Diastolic Blood Pressure -
Important or Not?

If you are like me (and most doctors), diastolic blood pressure was the least important of the two numbers - systolic and diastolic. Well, I'll let you in on a little secret.

It depends on what health concern you're talking about.

Normal blood pressure at the top of its range is 120/80. The top number is the systolic, the bottom number the diastolic.

The systolic is the pressure at the peak of a heart beat. Diastolic is the pressure between two beats when the heart is at rest.

Even though the heart is between beats, the pressure does not go to zero. It only drops to a figure about two thirds of the maximum pressure. For instance, in the normal blood pressure figure of 120/80, 80/120 equals 2/3.

Thus, we see that substantial pressure remains after the heart beat.

Blood vessels are the largest near the heart and become increasingly smaller the further away from the heart they get until they are tiny capillaries delivering oxygen and nutrients near the cells.

The diastolic pressure keeps the blood flowing through the smaller vessels. If there were no diastolic pressure, oxygen and nutrients would not reach the cells, and the cells would starve and die.

Nevertheless, the diastolic pressure can be too high.

My diastolic pressure averages around 73 or 74. Sometimes it is as low as 69. That is very good. (My problem is on the systolic side.)

Diastolic pressure from 80 to 89 puts one in prehypertension mode. Often, a high blood pressure diet can handle this easily.

From 90 to 99, one is in first stage hypertension. Above 100, you are in second stage hypertension. Your doctor will most likely prescribe drugs to bring that down at least to the prehypertension range.

Diastolic pressure above 120 is called malignant hypertension. This condition is serious and could lead to stroke or kidney damage. Blood pressure medication is mandatory here as it could be life saving.

Such a high pressure means that the blood vessels have not relaxed, so they are constantly under stress and become weakened.

Treatment of high diastolic blood pressure

You and your doctor will try to move you toward normal blood pressure, which per the hypertension definition is 120/80.

Here are some scenarios, and what many knowledgeable health practitioners would recommend:

1. Diastolic approaching 80 - dieting and exercising, cutting out smoking and excess alcohol, losing weight if you are overweight, cutting down on salt.

2. Diastolic 80 to 89 - as above with diet that emphasizes fruits, vegetables and low fat protein.

3. 90 to 120 - as above with major lifestyle changes and medication.

4. Above 120 - possible hospitalization followed with medication.

With any of these scenarios, you should immediately start building into your daily life many of the recommendations found on this site.

High diastolic pressure can be handled, but don't wait until it has climbed out the roof!

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