Medical Book

LANGUAGE
English Español 中文 Українська
Search

Showing results for: Array

    Medical Book

    LANG
    English Español 中文 Українська
    DBP
    Home > Parameters

    DBP

    Diastolic blood pressure: ESC 2024 categories, pulse pressure, causes of high values and warning signs.

    Diastolic blood pressure (DBP) is the lower number of a blood-pressure reading: the lowest pressure in the arteries while the heart relaxes and refills between beats. It mainly reflects the resistance of the small arteries (arterioles) and the elasticity of the large arteries. Raised diastolic pressure is common in younger and middle-aged adults with hypertension. In older people diastolic pressure often falls as the arteries stiffen, while systolic pressure rises.

    Blood pressurePeripheral resistanceHypertension
    Non-elevated (ESC 2024)< 70 mmHg
    Elevated70–89 mmHg
    Hypertension≥ 90 mmHg (office)
    Pulse pressureSBP − DBP, ≈ 40 mmHg
    Office diastolic blood pressure categories according to the 2024 ESC guideline: non-elevated below 70, elevated 70 to 89, hypertension from 90, very high from 120 mmHg Office diastolic blood pressure (mmHg) Non-elevated below 70 70 Elevated 70–89: lifestyle, risk assessment 90 Hypertension ≥ 90: confirm, treat 120 Very high ≥ 120: urgent assessment
    Figure 1. Office diastolic blood pressure categories (ESC 2024). In treated older patients, very low diastolic pressure may reduce blood flow to the heart.

    Pulse pressure

    The difference between systolic and diastolic pressure is the pulse pressure, normally about 40 mmHg. A wide pulse pressure (for example 160/70) is typical of arterial stiffness in older age, and also of aortic regurgitation, hyperthyroidism and anaemia. A narrow pulse pressure can occur with low cardiac output, aortic stenosis or blood loss.

    Causes of high diastolic pressure

    • Primary hypertension, often with overweight, high salt intake, alcohol, stress and lack of exercise
    • Secondary causes: kidney disease, primary aldosteronism, sleep apnoea, hypothyroidism, medicines (NSAIDs, decongestants, oral contraceptives)

    Isolated diastolic hypertension in young adults also increases long-term cardiovascular risk and should not be ignored.

    Seek emergency care

    if diastolic pressure is 120 mmHg or higher with chest pain, breathlessness, severe headache, confusion, visual disturbance or weakness.

    Planned evaluation

    Repeatedly raised diastolic pressure should be confirmed with home or ambulatory measurements and discussed with a doctor, together with cardiovascular risk factors.

    References

    1. McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912–4018. doi:10.1093/eurheartj/ehae178

    This article is for general information and does not replace a consultation with a doctor. Measurements must be interpreted by a physician together with symptoms and other tests.

    Published on 2 June 2019