From the Guidelines
Diastolic hypertension is considered when diastolic blood pressure readings are consistently 90 mmHg or higher, as stated in the most recent guidelines 1. This classification is crucial because elevated diastolic pressure indicates that the heart is not relaxing properly between beats, creating persistent pressure in the arteries. The constant pressure can damage blood vessels over time, increasing the risk of serious cardiovascular complications including heart attack, stroke, and kidney damage. Regular blood pressure monitoring is essential for those with elevated readings, and lifestyle modifications such as reducing sodium intake, maintaining a healthy weight, regular exercise, limiting alcohol, and avoiding tobacco are recommended first-line interventions. If lifestyle changes are insufficient, medication may be necessary based on individual risk factors and overall cardiovascular health assessment. Key considerations include:
- Diastolic blood pressure of 90 mmHg or above is considered hypertensive 1
- Lifestyle modifications are recommended as first-line interventions for diastolic blood pressure between 80-89 mmHg 1
- Medication may be necessary for diastolic blood pressure of 90 mmHg or above, or if lifestyle changes are insufficient 1
- Regular blood pressure monitoring is essential for those with elevated readings 1
- Individual risk factors and overall cardiovascular health assessment should guide treatment decisions 1
From the Research
Diastolic Hypertension Levels
- Diastolic blood pressure levels of 80 to 89 mm Hg are considered stage 1 diastolic hypertension, and levels of 90 mm Hg or higher are considered stage 2 diastolic hypertension, as defined by the 2017 American College of Cardiology/American Heart Association blood pressure guidelines 2.
- The 2017 ACC/AHA guideline lowered the threshold of blood pressure for hypertension to 130/80 mm Hg, which includes diastolic blood pressure of 80 mm Hg or higher as a criterion for hypertension 3.
- In contrast, the Joint National Committee 7 (JNC7) definition of isolated diastolic hypertension is a diastolic blood pressure of 90 mm Hg or higher, with a systolic blood pressure of less than 140 mm Hg 3.
Comparison of Guidelines
- The estimated prevalence of isolated diastolic hypertension is higher when defined by the 2017 ACC/AHA guideline (6.5%) compared to the JNC7 guideline (1.3%) 3.
- However, the association between isolated diastolic hypertension and cardiovascular outcomes is not significant when defined by the 2017 ACC/AHA guideline 3, whereas other studies suggest that isolated diastolic hypertension is associated with an elevated risk of subsequent cardiovascular events 2, 4.