High diastolic blood pressure is a manifestation of high blood pressure. When the diastolic blood pressure is higher than 90mmHg, it is considered to be high diastolic blood pressure. This situation is more common in young hypertensive patients, especially men. The main causes of high diastolic blood pressure are usually related to bad lifestyle habits, such as smoking, alcoholism, lack of sleep, work stress, lack of exercise, lack of health care knowledge and neglect of health. For the treatment of high diastolic blood pressure, blood pressure can be lowered by improving lifestyle, such as taking a low-salt diet, proper exercise, and weight loss. If the blood pressure has not been reduced after 6 months, or the degree of high diastolic blood pressure is more serious, drug treatment can be considered.
Epidemiology
Epidemiology
There is currently no authoritative epidemiological data on this symptom.
Infectious
Not contagious.
Incidence
There is no authoritative data on the incidence of this symptom.
Prone population
Generally speaking, young hypertensive patients have a higher proportion of high diastolic and diastolic blood pressure, especially men.
symptom
Typical manifestations
The symptoms of high low blood pressure are more complicated and often vary from person to person. Some patients may have no symptoms or mild symptoms, while others may experience headaches and dizziness, fatigue, eye discomfort, palpitations, and breathing difficulties.
1. Headache and dizziness
This is one of the most common symptoms of low blood pressure. You may feel pain on the sides of your head or in your neck, which may gradually increase in intensity. You may also feel dizzy or lightheaded, especially when you stand up or change position.
2. Easy to get tired
High diastolic pressure may cause the patient to tire easily, which may not be completely relieved even after a period of rest. This feeling of fatigue may be due to the heart not being able to fill fully during diastole, resulting in a decrease in cardiac output, which affects the body’s normal function.
3. Eye discomfort
High blood pressure may cause eye discomfort, such as blurred vision, eye fatigue, etc. This may be due to the increase in blood pressure affecting the blood supply to the eyes.
4. Palpitations and dyspnea
Some patients may experience palpitations and difficulty breathing, especially during activity or exercise. This may be due to the heart not filling fully during diastole, resulting in reduced cardiac output, which affects the body’s normal oxygen supply.
complication
1. Cardiovascular and cerebrovascular diseases
Long-term high diastolic pressure may lead to cardiovascular and cerebrovascular diseases, such as coronary heart disease, angina pectoris, myocardial infarction, cerebral infarction, etc. This is because high diastolic pressure will increase the burden on the heart, leading to cardiac hypertrophy and enlargement, and then causing heart failure and heart failure. At the same time, high diastolic pressure may also promote the formation of atherosclerosis and increase the risk of cardiovascular and cerebrovascular events.
2. Kidney disease
High blood pressure may damage the kidneys and lead to kidney disease. Long-term high blood pressure may cause lesions such as renal artery sclerosis and glomerular sclerosis, which in turn lead to symptoms such as abnormal renal function, proteinuria, and hematuria. In severe cases, it may also lead to renal failure.
3. Eye diseases
High diastolic pressure may also lead to eye diseases, such as retinopathy, fundus hemorrhage, etc. This is because high diastolic pressure may affect the blood supply to the eye blood vessels, leading to retinal ischemia, hypoxia and other diseases.
reason
Overview
The causes of high low blood pressure can be divided into two categories: disease factors and non-disease factors. Disease factors include kidney disease, endocrine disease, cardiovascular disease, cranial and cerebral disease, etc.; non-disease factors include genetic factors, overweight and obesity, long-term mental stress, dietary factors, smoking and drinking, drugs, etc.
Cause of symptoms
1. Disease factors
(1) Kidney diseases: such as glomerulonephritis, chronic pyelonephritis, congenital kidney disease (polycystic kidney disease, etc.), secondary kidney diseases (connective tissue disease, diabetic nephropathy, renal amyloidosis, etc.), renal artery stenosis and kidney tumors.
(2) Endocrine diseases: such as hypercortisolism, pheochromocytoma, primary aldosteronism, hyperthyroidism, hypothyroidism, hyperparathyroidism, hyperpituitarism and menopausal syndrome.
(3) Cardiovascular diseases: such as aortic valve stenosis, complete atrioventricular block, aortic coarctation and Takayasu arteritis.
(4) Brain diseases: such as brain tumors, brain trauma, brain stem infection, etc.
