From the Guidelines
High diastolic blood pressure is primarily caused by increased resistance in the small arteries, with common causes including obesity, high sodium intake, excessive alcohol consumption, physical inactivity, stress, and smoking, as well as medical conditions like kidney disease, thyroid disorders, sleep apnea, and certain medications 1. The causes of high diastolic blood pressure can be categorized into lifestyle factors and medical conditions. Lifestyle factors that contribute to high diastolic blood pressure include:
- Obesity
- High sodium intake
- Excessive alcohol consumption
- Physical inactivity
- Stress
- Smoking These factors can increase blood pressure by causing blood vessels to constrict, increasing blood volume, and damaging blood vessels over time. Medical conditions that can cause high diastolic blood pressure include:
- Kidney disease
- Thyroid disorders
- Sleep apnea
- Certain medications, such as NSAIDs, decongestants, birth control pills, and some antidepressants Genetics also plays a role in the development of high diastolic blood pressure, with family history of hypertension increasing the risk 1. Age-related arterial stiffening typically affects systolic pressure more than diastolic, so elevated diastolic pressure in younger people warrants attention 1. Treatment of high diastolic blood pressure usually begins with lifestyle changes, such as reducing sodium to less than 2,300mg daily, regular exercise (150 minutes weekly), limiting alcohol to 1-2 drinks daily, weight loss if needed, and stress management 1. If these measures are insufficient, medications like ACE inhibitors (lisinopril 10-40mg daily), ARBs (losartan 25-100mg daily), calcium channel blockers (amlodipine 2.5-10mg daily), or thiazide diuretics (hydrochlorothiazide 12.5-25mg daily) may be prescribed 1. Consistent monitoring is essential, as elevated diastolic pressure increases the risk of heart disease and stroke even without symptoms 1.
From the Research
Causes of High Diastolic Blood Pressure
- High diastolic blood pressure can be caused by various factors, including lifestyle and genetic components 2
- Certain medical conditions, such as chronic kidney disease, can also contribute to high diastolic blood pressure 3
- Endocrine disorders, including primary aldosteronism, pheochromocytoma, and Cushing syndrome, can also lead to secondary hypertension, which may manifest as high diastolic blood pressure 4
Related Conditions
- Sleep apnea has been linked to an increased risk of resistant hypertension, which can contribute to high diastolic blood pressure 5, 6
- The relationship between sleep apnea and high diastolic blood pressure is complex and may involve common underlying mechanisms, such as volume excess 6
- Chronic kidney disease can also exacerbate high diastolic blood pressure, and patients with both conditions may be at higher risk for adverse outcomes 5, 6
Key Factors
- Lifestyle modifications, such as weight loss, healthy dietary patterns, and physical activity, can help lower diastolic blood pressure 2
- Certain medications, including thiazide diuretics, angiotensin-converting enzyme inhibitors, and calcium channel blockers, can also be effective in managing high diastolic blood pressure 2
- Identifying and treating underlying medical conditions, such as endocrine disorders or sleep apnea, may also be necessary to control high diastolic blood pressure 4, 5, 6