How To Lower The Bottom Number Of Blood Pressure?

What is blood pressure?

Blood pressure is the pressure of the blood in arteries and vessels that is required to allow blood to circulate from your heart to the rest of the body. Blood pressure rises and falls naturally during the day.1

Understanding the blood pressure readings

The blood pressure is recorded as two numbers:

  • The first number indicates how much pressure the blood is exerting against the artery wall when the heart beats; this is called systolic blood pressure
  • The second number indicates how much pressure the blood is exerting against the artery wall when the heart is resting between beats; this is called diastolic blood pressure 

High blood pressure is diagnosed by either an elevated systolic or diastolic blood pressure 

Blood pressure chart 

According to the American Heart Association, there is a spectrum of five different blood pressures: 

  • Normal blood pressure: When blood pressure is less than 120/80 mmHg (millimetres of mercury) it is considered to be within the normal range
  • Elevated blood pressure: When the blood pressure reading range is from 120 -129 systolic blood pressure and less than 80 mmHg diastolic blood pressure, it is considered elevated blood pressure 
  • Hypertension stage 1: When the blood pressure ranges from 130-139 systolic and 80-89 mmHg diastolic blood pressure, it is classified as hypertension stage 1
  • Hypertension Stage 2: When the blood pressure range is at 140-40 mmHg or higher, it is classified as hypertension stage 2
  • Hypertension crisis: When your blood pressure exceeds 180/120 mmHg and doesn’t retain in 5 minutes, it is classified as a hypertension crisis

Hypertension can be divided into:1  

  • Isolated systolic 
  • Isolated diastolic 
  • Systolic and diastolic mixed hypertension

Isolated diastolic hypertension (IDH) is defined as diastolic blood pressure of 90 mmHg or more and systolic blood pressure of less than 140 mmHg or less than 150 mmHg if the patient age is over 60 years and has a history of diabetes and chronic kidney disease.2

Causes of high diastolic blood pressure 

The main causes of high diastolic blood pressure include: 

  • Primary hypertension: This is also known as idiopathic or essential hypertension. It is multifactorial, meaning it does not have a specific cause. This occurs primarily in young adults 
  • Obesity: Extra fat in the form of cholesterol can lead to forming plaque, which narrows the blood vessels and causes high diastolic blood pressure
  • Obstructive sleep apnea: Repeating episodes of breathing cessation during a single night
  • High salt intake: An increase in salt consumption leads to an increase in water retention, resulting in high blood pressure
  • Smoking and alcohol: Nicotine found in cigarettes leads to constriction of the blood vessels and increases heart rate, leading to high diastolic blood pressure
  • Race and ethnicity: African Americans have a higher risk of developing high blood pressure compared to another ethnicity
  • Increased stress

Symptoms of high diastolic blood pressure 

Hypertension is known as the silent killer. Symptoms of high diastolic blood pressure include:

  • Dizziness
  • Headache
  • Difficulty sleeping
  • Bleeding from the nose 
  • Night sweats 
  • Nausea
  • Palpitation

Ways to lower diastolic blood pressure

The major ways to lower diastolic blood pressure are:

  • Avoid alcohol consumption
  • Maintain healthy weight 
  • Stop smoking
  • Reduce and manage stress
  • Physical activity: Exercise improves blood flow and allows the heart to pump with less effort. It includes walking, running, cycling and swimming. Exercising for at least 30 minutes every day in a week is recommended. You should check with your doctor before going ahead with an exercise routine
  • Healthy diet:
    • Reduce sodium intake: Don’t consume more than 1,500 mg of sodium each day
    • Reduce caffeine: High caffeine leads to the inhibition of the hormone responsible for maintaining the artery open, resulting in the narrowing of the blood vessels which in turn leads to high diastolic blood pressure
    • Less red meat: High fat in red meat can raise cholesterol and blood pressure
    • Increase omega-3 fatty acids: Omega-3 fatty acids lower blood pressure. Foods rich in omega-3 include tuna, salmon, tilapia, walnuts and mackerel

Treatment 

Blood pressure can be treated by: 

  • Life stay changes: As mentioned above, avoiding alcohol consumption, maintaining a healthy weight, avoiding smoking, reducing and managing stress and incorporating physical activity and healthy eating habits are essential to managing your blood pressure normal
  • Medications: Your healthcare provider might prescribe diuretics, beta-blockers, vasodilators, calcium chanal blockers, angiotensin-converting enzyme inhibitors or angiotensin two receptor blockers to lower your blood pressure

Does lowering diastolic blood pressure affect systolic blood pressure?

Treatment of isolated diastolic hypertension in older persons leads to lowering the normal systolic blood pressure, thereby increasing cardiovascular complications and also increasing the incidence of stroke. So, the decision to treat IDH in old people should be individualized to suit them.3

Risks of high diastolic blood pressure 

High diastolic blood pressure increases the risk of abdominal aneurysm and progresses to systolic hypertension. Systolic hypertension is a predictor of stroke, diabetes and heart failure. It increases the risk of heart disease.

Summary

Blood Pressure is the force needed to get the blood moving from your heart to the rest of the body. It's recorded in two numbers: systolic blood pressure and diastolic blood pressure. When the blood pressure is less than 120/80 mmHg, this is considered within the normal range. Diastolic blood pressure represents the resistance in the blood vessels. Hen the resistance increases by constriction of the blood vessels, the diastolic blood pressure becomes high. Isolated diastolic blood pressure is when the diastolic blood pressure is 90 mmHg or more than normal systolic blood pressure. The major causes of high diastolic blood pressure include high salt intake, obesity, sleep apnea, smoking, and alcohol consumption. Symptoms you might experience include headaches, difficulty sleeping, bleeding from the nose, night sweats, nausea, and palpitations. High diastolic blood pressure increases the risk of systolic hypertension, heart attack and cardiovascular disease. High blood pressure can be lowered by making small lifestyle changes and by taking the medications prescribed by your healthcare provider.

References

  1. Li Y, Wei FF, Wang S, Cheng YB, Wang JG. Cardiovascular risks associated with diastolic blood pressure and isolated diastolic hypertension. Curr Hypertens Rep [Internet]. 2014 Nov [cited 2024 Jan 8];16(11):489. Available from: http://link.springer.com/10.1007/s11906-014-0489-x 
  2. Aggarwal G, Abed M, Aggarwal S, Alla V. Isolated diastolic hypertension in the united states: analysis from the national health and nutrition examination survey. Journal of the American College of Cardiology [Internet]. 2019 Mar [cited 2024 Jan 8];73(9):1892. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0735109719324982 
  3. Chrysant SG. The clinical significance of isolated diastolic hypertension. Postgraduate Medicine [Internet]. 2020 Oct 2 [cited 2024 Jan 8];132(7):624–8. Available from: https://www.tandfonline.com/doi/full/10.1080/00325481.2020.1788294 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Malaz Ameer Ata Almanan

Medical Student - University of Bahri, Khartoum, Sudan

Malaz Ameer Ata Almanan Mohammed. 4th year medical student. Researcher enthusiast. Passionate about ophthalmic surgery. I would like to be ophthalmologist.

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