Why Is My Bottom Blood Pressure Number High?

With hypertension, typically both systolic and diastolic blood pressures are elevated. However, isolated diastolic hypertension (IDH) occurs when your systolic blood pressure is normal, and only your diastolic blood pressure is high (over 80 mm Hg).

IDH is an uncommon type of hypertension, accounting for less than 20% of all hypertension cases. Like other types of hypertension, IDH can increase the risk of stroke, heart disease, heart attack, heart failure, aneurysm, atrial fibrillation, peripheral arterial disease, vision loss, and chronic kidney disease.

Possible causes of isolated diastolic hypertension include:

• High-sodium diet
• Obesity
• Lack of physical activity
• Excessive alcohol consumption
• Stress and anxiety
• Medications including: 
  • Amphetamines
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Antidepressants
  • Oral contraceptive pills
  • Caffeine
  • Decongestants
  • Atypical antipsychotics
  • Steroids

Hypertension or high blood pressure (high BP) is a medical condition

Hypertension or high blood pressure (high BP) is a medical condition where the pressure in the arteries is persistently elevated. The heart pumps blood into the arteries, and it is circulated to all parts of the body. Hypertension develops when the heart constantly needs to exert higher force to deliver blood to the organs through the arteries. Since a hypertensive heart must work harder to deliver blood, hypertension can increase the risk of cardiovascular disease, heart attack, and heart failure. Also, the blood vessels in people with hypertension are narrower, putting them at risk of stroke, kidney disease, and vision loss.

There are many reasons for high blood pressure. Some possible causes include

• caffeine,
• acute stress or anxiety,
• certain medications (such as nonsteroidal anti-inflammatory drugs),
• combinations of medications,
• recreational drugs,
• sudden or acute pain,
• dehydration and
• white coat effect (fear of being in a hospital or doctor’s clinic).

Hypertension is generally considered a silent killer. Most people with hypertension do not have any symptoms.

It may take many years for the condition to become severe and for symptoms to appear. Many times, these symptoms may be attributed to other issues. The best way to know the blood pressure levels is through regular checkups.

Symptoms of severe hypertension include:

• Severe headaches
• Anxiety
• Nosebleeds
• Nervousness
• Sweating
• Fatigue or confusion
• Irregular heartbeat
• Facial flushing
• Dizziness
• Vision problems
• Chest pain
• Shortness of breath
• Sleeping problems
• Blood in the urine
• Black spots in the eyes
• Pounding in the chest, neck, or ears

There are two types of hypertension:

1. Primary or essential hypertension

Primary or essential hypertension is when hypertension has no identifiable cause (for example, another disease or condition). It develops gradually over years.

This type of hypertension may be the result of multiple factors, including:

• Blood plasma volume
• Hormone activity
• Genes
• Physical changes in the body due to age
• Environmental factors, such as stress and lack of exercise

2. Secondary hypertension

In some people, hypertension is caused by an underlying health condition. This type of hypertension tends to appear suddenly. Secondary hypertension also generally causes higher blood pressure than primary hypertension.

Secondary hypertension is caused by specific conditions and their complications:

• Kidney disease
• Congenital heart defects
• Congenital defects in blood vessels
• Obstructive sleep apnea
• Certain endocrine tumors
• Adrenal gland tumors
• Cushing syndrome
• Congenital adrenal hyperplasia
• Thyroid problems
• Pregnancy
• Obesity
• Certain medications, such as birth control pills, cold remedies, decongestants, pain relievers, and some prescription drugs
• Use of illegal drugs, such as cocaine and amphetamines

Isolated diastolic blood pressure can often be managed with lifestyle modifications, dietary supplements, and medications.

Lifestyle modifications

• Maintaining a healthy weight
• Eating a high-fiber diet rich in fruits and vegetables and low in saturated fat and dairy products
• Reducing sodium in the diet
• Exercising regularly
• Quitting smoking
• Limiting alcohol use
• Managing stress
• Getting adequate sleep
• Practicing slow deep breathing
• Monitoring blood pressure at home

Dietary supplements

Dietary supplements that may help lower blood pressure include:

• Minerals like magnesium, calcium, and potassium
• Supplements that widen blood vessels, such as cocoa, coenzyme Q10, L-arginine, and garlic
• Omega-3 fatty acids are found in fish oil supplements and flaxseeds

Medications

If lifestyle and dietary changes are not enough to lower your blood pressure, your doctor may be able to prescribe medications for you.

Factors that increase the risk of hypertension include:

• Being over the age of 60, when arteries stiffen and narrow due to plaque buildup
• Being overweight or obese
• Regular tobacco use
• Alcohol abuse
• Male gender
• Sedentary lifestyle
• Lack of exercise
• High fat intake
• High salt intake in the diet
• Low potassium intake diet
• Stress
• Family history of hypertension
• Existing health conditions: 
  • Cardiovascular disease
  • Diabetes
  • Chronic kidney disease 
  • Sleep apnea
  • High cholesterol levels