How to Lower Diastolic Blood Pressure, and What Causes It in the First Place?

If you’re watching your blood pressure (BP), chances are you’re paying more attention to the top number, the systolic blood pressure. But should you worry if the bottom number – the diastolic blood pressure – is high? The short answer is yes: if the bottom number is above 90 mm/Hg you are considered to have hypertension. However, while this may sound bad, the good news is that you can work with your doctor and adopt a few simple lifestyle changes that will help you to lower your diastolic blood pressure.

In this short article we’ll explain more about diastolic blood pressure and why it matters. We’ll also take a look at what causes high diastolic blood pressure and what you can do to lower your reading safely.

Systolic vs. Diastolic Blood Pressure

When you visit your physician and they take your blood pressure, two numbers are generated, a top number and a bottom number, with the top number always larger than the bottom number. Your physician will look at these numbers and then tell you whether your blood is high, low, or just right. However, do you, as a patient, know what these numbers represent?

The top, larger, number is your systolic blood pressure: this is the highest pressure exerted by the heart onto your arteries during a single beat.
The bottom, smaller, number is your diastolic blood pressure:this is the amount of pressure present in the arteries between heart beats.

The first number in your reading, the systolic pressure, usually receives much more attention than the diastolic pressure, which is likely because a fairly common type of hypertension involves a high systolic BP and a normal diastolic BP. However, it’s important to keep a close eye on diastolic blood pressure too, especially if your number is creeping towards, or exceeding, 90 mm/Hg.

What is diastolic blood pressure?

As mentioned above,diastolic blood pressure is a measure of the pressure in the arteries when the heart is at rest, i.e. between beats. During this time, the heart is re-filling with oxygenated blood from the lungs (through the pulmonary artery).

While elevated systolic blood pressure is extremely common for hypertensive patients and historically received more attention, we now know that both numbers are important and your diastolic blood pressure can also be a useful indicator of general cardiovascular health. Either an elevated systolic or diastolic BP reading may be used to diagnose high blood pressure.

Here’s how to understand your diastolic blood pressure number:

Why is diastolic blood pressure important?

A 2019 study published in the New England Journal of Medicine reviewed 36 million blood pressure readings from 1.3 million adults in Northern California, taken between 2007 and 2016. Dr. Alexander Flint, who led the study, told NBC News, “Although systolic [blood pressure] does count for a little bit more in terms of the risk of heart attack and stroke, diastolic high blood pressure is a close second, and it’s an independent predictor of those risks.”

If you have elevated diastolic pressure but normal systolic pressure then you could have isolated diastolic hypertension (IDH). Like other types of high blood pressure, IDH can increase the risk of serious conditions including stroke, heart disease, heart attack, heart failure, aneurysm, vision loss, and kidney disease.

What causes isolated diastolic hypertension?

Isolated diastolic hypertension is associated with specific health issues, including endocrine disorders, which affect hormone production and regulation, and renovascular disorders, which impact blood flow to the kidneys. A study completed in 2013 also demonstrated a link between severe sleep apnea, a condition characterized by pauses in breathing or shallow breaths during sleep, and elevated diastolic blood pressure.

Of course, lifestyle can make you more likely to have high diastolic blood pressure, too. A study of 8,475 patients aged 18 and above in China revealed three significant risk factors:

• Age: patients with isolated diastolic hypertension (IDH) were much younger than those with isolated systolic hypertension (ISH)
• BMI: high BMI is a significant risk factor for IDH, but not for ISH
• Smoking: significantly associated with IDH but not with ISH

These study results suggest that keeping fit and giving up smoking might be particularly effective for young patients looking to manage diastolic blood pressure.

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Stress and diastolic blood pressure

When you’re experiencing stress, your body releases hormones that cause your heart to beat faster and your blood vessels to narrow. This can increase the pressure on the walls of your blood vessels and lead to high blood pressure.

Chronic stress can also lead to other unhealthy behaviours, such as overeating or smoking, which can further contribute to high blood pressure. Managing stress through techniques such as exercise, meditation, or deep breathing can be helpful in reducing diastolic blood pressure, as well as maintaining a healthy blood pressure overall.

For a comprehensive understanding of natural methods to control high blood pressure, you may find valuable insights and practical tips in our article, ‘How to Lower High Blood Pressure Naturally, Without Medication‘.

