How to Lower Diastolic Blood Pressure (and Whether You Should)

Generally, blood pressure needs to be controlled if it exceeds the normal blood pressure range. However, if the systolic remains the same, and the diastolic blood pressure changes, there might be an underlying factor that patients must address. In that case, it is vital to know how to lower diastolic blood pressure effectively.

For today’s blog, we’ll take a deeper dive into understanding how and why you should lower your diastolic blood pressure. Let’s begin!

Understanding Blood Pressure Reading

There are two important numbers in reading your blood pressure results. Systolic blood pressure is the first number that indicates the power exerted on blood vessels when the heart beats to pump out blood to the circulatory system. The diastolic blood pressure is the second number that indicates the power exerted when the heart is resting between beats. For instance, 110/70 bp is a measurement of 110 systolic and 70 diastolic. This reading uses the mm Hg or millimeters of mercury for the unit measurement.

Different blood pressure readings can be observed throughout the day that are influenced by various activities and food intake.

Normal blood pressure ranges from a systolic blood pressure reading of 110-130 mm Hg and a diastolic blood pressure reading of 60-70 mm Hg. Hence, an increase in normal blood pressure with a range of 130 to 139 mm Hg systolic pressure reading and 80 to 89 mm Hg diastolic pressure reading is categorized as high blood pressure also known as hypertension.

Isolated diastolic high BP

Before the various accumulation of evidence and studies about the importance of systolic pressure, diastolic blood pressure was traditionally considered the most important part of blood pressure and was the basis and target of antihypertensive treatment.

First, let’s define some terms (based on the 2017 American College of Cardiology (ACC)/American Heart Association (AHA)):

• Isolated systolic hypertension (ISH) – is a systolic blood pressure greater than or equal to 130 mm Hg in people with a normal diastolic blood pressure of less than 80 mm Hg. ISH is more prevalent in the older patient population.
• Isolated diastolic hypertension (IDH) – is a diastolic blood pressure greater than or equal to 80 mm Hg in people with a normal systolic blood pressure of less than 130 mm Hg. IDH is more commonly seen in younger patients.

Both isolated systolic and diastolic blood pressure readings can be used to predict the risks of cardiovascular events.

However, you can’t specifically target to lower your systolic or diastolic blood pressure alone. So, if your blood pressure falls in the hypertensive range, it is better to lower your overall blood pressure. Clinical improvement in risk prediction includes both systolic and diastolic blood pressure monitoring.

Risk factors for high diastolic blood pressure

Some common uncontrollable risk factors include age, cardiovascular diseases, and kidney disease.

A 2021 study reported different risk factors of isolated diastolic blood pressure that were predominantly seen in the younger patient population. Patients with IDH were observed to have a high body mass index (BMI) and a smoking history. A study reported a high incidence rate of IDH in the younger patient population.

Additionally, certain medical conditions are also risk factors for IDH such as:

• Constrictive pericarditis – a medical condition that decreases diastolic filling leading to increased diastolic pressure and decreased cardiac output.
• Autonomic dysreflexia – a medical condition that results from a spinal cord injury and causes an overreaction of the involuntary nervous system such as high blood pressure (elevation of diastolic pressure greater than 10 mmHg).

Diagnosis and Symptoms

The diagnosis of lower diastolic blood pressure is mainly based on a blood pressure reading of <130 mmHg/ ≥80 mmHg) accompanied by hypertensive symptoms. Patient-centered factors like age, weight, and medical comorbidities also play a significant part in patient diagnosis.

Patients with hypertension may or may not display symptoms. The following symptoms are observed in high diastolic pressure readings:

• Lightheadedness or dizziness
• Headache
• Increased sweating
• Heart palpitations
• Nausea or feeling like you are about to vomit
• Blurry vision

Medical conditions that cause high blood pressure:

• Obesity

Obesity causes the heart to exert extra force to pump blood into the body and this may strain the arteries causing the blood pressure to rise.

• Hypothyroidism

Hypothyroidism or underactive thyroid is a common secondary cause of isolated diastolic hypertension. Patients with hypothyroidism demonstrate cardiovascular changes such as a decrease in cardiac output and increased peripheral vascular resistance which is associated with IDH. Effective medication using thyroxine is readily available for the treatment of hypothyroidism.

