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Diastolic Blood Pressure – Normal Values and Meaning

Diastolic blood pressure is the lowest pressure in the arteries, measured when the heart is at rest between beats. It is a key indicator of cardiovascular health.

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Things worth knowing about "Diastolic Blood Pressure"

Diastolic blood pressure is the lowest pressure in the arteries, measured when the heart is at rest between beats. It is a key indicator of cardiovascular health.

What Is Diastolic Blood Pressure?

Diastolic blood pressure refers to the pressure in the arteries during the resting phase of the heart – the moment between two heartbeats. During this phase, known as diastole, the heart relaxes and refills with blood before the next contraction. The diastolic value is the lower of the two blood pressure readings and is expressed in millimeters of mercury (mmHg). A typical healthy blood pressure is 120/80 mmHg, where 80 represents the diastolic value.

Normal Values and Classification

According to the guidelines of the European Society of Cardiology (ESC) and the World Health Organization (WHO), the following reference ranges apply for diastolic blood pressure in adults:

  • Optimal: below 80 mmHg
  • Normal: 80–84 mmHg
  • High-normal: 85–89 mmHg
  • Grade 1 hypertension (mild): 90–99 mmHg
  • Grade 2 hypertension (moderate): 100–109 mmHg
  • Grade 3 hypertension (severe): 110 mmHg or higher

A persistently elevated diastolic blood pressure (90 mmHg or above) is referred to as diastolic hypertension and requires medical evaluation and treatment. A diastolic value that is too low (below 60 mmHg) may also indicate an underlying health problem.

Causes of Elevated Diastolic Blood Pressure

Elevated diastolic blood pressure often results from a combination of factors, including:

  • Unhealthy diet: high salt intake and high-fat foods
  • Overweight and obesity
  • Physical inactivity
  • Chronic stress and psychological strain
  • Smoking and excessive alcohol consumption
  • Genetic predisposition
  • Kidney or thyroid disease
  • Sleep apnea
  • Certain medications (e.g., pain relievers, oral contraceptives)

Causes of Low Diastolic Blood Pressure

A persistently low diastolic value (below 60 mmHg) may be caused by:

  • Dehydration (fluid deficiency)
  • Heart failure or heart valve disorders
  • Severe infections (septic shock)
  • Significant blood loss
  • Side effects of blood pressure-lowering medications

Symptoms

With Elevated Diastolic Blood Pressure

High blood pressure often causes no noticeable symptoms and is therefore known as a silent condition. At very high levels, possible symptoms include:

  • Headaches, especially at the back of the head
  • Dizziness and nausea
  • Visual disturbances
  • Nosebleeds
  • Palpitations or a racing heartbeat

With Low Diastolic Blood Pressure

  • Dizziness and fainting
  • Fatigue and weakness
  • Light-headedness when standing up (orthostatic hypotension)

Diagnosis

Diastolic blood pressure is measured using a sphygmomanometer placed around the upper arm or wrist. For a reliable diagnosis, medical guidelines recommend multiple measurements at different times of the day, as well as 24-hour ambulatory blood pressure monitoring (ABPM), which tracks blood pressure continuously throughout the day and night.

Treatment and Prevention

Non-Pharmacological Measures

  • Low-sodium, balanced diet (e.g., DASH diet)
  • Regular physical activity (at least 150 minutes of moderate exercise per week)
  • Weight reduction in cases of overweight
  • Stress management and relaxation techniques
  • Quitting smoking and limiting alcohol intake

Medication-Based Treatment

When blood pressure remains persistently elevated, various antihypertensive medications may be prescribed, including:

  • ACE inhibitors (e.g., Ramipril)
  • Beta-blockers (e.g., Metoprolol)
  • Calcium channel blockers (e.g., Amlodipine)
  • Diuretics (e.g., Hydrochlorothiazide)
  • Angiotensin II receptor blockers (ARBs) (e.g., Losartan)

The choice of medication depends on individual patient factors and coexisting conditions and should always be managed under medical supervision.

References

  1. Williams B. et al. – 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 2018.
  2. World Health Organization (WHO) – Hypertension. Fact Sheet. Geneva, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension
  3. Whelton P.K. et al. – 2017 ACC/AHA High Blood Pressure Clinical Practice Guideline. Journal of the American College of Cardiology, 2018.

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