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Adequate Blood Pressure: Maintaining a High-Enough Level Prevents Undesirable Health Complications

Low blood pressure isn't always beneficial, research indicates. In fact, there's a rise in cardiovascular risk when diastolic value drops excessively.

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4 min read
Lower blood pressure isn't always a good sign. Studies indicate that an exceptionally low diastolic...
Lower blood pressure isn't always a good sign. Studies indicate that an exceptionally low diastolic pressure may heighten the risk of cardiovascular complications.

Keep an Eye on Those Low Dippers, Hypertension Folks!

Adequate Blood Pressure: Maintaining a High-Enough Level Prevents Undesirable Health Complications

In the future, it's crucial for individuals dealing with hypertension to keep a close watch on their lower blood pressure limits, especially the diastolic blood pressure (DBP). If the DBP drops too low as a result of medication, the medication dosage should be adjusted.

Dangers of a Plunging DBP

Back in 2015, the results of the SPRINT (Systolic Blood Pressure Intervention Trial) were unveiled, pinpointing optimal blood pressure values. Since then, experts have been highlighting the potential harm associated with a significant reduction in the DBP. This reduction can lead to a higher risk of "cardiovascular death" (fatalities due to heart failure, heart attacks, coronary artery disease, etc.). In hypertension patients taking medication for high blood pressure, a DBP decrease is often observed, and the accompanying negative consequences were also evident in the ARIC cohort, which followed 15,700 people for 21 years. The participants with a low DBP from the beginning of the cohort experienced up to a 1.5 times higher risk of coronary heart disease with fatalities.

The development of heart disease is apparently most likely in the ARIC cohort when the upper blood pressure value is high and the lower value is low. The resulting imbalance could potentially damage the heart, but no significant increase in stroke risk was noted.

Is It All Just a Lower Number Game?

Professor Bernhard Kraemer, Director of the 5th Medical Clinic at Mannheim University Hospital and Chairman of the German Hypertension League e.V., commented on a post-hoc analysis of blood pressure reduction in high-risk patients. His insights in the German Medical Journal emphasize the issue with a DBP value lower than 70 mmHg, often occurring with an increased pulse pressure and higher vascular stiffness in hypertension patients. Corresponding investigations revealed more frequent hospitalizations due to heart failure when the DBP was less than 70 mmHg. The number of deaths also increased with a DBP below 70 mmHg compared to values between 70 and 80 mmHg. The lowest risk seems to be at a mean blood pressure value of 75 mmHg.

Lower Than 70 mmHg, Still A-OK?

Professor Zidek of Charité Berlin's Medical Clinic for Nephrology differs in his perspective on the problematic nature of a low DBP value. He posits that the issue revolves around the increased blood pressure amplitude. In his opinion, a low DBP value is not harmful if the systolic value is also below 120 mmHg. In simpler terms, if both values are low, there don't appear to be any negative consequences, but the disease risk increases with a greater discrepancy between a high upper and a too low lower blood pressure value.

How Does a Low DBP Affect the Brain?

Researchers from Beijing Anzhen Hospital investigated whether a low DBP could impair cognitive abilities in hypertensive patients. The German Hypertension League shares the findings, and they reveal that a low DBP does not impact brain blood flow in hypertensive patients, even with strict medication. In fact, blood flow was observed to improve when the DBP was below or equal to 70 mmHg. Consequently, intensive blood pressure control does not seem to harm cognitive abilities.

The Low-Down on Low DBP: What to Remember

To summarize a low DBP:

  • The risk of heart disease rises with a low DBP
  • A large difference between systole and diastole may be problematic
  • If both blood pressure values are low, no negative effects seem to be present
  • A DBP of 75 mmHg seems ideal
  • A low DBP has no negative impact on brain blood flow and cognitive abilities

Regular monitoring of blood pressure is crucial for those at risk for high or low blood pressure. It's worth noting that blood pressure is often higher in a doctor's office than when measured at home. A healthy diet and regular exercise can effectively combat blood pressure fluctuations.

  • The debate regarding the optimal diastolic blood pressure (DBP) continued, with experts warning of potential harm associated with a drastic reduction in DBP.
  • The SPRINT trial in 2015 highlighted the dangers of low DBP, showcasing a higher risk of "cardiovascular death" in hypertension patients.
  • The ARIC cohort study supported these findings, revealing a 1.5 times higher risk of coronary heart disease for participants with low DBP from the study's onset.
  • The development of heart disease appears to be more likely when the upper blood pressure value is high and the lower value is low, though stroke risk did not significantly increase.
  • Professor Bernhard Kraemer emphasized concerns over a DBP value below 70 mmHg, often accompanied by increased pulse pressure and higher vascular stiffness in hypertension patients.
  • Corresponding investigations indicated more hospitalizations due to heart failure when the DBP was less than 70 mmHg.
  • The number of deaths also increased with a DBP below 70 mmHg in comparison to values between 70 and 80 mmHg.
  • However, Professor Zidek posited that a low DBP value may not be harmful if the systolic value is also below 120 mmHg, suggesting the issue lies in the blood pressure amplitude.
  • Researchers from Beijing Anzhen Hospital found that a low DBP does not negatively impact brain blood flow in hypertensive patients, even with strict medication.
  • In terms of managing blood pressure, maintaining a DBP of 75 mmHg seems ideal, and a low DBP does not affect cognitive abilities.
  • Regular monitoring of blood pressure is essential for those at risk, and a healthy diet and regular exercise can help control blood pressure fluctuations.
  • Furthermore, individuals dealing with hypertension should be mindful of their workplace-wellness, incorporating stress-reduction techniques to maintain overall health, which may include fitness-and-exercise, eye-health, hearing, skin-care, and mental-health therapies-and-treatments.
  • Lastly, addressing other health-and-wellness concerns, such as chronic-diseases like respiratory-conditions, digestive-health issues, skin-conditions, autoimmune-disorders, and sexual-health matters, as well as cardiovascular-health, aging, women's-health, mens-health, parenting, weight-management, and nutrition, should also be prioritized.
  • Of course, Medicare and other health policies can serve as crucial resources in managing and monitoring these various health aspects, with potential treatments and alternatives like CBD offering potential solutions.

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