Risks of High Diastolic Blood Pressure

One of the primary outcomes of high diastolic blood pressure is an increased risk of cardiovascular diseases, such as heart attack and stroke. This is because high blood pressure puts a strain on the heart (due to blood vessel narrowing and an increased heart rate), causing it to work harder to pump blood throughout the body, which, over time, can damage the arteries.

Another risk associated with high diastolic blood pressure is damage to other vital organs, such as the kidneys. The kidneys play a crucial role in regulating blood pressure, and high blood pressure can cause damage to their delicate blood vessels, leading to kidney failure or other kidney problems. High blood pressure can even damage the blood vessels in the eyes, causing vision problems and even blindness.

Other risks associated with high diastolic blood pressure include an increased risk of aneurysms, peripheral artery disease, and sexual dysfunction. High BP can also cause cognitive impairment and increase the risk of developing dementia, as it can damage the blood vessels in the brain, affecting its functioning.

Dementia and blood pressure

Studies have suggested a possible link between high blood pressure and an increased risk of dementia because, as noted above, high blood pressure can damage blood vessels and reduce blood flow to the brain, therefore increasing the risk of dementia and cognitive decline.

One study published in the journal Neurobiology of Aging found that individuals with high blood pressure in midlife were more likely to develop cognitive impairment later in life than those with normal blood pressure. Another study found that high blood pressure in middle age was associated with an increased risk of dementia in later life.

However, it’s important to note that the relationship between high blood pressure and dementia is complex and not fully understood. Other factors, such as genetics, lifestyle, and overall health can also influence the risk of developing dementia.

Lowering blood pressure through lifestyle changes, such as diet and exercise, and medication (if needed), can help reduce the risk of cognitive decline and dementia. It’s important to talk to your healthcare provider about your blood pressure and any concerns you may have about your cognitive health.

How can you reduce diastolic blood pressure?

There are many things you can do to lower your blood pressure overall. Your doctor may recommend changes to your diet and lifestyle, and will sometimes prescribe blood pressure medication.

However, if you only have high diastolic blood pressure, it’s important to work closely with your doctor to make sure it doesn’t reduce too much. Low diastolic blood pressure (under 60 mmHg) means your heart muscles won’t get enough oxygenated blood, which can lead to a condition called diastolic heart failure. In fact, people with a diastolic blood pressure below 60 mmHg are 50% more likely to sustain heart damage.

Tips to Reduce Blood Pressure

1. Exercise regularly

The NHS recommends that adults should do at least 2.5 hours of exercise a week, with a recent study finding that only 30 minutes of exercise in the morning may be as effective as medication at lowering blood pressure for that day.

A moderate-intensity aerobic activity, such as brisk walking, jogging, cycling or swimming, is ideal. But, if you hate the gym and you’ve never considered yourself a sporty person, don’t panic. Try these tips:

• Find a physical activity you enjoy, like gardening, walking the dog or even a dance class – anything that makes you breathe harder and your heart beat a little faster.
• Pair up with a friend or family member who is also looking to get fitter – that way, you have someone else to keep you company and hold you accountable.
• Find ways to build more activity into your daily routine, such as getting off the bus a couple of stops early, always using the stairs or taking a lunchtime walk.

Check out our guide to exercising safely with high blood pressure, the best forms of exercise for high blood pressure and the exercises you should probably avoid.

2. Eat healthily

A healthy, balanced diet that’s low in sodium and high in potassium can lower blood pressure by helping to reduce the amount of fluid in the body, meaning the blood vessels can expand and contract more easily, which helps to lower blood pressure.

• Take a look at the NHS’s Eatwell Guide, designed for people with hypertension who want to make healthy changes to their diet.
• Aim to eat more unprocessed foods, including fruit and vegetables, dark leafy greens like spinach and kale, fatty fish like salmon, mackerel and herring, and nuts.
• Eat plenty of fibre – things like wholegrain rice, brown bread, and whole wheat pasta are best.
• If you have a sweet tooth, swap your usual treats for dark chocolate – chocolate with a 70% or higher cocoa content has been shown to help lower blood pressure.

To start, read about the DASH (Dietary Approaches to Stop Hypertension) diet and talk to your doctor about incorporating it into your life. Here are some easy recipes to help lower blood pressure, and take a closer look at the best food types to lower blood pressure.

