From the Guidelines
A diastolic blood pressure below 60 mmHg is generally considered too low and may be associated with increased risk of adverse effects, particularly in older adults or those with heart disease. Diastolic blood pressure is the bottom number in a blood pressure reading, measuring the pressure in your arteries when your heart rests between beats. Low diastolic pressure (diastolic hypotension) can reduce blood flow to your heart, brain, and other organs, potentially causing symptoms like dizziness, fatigue, blurred vision, or fainting.
According to the most recent guidelines, the threshold for hypotension is considered to be a diastolic blood pressure below 60 mmHg 1. The American College of Cardiology/American Heart Association guidelines advocate a blood pressure target <130/80 mmHg for all patients, with or without diabetes, but also consider the potential adverse effects of antihypertensive therapy, such as hypotension, syncope, falls, acute kidney injury, and electrolyte abnormalities 1.
In patients with low absolute cardiovascular risk (10-year ASCVD risk <15%) or with a history of adverse effects of intensive blood pressure control or at high risk of adverse effects, a blood pressure target of <140/90 mmHg is recommended, if it can be safely attained 1. However, in patients with high absolute cardiovascular risk, it may be reasonable to target blood pressure <130/80 mmHg, even if it means a lower diastolic blood pressure, as the benefits of intensive blood pressure control may outweigh the risks 1.
It is essential to consult a healthcare provider if you consistently have diastolic readings below 60 mmHg and experience symptoms, as they may adjust medications, recommend lifestyle changes, or prescribe medications to raise blood pressure. Regular monitoring is crucial to maintain appropriate diastolic blood pressure levels and ensure adequate oxygen and nutrient delivery to tissues. The body needs adequate diastolic pressure to ensure proper perfusion of vital organs, especially the coronary arteries which primarily fill during diastole.
Key points to consider:
- Diastolic blood pressure below 60 mmHg is generally considered too low
- Low diastolic pressure can reduce blood flow to vital organs and cause symptoms
- The threshold for hypotension is a diastolic blood pressure below 60 mmHg
- Blood pressure targets should be individualized based on cardiovascular risk and potential adverse effects of antihypertensive therapy
- Regular monitoring is essential to maintain appropriate diastolic blood pressure levels.
From the Research
Definition of Low Diastolic Blood Pressure
- Low diastolic blood pressure (DBP) is generally considered to be below 60-70 mmHg 2, 3, 4, 5, 6
- The threshold for hypotension, specifically diastolic hypotension, is often defined as a DBP below 60 mmHg 4, 6
Health Risks Associated with Low DBP
- A DBP below 60 mmHg has been associated with increased risk of cardiovascular events, including all-cause mortality, nonfatal myocardial infarction, and nonfatal stroke 2, 4, 5, 6
- Low DBP may lead to inadequate organ perfusion, particularly in patients with pre-existing cardiovascular disease 3, 4, 6
- The risk of adverse cardiovascular events increases with decreasing DBP, with a DBP of 60-69 mmHg also associated with an increased risk of all-cause mortality 6