(5) Other diseases: including sleep apnea syndrome, pregnancy-induced hypertension syndrome, polycythemia vera, etc.
2. Non-disease factors
(1) Genetic factors: People whose parents both have hypertension have a higher risk of developing the disease.
(2) Overweight and obesity: As weight increases, the risk of developing high low blood pressure gradually increases.
(3) Long-term mental stress: Long-term mental stress can cause over-excitement of the sympathetic nerves, leading to increased low blood pressure.
(4) Dietary factors: High-salt diet, high-protein diet, high-fat diet, etc. can all lead to increased low blood pressure.
(5) Smoking and drinking: Nicotine and other ingredients in alcohol and tobacco can cause high blood pressure.
(6) Drugs: Long-term oral use of certain drugs, such as birth control pills, ephedrine, glucocorticoids, etc., may also lead to increased diastolic blood pressure.
Common diseases
Glomerulonephritis, chronic pyelonephritis, polycystic kidney, connective tissue disease, diabetic nephropathy, renal amyloidosis, renal artery stenosis, renal tumor, hypercortisolism, pheochromocytoma, primary aldosteronism, hyperthyroidism, hypothyroidism, hyperparathyroidism, hyperhypophysitis, menopausal syndrome, aortic valve stenosis, complete atrioventricular block, coarctation of the aorta, Takayasu arteritis, brain tumor, brain trauma, brain stem infection, sleep apnea syndrome, pregnancy-induced hypertension syndrome, polycythemia vera
Medical treatment
Outpatient Indications
1. Blood pressure was measured multiple times, and the low pressure was always over 90 mmHg.
2. Symptoms such as headache, dizziness, fatigue, palpitations, and difficulty breathing may occur.
3. Other severe, persistent or progressive symptoms and signs occur.
All of the above require prompt medical consultation.
Department
Patients can go to the cardiovascular department for treatment.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. When going to the doctor, try to stay calm, don’t be too nervous, and don’t rush around or get tired.
3. Blood tests may be performed, and it is best to visit the doctor in the morning on an empty stomach.
4. If you have had medical treatment recently, please bring relevant medical records, examination reports, test results, etc.
5. If you need to take some medicine to relieve symptoms recently, you can bring the medicine box with you.
6. Family members can be arranged to accompany the patient to seek medical treatment.
7. Prepare a list of questions you want to ask in advance.
Questions your doctor may ask you
1. What discomforts do you currently have?
2. How long have you been experiencing this condition?
3. Are your symptoms persistent or intermittent? Is there any pattern?
4. Have your symptoms gotten worse or better since you became ill? Is there any reason for this?
5. Have you ever had similar symptoms before?
6. Have you ever been treated before? How was it treated? What was the effect?
7. Are you taking any medication?
8. Do you smoke? How long have you been smoking? How many cigarettes do you smoke on average per day?
9. Do you drink alcohol? How long have you been drinking? How much do you drink on average per day?
10. Is there anyone in your family who has a similar situation?
Questions patients can ask their doctors
1. Is my condition serious? Can it be cured?
2. Why does this happen to me?
3. How should I be treated? Do I need to be hospitalized? How long will it take to recover?
4. What are the risks of these treatments?
5. If medication is used for treatment, what are the usage, dosage and precautions of the medication?
6. What tests do I need to take? Are they covered by medical insurance?
7. I have other diseases. Will this affect my treatment?
8. How should I take care of myself after returning home?
9. Do I need follow-up examinations? How often?
examine
Estimated inspection
Patients first need to have their blood pressure measured and other physical examinations, and then undergo examinations such as blood routine, urine routine, blood biochemistry, 24-hour urine protein quantification, echocardiography, renal ultrasound, chest X-ray, electrocardiogram and dynamic blood pressure monitoring.
Physical examination
1. Blood pressure check
Blood pressure examination requires the subject to rest quietly for at least 5 minutes before measurement begins. Upper arm blood pressure should be measured in a sitting position, and the measurement position should be at heart level.
2. Visual examination
Observe whether the patient has edema in both lower limbs; whether there are any abnormalities in respiratory rate and rhythm; whether there are any abnormalities in apex beat; whether the patient’s mental state is normal; and whether the patient has any special facial features.
3. Auscultation
Auscultate the patient to see if the breathing sounds are normal; whether there are abnormal heart sounds or heart murmurs; whether there are thyroid vascular murmurs, renal artery vascular murmurs, etc.
