High Diastolic Blood Pressure: When to Seek Medical Advice

Diastolic hypertension

Hello, doctor.
I have a habit of measuring my blood pressure.
My systolic pressure has consistently been in the 110s or 120s, but my diastolic pressure ranges from 80 to 90, sometimes dropping to the 70s and other times rising to the 90s.
In early March, I measured my blood pressure, and both arms showed 110/80.
Recently, I felt unwell for the past two days, so today I measured my blood pressure at home.
The systolic pressure was in the 110s to 120s, and the diastolic pressure was over 90.
After resting for 2-3 minutes, it dropped by 10 mmHg to 80s.
Later, after going to the bathroom and chatting with my family, my diastolic pressure rose to over 90, with the numbers fluctuating.
I would like to ask if I should seek medical attention for this situation.
If I need medication, will I have to continue taking it indefinitely? Thank you, doctor.

C, 20~29 year old female. Ask Date: 2023/05/10

Dr. Li Shengkai reply Cardiology

According to the guidelines from the Taiwan Hypertension Society, a home blood pressure reading exceeding 130/80 mmHg is considered hypertension.
Blood pressure measurements should be standardized; it is important to rest for 5-10 minutes before measuring and to avoid vigorous exercise or holding in urine.
The measurement protocol is "7-2-2," which means taking measurements for 7 consecutive days, measuring blood pressure in the morning and evening, and averaging two readings.
Young individuals may have slightly higher diastolic pressure due to better vascular elasticity; discomfort can also lead to elevated blood pressure.
Controlling blood pressure does not necessarily require medication; more importantly, lifestyle changes are crucial.
The mnemonic "SABCDE" can be used to remember these changes: S: limit sodium intake; A: limit alcohol consumption; B: maintain a healthy weight; C: quit smoking; D: dietary control, eat more fruits and vegetables, consume more white meat, and reduce oil, sugar, and red meat intake; E: exercise daily.

Reply Date: 2023/05/10

More Info

Understanding high diastolic blood pressure and when to seek medical advice is crucial for maintaining cardiovascular health. Based on your description, it appears that you have been monitoring your blood pressure regularly and have noticed fluctuations in your diastolic readings, which can be concerning.

Firstly, it’s important to understand what diastolic blood pressure represents. Diastolic pressure is the pressure in your arteries when your heart rests between beats. A normal diastolic reading typically ranges from 60 to 80 mmHg. Readings consistently above 80 mmHg, especially those reaching the 90s, can indicate a condition known as diastolic hypertension. This condition can increase the risk of cardiovascular diseases, including heart attack and stroke, particularly if it is persistent.

In your case, the fluctuation of your diastolic pressure between the 70s and 90s suggests that there may be underlying factors affecting your blood pressure regulation. Factors such as stress, hydration status, physical activity, and even the time of day can influence blood pressure readings. For instance, you mentioned that after resting, your diastolic pressure dropped, but then rose again after some activity. This variability can be normal, but if you are experiencing symptoms such as discomfort, it may warrant further investigation.

Given your situation, here are some recommendations:
1. Monitor Your Symptoms: If you are experiencing discomfort, it is essential to note the nature of these symptoms. Are they related to physical exertion, stress, or do they occur at rest? Symptoms such as chest pain, shortness of breath, or severe headaches should prompt immediate medical attention.

2. Regular Monitoring: Continue to monitor your blood pressure regularly. Keep a log of your readings, noting the time of day and any activities you were engaged in prior to taking your measurements. This information can be valuable for your healthcare provider.

3. Consult a Healthcare Provider: Given the fluctuations in your diastolic pressure and the discomfort you are feeling, it would be prudent to consult with a healthcare professional. They can perform a thorough evaluation, which may include a physical examination, blood tests, and possibly an electrocardiogram (ECG) to assess your heart's health.

4. Medication Considerations: If your healthcare provider determines that you need medication to manage your blood pressure, it is crucial to follow their guidance. Blood pressure medications are often prescribed to help maintain a stable blood pressure and reduce the risk of complications. If you are prescribed medication, it is generally not advisable to stop taking it without consulting your doctor, as this can lead to rebound hypertension or other complications.

5. Lifestyle Modifications: In addition to medication, lifestyle changes can significantly impact blood pressure management. These include maintaining a healthy diet (rich in fruits, vegetables, whole grains, and low in sodium), regular physical activity, managing stress through relaxation techniques, and avoiding tobacco and excessive alcohol consumption.

In conclusion, while occasional fluctuations in blood pressure can be normal, persistent high diastolic readings, especially when accompanied by discomfort, should not be ignored. Seeking medical advice is a proactive step in managing your health. Your healthcare provider can help determine the best course of action, whether that involves lifestyle changes, medication, or further diagnostic testing. Remember, managing blood pressure is a long-term commitment, and regular follow-ups are essential for optimal health outcomes.

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