3. Cut down on salt

You probably already know that a diet that’s high in salt is bad news for your blood pressure. That’s because salt makes your body hold onto water. Eat too much of it, and the extra water in your blood increases the pressure on your blood vessels, raising your blood pressure.

Cutting down on salt is one of the easiest and quickest ways to lower your blood pressure. Try to:

• Use less salt in your cooking, and don’t put the salt shaker on the table.
• Check the labels on foods when you go shopping – even for foods you wouldn’t expect to contain a lot of salt. The traffic-light system used on some food packaging can help with this.
• If you eat out, call the restaurant in advance and ask if your chosen dish can be made with less salt.
• If food tastes bland to start with, persevere – your taste buds will soon get used to the taste.
• Rethink your go-to recipes and try adding flavour with onions, garlic, herbs, spices, chilli or lemon juice instead of salt.

4. Drink less alcohol

If you drink, it’s important to do so in moderation. According to a 2006 study, alcohol can raise your blood pressure by 1 mmHg for each 10 g of alcohol consumed where one unit is the equivalent of 8 g of alcohol.

Drinking too much alcohol too often has a number of detrimental effects on your health, including raising blood pressure above normal levels. Alcohol can make blood pressure medication less effective and is also linked to weight gain, another cause of high blood pressure. Our tips are:

• Stick within the recommended limits – no more than 3 to 4 units a day for men and  2 to 3 for women.
• Try alcohol-free or low-alcohol drinks – the range is much better than it used to be.
• Choose smaller glasses instead of large ones, and bottles instead of pints.
• Add mixers or water to make your drink last longer, or alternate between alcoholic and soft drinks.
• If you drink at home, buy a measure so you know exactly how much you’re drinking.

5. Reduce stress

Easier said than done, we know, but stress has several effects on the body, one of them being that it contributes to surges in stress hormones, which can then increase blood pressure.

Different people find different ways to reduce stress – some prefer a relaxing activity like yoga or reading, and others find physical activity more effective. You could:

• Get some exercise and boost your mental and physical health simultaneously. It doesn’t have to be intense – a walk in the fresh air could be all that’s needed (read how being active helps mental wellbeing).
• Talk to or spend time with friends and family.
• Do something that makes you laugh, like watching a comedy.
• Practise meditation or mindfulness – Headspace and Calm are two apps you could try to get started.
• Try to switch to a glass-half-full mindset, says Professor Cary Cooper, an occupational health expert at the University of Lancaster. ‘Try writing down three things that went well, or for which you’re grateful, at the end of every day.’
• If stress is making it harder to function day to day, speak to a doctor or mental health professional.

6. Take your medication

If your doctor has prescribed blood pressure medication, ensure you take the correct dose at the right time. Medications can help control hypertension by relaxing blood vessels, allowing blood to pass through more easily and relieving stress on your heart and organs. However, consistent blood pressure monitoring provides a comprehensive data set, empowering you and your healthcare provider to make more informed decisions about your medication.

Strategies to lower your diastolic blood pressure naturally

Several natural remedies have been found to be effective in lowering blood pressure in general, including garlic, omega-3 supplements, and hibiscus tea.

• Garlic contains compounds that can help relax blood vessels and lower blood pressure.
• Omega-3 fatty acids, which are found in fish, nuts, and seeds, have also been found to have blood pressure-lowering effects. They work by reducing inflammation and improving blood vessel function, which can help lower diastolic blood pressure.
• Hibiscus tea is another natural remedy that has been found to be effective in reducing diastolic blood pressure. It contains antioxidants called anthocyanins, which can help lower blood pressure by reducing the constriction of blood vessels.

When using natural remedies to lower diastolic blood pressure, it’s important to use them safely and effectively. Always consult with your healthcare provider before trying any new natural remedy, especially if you are taking medication or have a medical condition. Herbs and supplements can interact with medications, just as drugs can interact with each other. It’s important to inform your healthcare provider of all the remedies you’re using.

Since studies have traditionally focused on systolic blood pressure, we’re still discovering the true significance of diastolic blood pressure. If you’re affected, by far the best approach is to work with your doctor to develop an appropriate treatment plan.

Disclaimer: This article is for informational purposes only and does not contain medical advice, and is not a replacement for medical advice. The information in this article is not intended to diagnose, treat, cure, or prevent any disease. Talk to a qualified medical professional before making any changes to your health regimen.

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