4. Palpation
Check the thyroid gland for enlargement or nodules, check the abdomen for enlarged kidneys or masses, and check the arterial pulses and neurological signs in the limbs.
5. Fundus examination
Use an ophthalmoscope to examine the fundus blood vessels, optic disc and retina to determine whether there are lesions such as exudation and sclerosis, and to determine the damage to the fundus caused by low pressure and high blood pressure.
Laboratory tests
1. Blood routine test
A routine blood test can help you understand the composition and morphology of your blood, including red blood cells, white blood cells, platelets, etc. This helps you determine if you have an infection, anemia, or other conditions that may affect your blood pressure.
2. Urinalysis
A urinalysis can test urine for components such as protein, sugar, white blood cells, etc. This helps assess kidney function, as kidney problems can cause elevated low blood pressure.
3. Blood biochemistry
Including fasting blood sugar, blood lipids, blood creatinine, blood uric acid, electrolytes, etc., which help to determine whether there is diabetes, hyperlipidemia and kidney disease.
4. 24-hour urine protein quantification
It can test kidney function and protein loss, which helps to determine the cause and severity of the disease.
Imaging tests
1. Echocardiography
It helps to understand the structure and blood flow of the heart and determine whether there is heart disease.
2. Renal Ultrasound
It can examine the structure and function of the renal parenchyma, renal blood vessels, and adrenal glands, which helps to determine whether there is kidney disease.
3. Chest X-ray
It helps to observe images of the heart, great blood vessels, and lungs.
Other tests
1. Electrocardiogram
It can detect changes in the heart, particularly thickening or enlargement of the heart.
2. Dynamic blood pressure monitoring
Dynamic blood pressure monitoring is a method of measuring blood pressure automatically and regularly by an instrument, measuring blood pressure every 15 to 30 minutes for 24 hours or longer. This test can dynamically monitor blood pressure changes, assess the degree of blood pressure increase, short-term variation and circadian rhythm, and treatment effects.
diagnosis
Diagnostic principles
If the diastolic blood pressure is ≥90 mmHg when measured more than 3 times on different dates and times, combined with the patient’s typical symptoms and relevant examinations, it can be diagnosed as high BP. It should be noted that blood pressure measurement should be performed after the patient has been sitting or lying down for 5 minutes.
Differential Diagnosis
There are many causes of high low blood pressure. The following are some common differential diagnoses of diseases:
1. Glomerulonephritis
Glomerulonephritis is a glomerular disease, usually accompanied by symptoms such as proteinuria, hematuria, edema, etc. Diagnosis is usually confirmed by urinalysis, blood tests (such as renal function, immunoglobulins, etc.), renal imaging (such as ultrasound, CT scan), and renal biopsy.
2. Diabetic nephropathy
Diabetic nephropathy is kidney damage caused by long-term high blood sugar, usually accompanied by typical symptoms of diabetic patients, such as polydipsia, polyuria, fatigue, etc. Diagnosis depends on medical history, urinalysis (especially urine protein quantification), renal function test, fundus examination and renal imaging examination.
3. Renal artery stenosis
Renal artery stenosis can lead to impaired renal function and high blood pressure. Diagnosis usually requires imaging tests such as renal arteriography, ultrasound Doppler, and CT angiography.
4. Hypercortisolism
Hypercortisolism is an endocrine disease caused by excessive production of cortisol by the adrenal cortex, which may manifest as obesity, irritability, high blood pressure, etc. Diagnosis usually requires blood cortisol measurement, urine cortisol measurement, adrenal CT or MRI and other imaging examinations, as well as adrenal function tests.
5. Pheochromocytoma
Pheochromocytoma is an adrenal tumor that can lead to excessive secretion of adrenal hormones (such as epinephrine and norepinephrine), which manifests as symptoms such as paroxysmal hypertension, headache, sweating, etc. Diagnosis usually requires 24-hour urine catecholamine measurement, adrenal CT or MRI and other imaging examinations, and adrenal function tests.
6. Primary Aldosteronism
Primary aldosteronism is an endocrine disease caused by excessive secretion of adrenal aldosterone, manifested by symptoms such as hypertension and hypokalemia. Diagnosis usually requires blood aldosterone measurement, imaging examinations such as adrenal CT or MRI, and adrenal function tests.
