A diastolic blood pressure (DBP) of somewhere between 60 and 90 mm Hg is good in older people. Causes of low DBP include bed rest, dehydration, loss of water, alcohol use, hormone deficiencies, allergic reactions, nutritional deficiencies and prolonged standing leading to blood pooling in the legs.
A decrease in your diastolic blood pressure (DBP) probably represents age-related stiffening of the arteries. Blood vessels get stiff and narrow with age. They do not recoil as they should when the blood column tries to pass through. Therefore, blood pressure shows a low reading on the diastolic scale. This means the heart has to pump blood against increased resistance. The difference between your systolic blood pressure and DBP therefore increases.
Other causes of low DBP are as follows.
- Prolonged bed rest because it causes reduction in tone of the arteries.
- Dehydration due to excess sweating may reduce both systolic and DBP.
- Reduced water intake in old age.
- Loss of water in stools due to medications such as diuretics, prostate medications, antihypertensive medications, medications for Parkinson’s disease and narcotics tricyclic antidepressants.
- Alcohol can cause dilation of the blood vessels that may lead to lower DBP, lower heart rate, malfunctioning of the heart valves and heart attack. These are serious disorders that require care and treatment.
- Hormonal deficiencies and other endocrine dysfunctions such as hypothyroid or excess blood loss in menstruation.
- Allergic reactions due to drugs, food or insect bites.
- Nutritional deficiency of B vitamins and iron leading to anemia.
- Prolonged standing that may lead to pooling of blood in the legs.
What are the possible signs and symptoms of low diastolic blood pressure (DBP)?
A diastolic blood pressure (DBP) of somewhere between 60 and 90 mm Hg is good in older people. Once your blood pressure reading plummets to below 60 mm Hg, you may faint.
Many older people with low DBP get tired or dizzy and have frequent falls. Obviously, none of that is good news for people who are older and who may have brittle bones and poor healing. Common signs and symptoms of low DBP may include
- Feeling giddy
- Feeling weak
- Breathlessness
- Lightheadedness
- Fainting
- Dizziness that may increase with walking or position change
- Confusion
- Dullness
- Sweating
- Nausea
Studies have reported that very low DBP is associated with an increased risk of heart disease. Importantly, a study found that low DBP was associated with an increased likelihood of coronary heart disease events and mortality. Studies have explained that if individuals have DBP that is too low, there might not be enough blood flow to the heart muscle itself. This could lead to heart attacks or weakening of the heart muscle.
Which is more important, systolic or diastolic blood pressure?
In practice, systolic blood pressure should be regarded as more important than diastolic blood pressure (DBP). In general, there is a high correlation between systolic blood pressure and heart health. However, both systolic blood pressure and DBP are important risk factors for heart disease.
- Systolic blood pressure is the force generated on the inside of the blood vessels called the arteries when your heart contracts.
- DBP is pressure placed on your arteries between beats when your heart is relaxed.
According to a recent study, having DBP or systolic blood pressure that’s too high is a health risk but for different reasons.
- A high systolic reading increases the risk of heart attacks and heart disease more. Systolic blood pressure is most strongly linked with heart disease and heart failure but also with kidney disease and overall mortality.
- A high diastolic reading was linked with a higher risk of disease of the large artery called the aorta that carries blood from the heart to the abdomen and chest. People with an elevated diastolic reading were more prone to develop an abdominal aortic aneurysm (an enlargement of the aorta). The problem with such an enlargement is that it can lead to sudden rupture and a high risk of death.
Research favored high systolic readings as the most predictive of a harmful cardiovascular outcome. As a result, these readings were given more weight in cardiology guidelines and in estimating risk.
Should I be treated for low diastolic blood pressure (DBP)?
Most people with low diastolic blood pressure (DBP) do not display any signs and symptoms and, hence, do not require any treatments. However, for symptomatic people
- Careful examination that includes anemia screening and cardiovascular assessment is required. If they have low blood pressure due to certain medications, a change in the type of medication or dosage is necessary. They need to control alcohol and other addictions.
- Regular exercise is compulsory.
- Some leg exercises are necessary if they get up from prolonged rest.
- The intake of salt and water should be increased but not above 1,500 mg salt a day.
- If the problem still persists, a detailed cardiovascular check with neuroendocrine assessment is required.
- There are certain medications such as fludrocortisone that may be prescribed in certain cases.