Abnormal Blood Pressure: High and Low Readings Explained

Blood pressure (both high and low are abnormal)

Hello Dr.
Yao: I would like to ask you a question.
Recently, I have been experiencing unexplained dizziness, and the blood pressure readings show high systolic pressure and low diastolic pressure, as well as low systolic pressure and high diastolic pressure.
What should I do about this?

Ellen, 20~29 year old female. Ask Date: 2006/03/31

Dr. Yao Quan reply Internal Medicine

Dear Miss Ellen,
Hello.
I hope you can provide your blood pressure readings, as this would allow the physician to make more informed judgments and recommendations.
The difference between high systolic blood pressure and low diastolic blood pressure is referred to as pulse pressure.
Based on your correspondence, it appears that your pulse pressure is relatively low.
It is not uncommon for individuals to have low systolic blood pressure while having high diastolic blood pressure, such as a reading of 105/95, which I have encountered in a few cases during my clinic visits.
However, there has not been systematic research on this condition, and its clinical significance and importance remain unclear.

In medicine, the focus is often on elevated systolic blood pressure and low diastolic blood pressure, which indicates increased pulse pressure.
Some studies have found that an increase in pulse pressure can exert greater stress on the arteries, leading to the rupture of elastic components in the vessel walls, thereby increasing the risk of arteriosclerosis and thrombosis.
This condition is commonly seen in older adults.
To my knowledge, there is limited literature discussing the scenario of low systolic blood pressure and high diastolic blood pressure.

In September of last year, the European Heart Journal published an article stating that patients with severe heart failure and low pulse pressure have a higher mortality rate.
[Low pulse pressure is independently related to elevated natriuretic peptides and increased mortality in advanced chronic heart failure.
European Heart Journal.
26(17):1759-64, 2005 Sep.] However, I believe this does not apply to your situation.
There are many causes for dizziness, and both high and low blood pressure are just two possible reasons among many.

In summary, based on your situation and the information you have provided, I cannot give you a specific answer.
If your condition does not improve, I recommend that you see a physician, such as an internist or neurologist.
Sincerely,
Dr.
Yao Quan
Date: 95-4-6

Reply Date: 2006/03/31

More Info

Understanding abnormal blood pressure readings can be quite perplexing, especially when experiencing symptoms like dizziness. In your case, you mentioned having high systolic blood pressure (the top number) and low diastolic blood pressure (the bottom number), which results in a low pulse pressure. This situation can be concerning and warrants further exploration.

Blood pressure is measured in millimeters of mercury (mmHg) and is expressed as two numbers: systolic (the pressure in your arteries when your heart beats) over diastolic (the pressure in your arteries when your heart rests between beats). A normal blood pressure reading is typically around 120/80 mmHg. When the systolic pressure is high and the diastolic pressure is low, it can indicate several potential issues.

1. Pulse Pressure: The difference between systolic and diastolic pressure is known as pulse pressure. A normal pulse pressure is usually between 40 and 60 mmHg. A low pulse pressure, as you described, can be indicative of various health conditions, including heart failure or shock. It’s essential to monitor this closely, especially if you experience symptoms like dizziness.

2. Causes of Abnormal Readings: High systolic pressure can be caused by factors such as stress, anxiety, obesity, high salt intake, or underlying health conditions like kidney disease or hormonal disorders. On the other hand, low diastolic pressure can occur due to factors such as dehydration, blood loss, or certain medications. In your case, the combination of high systolic and low diastolic readings is less common and may require further investigation.

3. Symptoms of Concern: Dizziness can be a symptom of various conditions, including low blood pressure, dehydration, or even anxiety. It’s crucial to consider other symptoms you may be experiencing, such as fatigue, shortness of breath, or chest pain, which could indicate a more serious issue.

4. Next Steps: Given your symptoms and abnormal blood pressure readings, it is advisable to consult a healthcare professional. A thorough evaluation by a doctor, possibly including blood tests, an electrocardiogram (ECG), or an echocardiogram, may be necessary to determine the underlying cause of your symptoms and abnormal readings.
5. Lifestyle Modifications: In the meantime, consider lifestyle changes that can help manage blood pressure. These include maintaining a healthy diet low in sodium, engaging in regular physical activity, managing stress through relaxation techniques, and ensuring adequate hydration.

6. Monitoring: Keep a log of your blood pressure readings at different times of the day and under various conditions (e.g., after exercise, during stress) to provide your healthcare provider with comprehensive information.

In conclusion, while your current blood pressure readings and symptoms may seem alarming, they can often be managed effectively with proper medical guidance and lifestyle adjustments. It’s essential to seek medical advice to rule out any serious conditions and to develop a tailored plan for your health.

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