7. Hyperthyroidism
Hyperthyroidism is an endocrine disease caused by excessive secretion of thyroid hormone by the thyroid gland, which may lead to symptoms such as high blood pressure and tachycardia. Diagnosis is usually confirmed through blood thyroid hormone measurement, thyroid radionuclide scanning and other tests.
8. Aortic stenosis
Aortic valve stenosis can lead to obstruction of the heart’s pumping, which may cause symptoms such as high blood pressure and angina. Diagnosis usually requires cardiac ultrasound, electrocardiogram, cardiac catheterization, etc.
9. Polycythemia vera
Polycythemia vera is a hematopoietic system disease that may increase blood viscosity and cause symptoms such as high blood pressure, headache, and dizziness. Diagnosis usually requires blood tests, bone marrow puncture, and other tests to confirm.
treat
Expected treatment
The treatment of high diastolic blood pressure should adopt a comprehensive intervention strategy, including comprehensive improvement of lifestyle and drug therapy, so that blood pressure can reach the target. It is also necessary to control reversible risk factors such as obesity, dyslipidemia, and increased blood sugar to minimize the risk of heart, brain, kidney, and vascular complications and death.
Treatment of the cause
For some special reasons that cause high low blood pressure, such as pheochromocytoma and primary aldosteronism, treatment should be targeted at the cause. For example, for pheochromocytoma, surgery may be required to remove the tumor; for primary aldosteronism, drugs such as aldosterone receptor antagonists may be needed for treatment.
General treatment
1. Diet adjustment
Reduce sodium salt intake, and the daily salt intake should be controlled within 6 grams. Limit the intake of high-fat foods, such as animal offal, fatty meat, etc. Increase the intake of potassium, calcium, magnesium and other elements, such as kelp, lettuce, eggplant, dried shrimp, milk, soybeans and their products.
2. Weight control
Maintain a normal weight range and avoid obesity.
3. Increase exercise
Do moderate aerobic exercise, such as brisk walking, jogging, swimming, etc., to enhance cardiopulmonary function and vascular elasticity.
4. Quit smoking and limit alcohol consumption
Smoking and excessive drinking can both increase blood pressure and should be avoided as much as possible.
5. Psychological adjustment
Keep your mood happy and avoid excessive tension and anxiety.
Drug treatment
1. Angiotensin-converting enzyme inhibitors (ACEI)
For example, captopril, enalapril, benazepril, etc. These drugs can dilate blood vessels, lower blood pressure, and protect the heart.
2. Angiotensin II receptor blocker (ARB)
For example, losartan, valsartan, irbesartan, etc. These drugs can also dilate blood vessels, lower blood pressure, and protect the heart.
3. Calcium channel blockers (CCBs)
For example, nifedipine, amlodipine, etc. These drugs can prevent calcium ions from entering cells, thereby relaxing vascular smooth muscle and lowering blood pressure.
4. Diuretics
For example, hydrochlorothiazide, indapamide, etc. These drugs can reduce blood volume by excreting sodium and diuresis, thereby lowering blood pressure.
5. Beta-blockers
For example, metoprolol, bisoprolol, etc. These drugs can slow down the heart rate and reduce myocardial contractility, thereby reducing cardiac output and lowering blood pressure.
Related drugs
Captopril, enalapril, benazepril, losartan, valsartan, irbesartan, nifedipine, amlodipine, hydrochlorothiazide, indapamide, metoprolol, bisoprolol
Surgery
When high systolic pressure is caused by organic disease, surgical treatment can be performed to improve the condition.
Treatment cycle
The treatment cycle is affected by factors such as the severity of the disease, treatment plan, timing of treatment, age and physical condition, and may vary from individual to individual.
Estimated cost of treatment
There may be significant individual differences in treatment costs, and the specific costs are related to the selected hospital, treatment plan, medical insurance policy, etc.
Prognosis
General Prognosis
The prognosis of high diastolic pressure depends on the patient’s specific condition, treatment method, and whether there are other diseases. Generally speaking, if it can be diagnosed in time and effective treatment measures are taken, the prognosis is usually good. However, if it is not treated in time or treated improperly, high diastolic pressure may lead to a series of serious complications, such as heart disease, stroke, kidney disease, etc., and may also increase the patient’s risk of cardiovascular events, such as myocardial infarction, heart failure, etc.