Complications

Hypertension is known to cause cardiovascular complications.

Here are some IDH complications:

• Myocardial infarction
• Stroke
• Heart failure
• Cardiovascular disease death
• Progression to systolic high blood pressure/ hypertension – a predictor of stroke and heart failure
• Sleep apnea causes breathing causes during sleep and shortens the time in between heartbeats

According to a study conducted in Japan, high diastolic blood pressure was reported to be independently associated with a higher risk for heart failure, atrial fibrillation, myocardial infarction, and stroke.

What are some ways to lower diastolic blood pressure?

Lifestyle changes and possible pharmacological treatment are beneficial in the management of high diastolic blood pressure. According to a study, most patients having IDH were younger and observed to have a high body mass index (BMI) and are smokers. Hence, being fit, following a prescribed diet, proper exercise training, and quitting smoking are some efficient blood pressure management treatments. If lifestyle changes and diet changes are not enough to lower your blood pressure, your doctor may prescribe the following medications:

• Thiazide diuretics
• Angiotensin converting enzyme inhibitors (ACE)
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers (CCB)

Note that most patients have existing maintenance medications for other existing medical conditions. It is important to check for drug-drug interactions when adding an antihypertensive drug to the patient’s treatment regimen. Also, watch out for a sudden drop in blood pressure when given these types of medication.

How to lower diastolic blood pressure naturally?

Here are 5 beneficial tips to achieve normal blood pressure naturally:

• Maintain an active lifestyle (increase in aerobic exercises)

Physical exercise reduces blood pressure on exertion and is generally recommended regularly. It was observed that endurance training, resistance training, isometric, and combined training markedly decreased diastolic blood pressure. Shorter endurance training exercise duration at moderate to high intensity was noted to have larger blood pressure reductions.

• Weight reduction

Long-term compliance with the DASH diet and exercise training would help in reducing weight which would lead to a decrease in blood pressure.

• Stress reduction

As a reaction to stress, your body produces hormones that increase blood pressure. It is important to know your stress factors and avoid things that trigger them. Practice deep breathing exercises to reduce stress.

• Avoid smoking

Nicotine content in cigarettes causes an increase in blood pressure. It will be beneficial to taper and stop smoking to prevent an increase in blood pressure.

• Daily blood pressure monitoring

Record and observe your blood pressure trends and consult your doctor to interpret the results for optimal and updated treatment regimen recommendations.

What are the best foods to eat to lower diastolic blood pressure?

• DASH diet

Dietary Approaches to Stop Hypertension (DASH) diet is a suitable and effective nutritional diet strategy to lower blood pressure that is composed of:

• Vegetables
• Fruits
• Fish
• Reduced portions of red meats
• Reduced sugar-sweetened foods
• Reduced sugar-sweetened beverages
• Low-fat dairy products
• Reduced saturated fat and cholesterol
• Add magnesium and potassium-rich food to your diet

Nuts, legumes, and vegetables contain magnesium which has a protective effect against hypertension. Potassium supplementation also showed to reduce blood pressure levels.

• Consume high-fiber food

Foods that are high in fiber such as whole oats, whole barley, legumes, peas, beans, and flax seeds are beneficial in patients with high blood pressure.

• Probiotics

Studies reported the high efficacy of probiotics in reducing diastolic and systolic blood pressure in patients with underlying medical conditions such as diabetes and obesity.

• Reduce salt intake

Since sodium can increase your blood pressure, reduce sodium intake to 1,500 milligrams or preferably less per day.

• Reduce alcohol intake

Alcohol consumption elevates your blood pressure.

When to consult with your doctor

High-risk patients with high blood pressure must have a routine check-up with their doctors.

Your doctor will lay out the best treatment plan that best suits your symptoms and condition. Also, consult with your doctor about a good BP monitor and some best practices for taking your blood pressure.

Conclusion

Working on how to lower diastolic blood pressure can be challenging. There are several approaches on how to achieve the desired outcome. However, it is still best to follow a treatment plan that is specified for your situation. That’s why it is ideal to seek immediate help when a patient needs to lower diastolic blood pressure.
If you are one of those patients who needs to lower their diastolic blood pressure, don’t hesitate to book a consultation with a cardiologist.