Why Is My Bottom Blood Pressure Number High?

Reviewed on 5/26/2021
high diastolic blood pressure
Isolated diastolic hypertension (IDH) occurs when only your diastolic blood pressure is high

Blood pressure is the force of your blood pushing against the walls of your arteries, which carry blood to other parts of your body. Your blood pressure can be measured using two numbers: 

  • Systolic (the number on top): pressure exerted when the heart pumps blood throughout the body
  • Diastolic (the number at the bottom): pressure exerted when the heart relaxes and refills with blood

When your blood pressure is consistently higher than 130/80 mm Hg, you are considered to have hypertension.

What is isolated diastolic hypertension?

With hypertension, typically both systolic and diastolic blood pressures are elevated. However, isolated diastolic hypertension (IDH) occurs when your systolic blood pressure is normal, and only your diastolic blood pressure is high (over 80 mm Hg).

IDH is an uncommon type of hypertension, accounting for less than 20% of all hypertension cases. Like other types of hypertension, IDH can increase the risk of stroke, heart disease, heart attack, heart failure, aneurysm, atrial fibrillation, peripheral arterial disease, vision loss and chronic kidney disease.

What causes high diastolic blood pressure?

Possible causes of isolated diastolic hypertension include:

What are symptoms of high diastolic pressure?

If only your diastolic blood pressure is high, you may not experience any symptoms. However, severe hypertension symptoms include:

How is high diastolic blood pressure treated?

Isolated diastolic blood pressure can often be managed with lifestyle modifications, dietary supplements, and medications.

Lifestyle modifications

  • Maintaining a healthy weight
  • Eating a high-fiber diet rich in fruits and vegetables and low in saturated fat and dairy products
  • Reducing sodium in the diet
  • Exercising regularly
  • Quitting smoking
  • Limiting alcohol use
  • Managing stress
  • Getting adequate sleep
  • Practicing slow deep breathing
  • Monitoring blood pressure at home

Dietary supplements

Dietary supplements that may help lower blood pressure include:

Medications

If lifestyle and dietary changes are not enough to lower your blood pressure, your doctor may be able to prescribe medications for you.

QUESTION

Salt and sodium are the same. See Answer

What are the different blood pressure levels?

Table: Blood pressure levels
Blood pressure levels Systolic (mm Hg) Diastolic (mm Hg)
Normal blood pressure Less than 120 Less than 80
Elevated blood pressure or prehypertension Between 120 to 129 Less than 80
Stage 1 hypertension Between 130 to 139 Between 80 to 89
Stage 2 hypertension 140 or higher 90 or higher
Hypertensive crisis Higher than 180 Higher than 120

What are the main types of hypertension?

There are two types of hypertension:

1. Primary or essential hypertension

Primary or essential hypertension is when the hypertension has no identifiable cause (for example, another disease or condition). It develops gradually over years.

This type of hypertension may be the result of multiple factors, including:

  • Blood plasma volume
  • Hormone activity
  • Genes
  • Physical changes in the body due to age
  • Environmental factors, such as stress and lack of exercise

2. Secondary hypertension

In some people, hypertension is caused by an underlying health condition. This type of hypertension tends to appear suddenly. Secondary hypertension also generally causes higher blood pressure than primary hypertension.

Secondary hypertension is caused by specific conditions and their complications:

What are the risk factors of high blood pressure?

Factors that increase the risk of hypertension include:

SLIDESHOW

How to Lower Blood Pressure: Exercise Tips See Slideshow

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References
Midha T, Lalchandani A, Nath B, Kumari R, Pandey U. Prevalence of isolated diastolic hypertension and associated risk factors among adults in Kanpur, India. Indian Heart J. 2012;64(4):374-379. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860613/

Mahajan S, Zhang D, He S, et al. Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project. J Am Heart Assoc. 2019; 8(19): e012954. https://www.ahajournals.org/doi/10.1161/JAHA.119.012954

Alexander MR. Hypertension. Medscape. https://emedicine.medscape.com/article/241381-overview

Medscape. New Hypertension Guidelines: JNC 7. Journal Watch. 2003;2(5). https://www.medscape.com/viewarticle/457298

Benetos A, Petrovic M, Strandberg T. Hypertension Management in Older and Frail Older Patients. Circ Res. March 28, 2019;124:1045–1060. https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313236

American Academy of Family Physicians. Hypertension in Adults Over 60. January 2017. https://www.aafp.org/family-physician/patient-care/clinical-recommendations/all-clinical-recommendations/hypertension-over-60.html

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