If you have high blood pressure, or hypertension, you are not alone. According to the Centers for Disease Control and Prevention, this condition affects 1 of 3 adults in the U.S., and over time can lead to health problems such as heart and blood vessel disease, stroke, vision loss and kidney disease. Even in the short-term, severely high blood pressure increases the risk of stroke and organ damage. Blood pressure is recorded as 2 readings, such as 120/80, and it's common for both numbers -- the systolic and diastolic -- to be elevated in people with hypertension. While the top number is often viewed as a greater threat to health, elevations in the bottom , or diastolic number, also pose health risks.
About Blood Pressure
A blood pressure reading measures how much pressure is exerted against the artery walls as the heart pumps blood through the body. The top blood pressure reading is the systolic pressure, which represents how much force the heart exerts when it contracts. The second number is the diastolic pressure, which represents the level or pressure when the heart relaxes. The American Heart Association identifies readings below 120/80 as normal. Systolic readings over 140 or diastolic readings over 90 are classified as hypertension.
Diastolic Hypertension Health Risks
Historically, more attention has been placed on the health risks of elevated systolic blood pressure readings. But high diastolic readings, whether in isolation or along with high systolic readings, are also unhealthy for the body. A study of over 1900 adults, published in the March 2014 issue of "Journal of Hypertension," linked elevated diastolic and systolic readings to an increased risk of a cardiovascular event -- such as chest pain or heart attack. A review of the medical records of 1.25 million people, reported in the May 2014 issue of "The Lancet," provided additional clarification on the health effects of elevated systolic and diastolic readings. Study authors concluded that elevated systolic blood pressure posed a higher risk of heart disease-related chest pain as well as stroke caused by brain bleeds, while high diastolic blood pressure was linked to a greater risk of abdominal aortic aneurysm -- an enlargement of the body's main artery which can leak or burst and cause life-threatening complications. The health risks seem to extend beyond heart health, as a study published in the August 2009 issue of "Neurology" linked a 10 point increase in diastolic blood pressure to a 7 percent reduction in cognitive decline.
Risks in Younger Adults
Elevated diastolic blood pressure, without abnormal systolic pressure, is called diastolic hypertension and is more common in adults under the age of 45. In these younger adults, diastolic hypertension poses a greater risk of death from heart disease compared to high systolic blood pressure, according to a February 2011 report published in "British Medical Journal." In addition, people with high diastolic blood pressure are more likely to develop elevations in systolic pressure as they age, which increases future heart disease and stroke risk. This underscores the importance of blood pressure management and medical follow-up in anyone with elevated diastolic readings.
If your systolic or diastolic blood pressure readings are above normal range, work with your doctor on a treatment plan which may include medications and lifestyle changes such as healthy diet, weight loss and exercise. High blood pressure is often called the silent killer because it generally causes no symptoms, but can lead to serious health consequence or death . It's important to have your blood pressure checked regularly or purchase a monitor so you can track your readings at home, and to diligently follow your treatment plan. While normal blood pressure readings are below 120/80, your doctor can provide you with individualized blood pressure targets. Seek immediate medical attention if you develop chest pain, shortness of breath, or have a sudden onset of weakness, vision changes, difficulty speaking or back pain. Systolic blood pressure readings above 180, or diastolic readings above 120 -- or above 110 with symptoms -- are considered a medical emergency and require immediate treatment.
Reviewed by Kay Peck MPH RD
Is This an Emergency?
- JAMA: 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)
- American Heart Association: Understanding Blood Pressure Readings
- The Lancet: Blood Pressure and Incidence of Twelve Cardiovascular Diseases: Lifetime Risks, Healthy Life-Years Lost, and Age-Specific Associations in 1·25 Million People
- Centers for Disease Control and Prevention: High Blood Pressure Facts
- Neurology: Association of Higher Diastolic Blood Pressure Levels With Cognitive Impairment
- Journal of Hypertension: Overall Cardiovascular Prognosis of Isolated Systolic Hypertension, Isolated Diastolic Hypertension and Pulse Pressure Defined With Home Measurements: The Finn-Home Study.
- American Heart Association: Hypertensive Crisis: When You Should Call 9-1-1 for High Blood Pressure
- British Medical Journal: Association of Blood Pressure in Late Adolescence With Subsequent Mortality: Cohort Study of Swedish Male Conscripts
- Journal of the American Society of Hypertension: The Importance of Diastolic Blood Pressure in Predicting Cardiovascular Risk.