From the Guidelines
A diastolic blood pressure of 0 mmHg is a critical finding that requires immediate medical attention, as it typically indicates severe hypotension or cardiac arrest. This condition can arise from various causes, including massive hemorrhage, severe dehydration, profound shock, or cardiac tamponade, where the heart is not effectively filling with blood during diastole 1. It is essential to note that a diastolic pressure of 0 mmHg may also represent a measurement error, particularly when using automated blood pressure devices in patients with very weak pulses or severe arrhythmias.
In clinical practice, healthcare providers should promptly assess the patient's overall condition, including checking for consciousness, pulse, and other vital signs. Emergency interventions such as fluid resuscitation, vasopressors, or CPR may be necessary depending on the clinical context. Repeating the measurement manually is crucial to confirm the finding, as technical errors can sometimes produce falsely low readings 1. The American College of Cardiology and American Heart Association guidelines emphasize the importance of accurate blood pressure measurement, categorizing blood pressure into different stages based on systolic and diastolic values 1.
Key considerations in managing a patient with a diastolic blood pressure of 0 mmHg include:
- Immediate assessment of the patient's airway, breathing, and circulation
- Prompt intervention to address the underlying cause of hypotension
- Repeated measurement of blood pressure to confirm the finding
- Consideration of emergency interventions such as fluid resuscitation, vasopressors, or CPR
- Continuous monitoring of the patient's vital signs and overall condition.
From the Research
Diastolic Blood Pressure of 0
- A diastolic blood pressure of 0 is not a valid or possible reading, as diastolic blood pressure is the minimum pressure in the arteries between heartbeats and is typically measured in millimeters of mercury (mmHg) 2.
- The normal range for diastolic blood pressure is typically considered to be between 60-80 mmHg, with values below 60 mmHg potentially associated with increased risk of cardiovascular events 2.
- Studies have shown that extremely low diastolic blood pressure, such as less than 60 mmHg, can be associated with increased adverse cardiovascular events, including all-cause death, nonfatal myocardial infarction, and nonfatal stroke 2.
Optimal Diastolic Blood Pressure Range
- Research suggests that the optimal diastolic blood pressure range for adults with treated systolic blood pressure less than 130 mmHg is between 70-80 mmHg, as this range is associated with the lowest risk of cardiovascular events 2.
- A diastolic blood pressure of less than 60 mmHg is associated with significantly increased risk of cardiovascular events, including the primary outcome of all-cause death, nonfatal myocardial infarction, and nonfatal stroke (hazard ratio [HR], 1.46; 95% CI, 1.13-1.90; P = .004) 2.
Limitations of Current Studies
- The current studies do not provide direct evidence on the meaning of a diastolic blood pressure of 0, as this is not a valid or possible reading 3, 4, 5, 6, 2.
- Further research is needed to fully understand the relationship between diastolic blood pressure and cardiovascular risk, particularly in patients with treated systolic blood pressure less than 130 mmHg 2.