From the Guidelines
Increased diastolic blood pressure is primarily caused by lifestyle factors and certain medical conditions.
Causes of Increased Diastolic Blood Pressure
- Obesity
- Excess sodium intake
- Low-fiber diets
- Physical inactivity
- Excess alcohol intake
- Sleep apnea 1
Other Contributing Factors
- Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) 1
- Chronic kidney disease
- Endocrine disorders
- Renovascular disease
- Coarctation of the aorta 1
Importance of Accurate Measurement
It is essential to measure blood pressure accurately to diagnose and manage hypertension, using proper technique and considering the use of home blood pressure monitors or ambulatory blood pressure monitors if necessary 1.
Management and Treatment
Lifestyle modifications, such as dietary changes and increased physical activity, are recommended for all patients with elevated blood pressures, and medication may be necessary to control blood pressure in some cases 1.
From the Research
Causes of Increased Diastolic Blood Pressure
- Increased systemic resistance results in a rise in diastolic blood pressure 2
- Peripheral resistance, which regulates peripheral blood supply due to the run-off of conductance vessels during left ventricular diastole, can cause an increase in diastolic blood pressure if it is elevated 2
- Isolated diastolic hypertension (IDH), defined as a diastolic blood pressure (DBP) > 90 mmHg and a systolic blood pressure (SBP) < 140 mmHg, is a common situation in medical practice and can be a risk factor for cardiovascular events, particularly among young hypertensive patients (< 50 years old) 3
- Diastolic dysfunction, which is present in half of patients with hypertension, can also contribute to increased diastolic blood pressure and is associated with increased cardiovascular morbidity and mortality, as well as the development of heart failure 4
Relationship Between Diastolic Blood Pressure and Cardiovascular Risk
- Diastolic blood pressure is associated with an increased risk of cardiovascular events, particularly among young hypertensive patients (< 50 years old) 3, 5
- Low diastolic blood pressure in very young adults can result from elevation in stroke volume and/or arterial stiffness, and is potentially not a benign condition 5
- Isolated diastolic hypertension in young adults occurs predominantly in men with a high prevalence of metabolic syndrome and is potentially at increased risk for future diabetes and cardiovascular complications 5
- Concordant very high diastolic blood pressure, especially in older persons, defines potential hypertensive urgencies, emergencies, secondary forms of hypertension, and other high peripheral resistance states 5