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Date of last update: 10/20/2017.

Forum Name: Hypertension

Question: Low Diastolic Pressure (Isolated Systolic Hypertension)

 clemsonmike - Sun Feb 28, 2010 8:52 pm


First of all, I would like to thank you for your medical opinion/advice.

I'm a 24 year old very active/healthy male with isolated systolic hypertension. High blood pressure runs in my family. I'm currently taking 7.5mg Enalapril in the morning and 25mg Atenolol in the evening. My daily blood pressure averages 135/55. My concern is sometimes my diastolic pressure can get as low as 40! When it is this low my blood pressure is usually say 125/40.

Both my General Practitioner and Cardiologist seem to think this is not of any concern, as long as there are no precipitating symptoms. I do not have any symptoms from the low diastolic pressure.

Obviously having my blood pressure under control is the objective here, however do you think my medication needs to be adjusted to increase my diastolic pressure? Should I be concerned / is there any significance of me having low diastolic blood pressure?

FYI - I'm a very avid runner / weightlifter.

Thank you,

 Dr.M.jagesh kamath - Mon Apr 05, 2010 11:38 am

User avatar Hello,You have posed a very interesting question.Your doctor and cardiologist were right in reassuring you since you are young and no medical conditions you need not worry.
In the elderly therere is reason to keep the diastolic higher while controlling the systolic hypertension.Due to stiffening if the aorta and atherosclerosis,there risk perdictor, is the wide pulse pressure. ie increased systolic and lowered or normal diastolic.The diastolic mainly drives the coronary flow and the systolic,the predictive factor in stroke,congestive cardiac failure and increased left ventricular mass.
Thus in coronary heart disease and in elderly with systolic hypertension there is reason to reduce the systolic BP without compromising the diastolic.

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