arteries, where LDL (bad) cholesterol builds up, leading to further cardiovascular risk.
Preventing High Blood Pressure
A heart-healthy lifestyle can lower your risk. Prevention tips include:
- Eat a diet rich in fruits, vegetables, fiber, potassium, and lean proteins
- Exercise regularly (at least 150 minutes of moderate activity weekly)
- Avoid tobacco
- Limit alcohol to no more than 1–2 drinks per day
- Get at least six hours of quality sleep
The DASH diet is especially effective for blood pressure management. It emphasizes whole grains, vegetables, and fruits, and limits sugar, salt, and saturated fat.
A Quick Review
High diastolic blood pressure refers to an elevated bottom number in your blood pressure reading, indicating increased pressure in your arteries while your heart rests. This condition raises the risk of heart disease, stroke, and other complications. Managing it often involves lifestyle changes and possibly medications to reduce long-term health risks.