Hazards
1. Long-term high low blood pressure may lead to cardiac hypertrophy, heart failure, coronary heart disease, angina pectoris, myocardial infarction, etc.
2. High diastolic blood pressure may increase the risk of cerebral arteriosclerosis, and then cause cerebrovascular diseases such as cerebral infarction and cerebral hemorrhage.
3. Long-term low blood pressure may lead to abnormal kidney function, and in severe cases may cause renal failure, uremia, etc.
4. High hypotension may cause eye problems such as retinal hemorrhage, decreased vision, blurred vision, and even blindness.
5. High low blood pressure may also cause peripheral vascular damage, such as peripheral vascular atherosclerosis or weakened elasticity, as well as syncope or dizziness.
Self-healing
High low blood pressure caused by non-disease factors may gradually heal itself after improving your lifestyle.
Curative
Some patients with high low blood pressure may be cured after active treatment.
daily
Nursing principles
High diastolic blood pressure is closely related to the patient’s lifestyle. In daily life, patients should maintain a stable mental state, correct their unhealthy lifestyles, use medications correctly as prescribed by their doctors, and pay attention to monitoring changes in blood pressure.
Medication care
Patients should follow the doctor’s instructions and take the medicine on time. Do not increase or decrease the dosage or stop taking the medicine on your own. At the same time, pay attention to the adverse reactions of the medicine and seek medical attention in time if you feel unwell.
Life Management
1. Maintain a normal weight and do appropriate aerobic exercise, such as brisk walking, jogging, swimming, etc., to enhance cardiopulmonary function and vascular elasticity.
2. Keep a good mood and avoid excessive tension and anxiety. You can relieve stress through relaxation training such as meditation, yoga, deep breathing, etc.
3. Measure blood pressure regularly to understand changes in blood pressure. You can use an electronic blood pressure monitor to measure blood pressure at home, or you can go to the hospital for regular blood pressure testing.
Follow-up consultation instructions
Patients should strictly follow the doctor’s instructions for follow-up visits and bring their medical records with them.
diet
Diet
A scientific and reasonable diet can ensure the normal functioning of the body, and play a role in assisting in controlling the disease, maintaining the treatment effect, and promoting recovery from the disease.
Dietary advice
1. Increasing the intake of elements such as potassium, calcium, and magnesium, such as kelp, lettuce, milk, dried shrimps, eggplants, bananas and other foods, can help lower blood pressure.
2. Increasing the intake of foods rich in fiber, such as vegetables and fruits, can help improve intestinal function and promote bowel movements.
Dietary taboos
1. Control the intake of sodium salt, and consume less than 6 grams of salt per day. Avoid excessive salt intake to reduce the risk of water and sodium retention.
2. Control fat intake and avoid consuming too much high-fat food, such as animal offal, fatty meat, etc.
3. Smoking and excessive drinking can both lead to high blood pressure and should be avoided as much as possible. At the same time, limit the intake of caffeine, such as coffee, strong tea, etc.
prevention
Precautions
1. Eat a healthy diet
Limit the intake of sodium salt. The daily salt intake per person should not exceed 6g. Reduce fat intake and supplement with appropriate high-quality protein, such as fish, chicken, etc. Eat more vegetables and fruits, and take in enough trace elements such as potassium, magnesium, and calcium. Limit alcohol consumption, as alcohol may increase blood pressure.
2. Exercise moderately
Exercise can enhance cardiopulmonary function, improve blood circulation, and lower blood pressure. It is recommended to do aerobic exercise at least 3 to 5 times a week for more than 30 minutes each time, such as brisk walking, jogging, swimming, cycling, etc.
3. Control your weight
Maintaining a normal weight range and avoiding obesity can help prevent high low blood pressure.
4. Quit smoking
Smoking can cause high blood pressure and increase the risk of cardiovascular disease. Therefore, quitting smoking is one of the important measures to prevent high blood pressure.
5. Regulate your emotions
Learn to regulate your emotions. You can use meditation, yoga, deep breathing and other methods to relax and avoid excessive tension and anxiety.
6. Keep a regular schedule
Maintain a regular schedule and avoid staying up late and overwork. Sufficient sleep helps maintain stable blood pressure.
7. Regular physical examinations
Have regular physical examinations to understand your blood pressure. If your blood pressure is high, you should seek medical attention and take appropriate treatment measures.