Why Is My Bottom Blood Pressure Number High? Hypertension & BP Levels (2024)

What Is IDH?
- What is isolated diastolic hypertension?
Causes
- What causes the diastolic to be high?
- What causes your blood pressure to suddenly get high?
Signs/Symptoms
- What are symptoms of high diastolic pressure?
Types of Hypertension
- What are the main types of hypertension?
Treatment
- How is high diastolic blood pressure treated?
Risk Factors
- What are the risk factors of high blood pressure?
Comments
More

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 are the different blood pressure levels?

The table shows different blood pressure levels and conditions.

**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
"row">Stage 2 hypertension	140 or higher	90 or higher
Hypertensive crisis	Higher than 180	Higher than 120

What is isolated diastolic hypertension?

With hypertension, typically both systolic and diastolic blood pressures are elevated. However, isolateddiastolic 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 the diastolic to be high?

Possible causes of isolated diastolic hypertension include:

High-sodium diet
Obesity
Lack of physical activity
Excessive alcohol consumption
Stress and anxiety
Medications including:
- Amphetamines
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Antidepressants
- Oral contraceptive pills
- Caffeine
- Decongestants
- Atypical antipsychotics
- Steroids

What causes your blood pressure to suddenly get high?

Hypertension or high blood pressure (high BP) is a medical condition

Hypertension or high blood pressure (high BP) is a medical condition where the pressure in the arteries is persistently elevated. The heart pumps blood into the arteries, and it is circulated to all parts of the body. Hypertension develops when the heart constantly needs to exert higher force to deliver blood to the organs through the arteries. Since a hypertensive heart must work harder to deliver blood, hypertension can increase the risk of cardiovascular disease, heart attack, and heart failure. Also, the blood vessels in people with hypertension are narrower, putting them at risk of stroke, kidney disease, and vision loss.

There are many reasons for high blood pressure. Some possiblecauses include

caffeine,
acute stress or anxiety,
certain medications (such as nonsteroidal anti-inflammatory drugs),
combinationsofmedications,
recreational drugs,
sudden or acute pain,
dehydration and
white coat effect (fear of being in a hospital or doctor’s clinic).

QUESTION Salt and sodium are the same. See Answer

What are symptoms of high diastolic pressure?

Hypertension is generally considered a silent killer. Most people with hypertension do not have any symptoms.

It may take many years for the condition to become severe and for symptoms to appear. Many times, these symptoms may be attributed to other issues. The best way to know the blood pressure levels is through regular checkups.

What are the main types of hypertension?

There are two types of hypertension:

1. Primary or essential hypertension

Primary or essential hypertension is when 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:

Kidney disease
Congenital heart defects
Congenital defects in blood vessels
Obstructive sleep apnea
Certain endocrine tumors
Adrenal gland tumors
Cushing syndrome
Congenital adrenal hyperplasia
Thyroid problems
Pregnancy
Obesity
Certain medications, such as birth control pills, cold remedies, decongestants, pain relievers, and some prescription drugs
Use of illegal drugs, such as cocaine and amphetamines

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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:

Minerals like magnesium, calcium, and potassium
Supplements that widen blood vessels, such as cocoa, coenzyme Q10, L-arginine, and garlic
Omega-3 fatty acids are found in fish oil supplements and flaxseeds

Medications

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

What are the risk factors of high blood pressure?

Factors that increase the risk of hypertension include:

Being over the age of 60, when arteries stiffen and narrow due to plaque buildup
Being overweight or obese
Regular tobacco use
Alcohol abuse
Male gender
Sedentary lifestyle
Lack of exercise
High fat intake
High salt intake in the diet
Low potassium intake diet
Stress
Family history of hypertension
Existing health conditions:
- Cardiovascular disease
- Diabetes
- Chronic kidney disease
- Sleep apnea
- High cholesterol levels

Medically Reviewed on 12/2/2022

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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