THURSDAY, July 18, 2019 (HealthDay News) -- When it comes to blood pressure readings, the "top" number seems to grab all the attention. But a large, new study confirms that both numbers are, in fact, critical in determining the risk of heart attack and stroke. Blood pressure measurements are given as a "top" and
"bottom" number. The first reflects systolic blood pressure, the amount of pressure in the arteries as the heart contracts. The second reflects diastolic blood pressure, the pressure in the arteries between heart muscle contractions. For years, systolic blood pressure has been seen as the one that really matters. That's based on studies -- including the famous Framingham Heart Study -- showing that high systolic blood pressure is a stronger predictor of heart disease and stroke. At
the same time, though, doctors measure both systolic and diastolic blood pressure, and treatment guidelines are based on both. So just how important is that diastolic number? "The idea behind this new study was to address the confusion," said lead researcher Dr. Alexander Flint, an investigator with Kaiser Permanente Northern California's division of research. Using medical records from 1.3 million patients, his team confirmed that, yes, high systolic blood
pressure was a stronger risk factor for heart attack and stroke. But those risks also climbed in tandem with diastolic pressure; and people with normal systolic readings were still at risk if their diastolic pressure was high. "There's been a common belief that systolic blood pressure is the only one that matters," Flint said. "But diastolic definitely matters." He and his colleagues reported the findings in the July 18 issue of the New England Journal of Medicine. The
definition of high blood pressure has gotten a revamp in recent years. Guidelines issued in 2017 by the American College of Cardiology (ACC) and other heart groups lowered the threshold for diagnosing the condition -- from the traditional 140/90 mm Hg to 130/80. The fact that treatment guidelines include a diastolic pressure threshold implies that it's important. And indeed it is, said Dr. Karol Watson, a member of the ACC's prevention section and leadership council. In fact, she said, doctors once thought that diastolic blood pressure was the more important one -- based on research at the time. Then came the studies showing that systolic pressure was generally a better predictor of people's risk of heart disease and stroke. In addition, Watson said, high systolic blood pressure is more prevalent, because of natural changes in blood pressure as people age. "As we get older, systolic blood pressure keeps
marching up," she explained. Diastolic blood pressure, on the other hand, generally peaks when people are in their 40s to 60s -- and then it declines. But it's clear, Watson said, that while systolic and diastolic blood pressure are different, they both deserve attention. In the latest study, cardiovascular risks rose with each "unit increase" in systolic pressure above 140, by about 18% on average. Meanwhile, each increase in diastolic blood pressure above 90 was tied to a 6%
increase in heart disease and stroke risk. The researchers saw a similar pattern when they looked at blood pressure increases above the 130/80 threshold. That, Flint said, supports the 2017 guideline shift. The findings are based on over 1.3 million patients in the Kaiser Permanente health system who had roughly 36.8 million blood pressure readings taken from 2007 through 2016. Over eight years, more than 44,000 patients had a heart attack or stroke. According
to Flint, it's the largest study of its kind to date. The bottom line for patients, Watson said, is that they should care about both blood pressure numbers. In her experience, she noted, patients often point to the number that's in the normal range and say, "But look how good this is." Flint agreed, saying that no one should "ignore" the diastolic number. "It's important not only in blood pressure treatment, but on the side of diagnosis, too," he said.
A high diastolic reading (equal to or greater than 120 mmHg) is linked to a higher risk of heart disease A high diastolic reading (equal to or greater than 120 mmHg) is associated with an increased risk of stroke, heart attack, and other cardiovascular problems. High diastolic pressure is linked to a higher risk of disease involving the large artery called the aorta that carries blood and oxygen from the heart to distant body parts. People with an elevated diastolic reading are more prone to develop an abdominal aortic aneurysm (ballooning in the lining of the aorta). The problem with such ballooning is that it ruptures and causes a high risk of death. Diastolic pressure is pressure that the blood column puts on the arteries between beats when the heart is relaxed. What does it mean when the systolic number is high?In practice, systolic blood pressure (equal to or more than 160 mmHg) should be regarded as more important than diastolic blood pressure. Systolic blood pressure is the force generated on the inside of the blood vessels called the arteries when the heart contracts. According to a recent study, having a high systolic reading increased the risk of heart attacks and heart disease. Systolic blood pressure is linked not only with heart disease and heart failure but also with kidney disease and overall mortality. Research favored high systolic readings as most predictive of a harmful cardiovascular outcome. As a result, these readings were given more weightage in cardiology guidelines and risk estimation. How is blood pressure measured?Blood pressure is the force exerted by the blood column against the walls of arteries, which function to carry blood to different parts of the body. Blood pressure is measured in the following two variables:
Hypertension is when both systolic and diastolic blood pressures are raised. However, high diastolic blood pressure or isolated diastolic hypertension (IDH) happens when the systolic pulse is in the normal range and only the diastolic blood pressure is elevated (over 80 mmHg). What level of blood pressure can increase the risk of stroke?Any blood pressure reading that is equal to and more than 180/120 mmHg is usually considered hypertensive crisis. At this range of blood pressure, the blood vessels may rupture, and a person may get a hemorrhagic stroke. High blood pressure (hypertension) is the leading cause of strokes in the United States. However, it’s also one of the common risk factors that can be prevented. High blood pressure can damage or weaken the brain arteries, increasing a person’s risk of a stroke. Below are a few readings that everyone should know.
QUESTIONSalt and sodium are the same. See AnswerWhat causes high diastolic blood pressure?
In the vast majority with isolated diastolic hypertension (IDH), no specific cause has been identified In the vast majority with isolated diastolic hypertension (IDH), no specific cause has been identified. Some possible reasons for IDH are:
Health NewsWhat are the treatment options for high blood pressure?The goal of treatment is to reduce blood pressure so that a person may have a lower risk of health problems caused by high blood pressure.
Some common side effects of high blood pressure medicines include
SLIDESHOWHow to Lower Blood Pressure: Exercise and Tips See SlideshowWhat lifestyle changes can lower high blood pressure?Whatever the cause may be, isolated diastolic hypertension (IDH) should not be ignored because the systolic pressure will also elevate over time. IDH can be managed with some simple lifestyle changes, dietary enhancements, and medications. A few ways that aid in lowering IDH are:
Subscribe to MedicineNet's Heart Health NewsletterBy clicking "Submit," I agree to the MedicineNet Terms and Conditions and Privacy Policy. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time. Medically Reviewed on 3/11/2022 References https://pace-cme.org/2019/07/22/systolic-and-diastolic-hypertension-independently-associated-with-cv-outcomes/ American Heart Association. Understanding Blood Pressure Readings. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings Science Direct. Diastolic Blood Pressure. https://www.sciencedirect.com/topics/medicine-and-dentistry/diastolic-blood-pressure What does it mean if my diastolic blood pressure is high?A: A high diastolic blood pressure (80 mm Hg or higher) that stays high over time means you have high blood pressure, or hypertension, even when systolic blood pressure is normal. Causes of diastolic high blood pressure include both lifestyle factors and genetics, but the disease is multifactorial.
How can I lower my diastolic blood pressure quickly?Follow the 20 tips below to help lower your overall blood pressure, including diastolic blood pressure.. Focus on heart-healthy foods. ... . Limit saturated and trans fats. ... . Reduce sodium in your diet. ... . Eat more potassium. ... . Lay off the caffeine. ... . Cut back on alcohol. ... . Ditch sugar. ... . Switch to dark chocolate.. |