introduction

In rare cases, only the diastolic value of the blood pressure can be too high. From this so-called "Isolated diastolic hypertension" almost exclusively young people and middle-aged patients are affected. Those affected often measure blood pressure values ​​of 135/100. In the course of the disease, however, the systolic value usually rises so that therapy is unavoidable.

Therapy for increased diastole

Nowadays, the indication, i.e. the need for therapy, arises not only from the level of blood pressure, but rather from the total risk of cardiovascular diseases (heart attack, stroke, heart failure, etc.). This risk is e.g. in the presence of very high blood pressure values ​​(> 180/110 mmHg) and / or existing clinical pictures of the cardiovascular system, particularly high. In these cases, drug therapy is absolutely necessary. If only the diastolic pressure is increased, general measures may under certain circumstances bring about a sufficient decrease in diastole:

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Weight reduction

Overweight patients should aim to reduce their weight. The “body mass index” (BMI) can serve as a rough guide. It is calculated using the formula BMI = body weight (kg) / (body size [m]) 2 and should be around 25 kg / m2.

Diet change

If you suffer from high blood pressure and want to lower your diastole, you should refrain from eating salty foods and do not add salt to foods. Instead, it is advisable to use special dietary salt. A lot of fruit, vegetables, salad, nuts and as little animal fats as possible also have a beneficial effect on diastole.

Salt reduction

Generally speaking, humans need salt in order to be able to perform certain body functions properly. Most people, especially in Germany, however, tend to have an increased salt intake that far exceeds their daily requirement. Many medical professionals believe that salt contributes to high blood pressure.
Studies have shown that high blood pressure patients can react with an increase in blood pressure. But there were also a number of patients who showed no increase.
However, the general recommendation of doctors is a salt-reduced diet for high blood pressure patients, as further studies have shown that it can contribute to a mild form of lowering blood pressure, in particular the diastolic value.

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Lifestyle change

Smoking and excessive alcohol consumption promote the development of high blood pressure. You should therefore stop smoking and consume as little alcohol as possible. Coffee consumption can also have negative effects on diastolic blood pressure. Relaxation training and stress avoidance are also helpful.

Sports

Regular endurance training (5-7 / week for at least 30 minutes), such as swimming, walking or running, significantly reduces the risk of heart attacks and can have a decisive effect on lowering diastole.

Basically, even by fully exhausting the measures mentioned, about 25% of the cases, slightly increased blood pressure values ​​(especially diastole) can be reduced.

Drug therapy for increased diastole

In many cases, however, high blood pressure must be treated with medication. In principle, you can choose between a so-called "Monotherapy" and one "Combination therapy" can be distinguished. While only one drug is used in the former, two or more drugs are used in parallel with combination therapy. If only the diastole is worth treating and needs to be reduced, monotherapy is usually sufficient.

In total, you can choose from five different drug classes:

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  • Thiazides: They are among the diuretic, i.e. dehydrating drugs, and work in the kidneys. Thus, thiazides have an indirect antihypertensive effect. Well-known active ingredients are hydrochlorothiazide (HCT) or xipamide. Since the electrolytes (“salts”) in our body, especially potassium, can become unbalanced during therapy, regular blood tests must be carried out during therapy. The disadvantage of this group of substances is that they increase the blood sugar level, which is unfavorable in the case of diabetes mellitus. In emergencies or when no thiazides can be taken, loop diuretics (e.g. furosemide) are used. Since loop diuretics quickly lose a lot of water and thus electrolytes, sodium and potassium levels must be checked. Loop diuretics are helpful in acute heart failure because of their rapid and powerful effects.
  • ACE inhibitors and angiotensin receptor blockers: Active ingredients such as enalapril or ramipril or valsartan or candesartan lower blood pressure by interfering with the important renin-angiotensin-aldosterone system (RAAS), which through complex control loops, etc. regulates blood pressure. The crucial organs for this are the heart, lungs and kidneys.
  • Calcium antagonists: They block calcium channels in the walls of arterial blood vessels, causing them to widen or expand. In this way, active ingredients such as amlodipine lower blood pressure.
  • Beta blockers: For a long time, beta blockers (metoprolol, bisoprolol, etc.) were considered the drug of choice for high blood pressure. However, recent studies show that other drugs, such as ACE inhibitors have an advantage and better protect patients from secondary diseases. However, beta blockers are still indispensable in certain cases of high blood pressure.

Home remedies for lowering diastolic blood pressure

The most important principle in lowering the diastolic blood pressure value is stress reduction. A possible setting to find inner peace is, for example, a spa stay.
There are also herbal remedies that can help lower blood pressure, including moringa and hawthorn.
The use of base powder is medically questionable, but advocated by alternative practitioners. They are of the opinion that patients suffering from hypertension are very acidic.

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These diastolic values ​​are considered dangerous

Diastolic values ​​greater than 100 mmHg are considered a severe form of diastolic hypertension, i.e. high blood pressure. Isolated diastolic hypertension can lead to what is known as malignant hypertension.
In addition to diastolic values ​​of over 120-130 mmHg, malignant hypertension is characterized by other severe symptoms. These include nausea and vomiting, kidney failure, and damage to the eye and brain.
It is a medical emergency that should be treated immediately by a doctor. Malignant hyperthermia is not only a feared form of isolated diastolic hypertension, but can also arise on the basis of all other forms of hypertension.

forecast

Untreated high blood pressure damages the cardiovascular system in the long term. An increase in blood pressure of 10 mmHg above the normal value (150/100 mmHg) reduces life expectancy by around 10 years. This is because hypertension promotes calcification of the arteries, which significantly increases the risk of heart attack, stroke and PAD (peripheral arterial disease). Since the heart has to constantly pump against excessive pressure, it initially enlarges, but is permanently damaged and the risk of heart failure increases dramatically. A derailment of the blood pressure (> 200/120 mmHg) even represents a medical emergency, because there is a great risk that the cerebral arteries cannot withstand the pressure and rupture.

root cause

In over 90% of cases, no specific, individual cause for high blood pressure can be found. With this so-called "Primary hypertension", play different factors such as Obesity, increasing age, stress, diabetes or alcohol consumption play a role. Rarely, high blood pressure can also be the result of another underlying disease, such as Hyperthyroidism.On the one hand, it plays a role that the vessels, especially the arteries of the elastic type, become stiffer with age and can store less blood volume. This makes the blood flow faster. On the other hand, it is assumed that the body's own mechanisms for increasing blood pressure stimulate each other more and more and the kidney, which regulates the blood pressure, accepts higher values ​​than the original setpoint. The heart has to exert greater pressure to pump blood through the body against the increasing resistance. On the other hand, the volume of blood that our heart has to transport with each beat increases due to various causes. Both of these factors are mutually beneficial.

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Please also read our article on this Consequences of being overweight

Secondary hypertension is a less common but better understood form of high blood pressure. Secondary means that the causal problem lies in another organ and secondary causes high blood pressure. This can be, for example, renal artery stenosis or an endocrine disorder (affecting the hormonal balance) such as an overactive thyroid or hormone-producing tumors that increase blood pressure. An example of this is pheochromocytoma, a tumor of the adrenal medulla that produces large amounts of adrenaline.

Physiological basis of high blood pressure

The basic pressure that prevails in the vessels during the filling phase of the heart is called diastolic blood pressure. It is around 80 mmHg and depends on the blood volume, on (especially the venous) vessel diameter and on the cardiac output. This is the amount of blood that the heart pumps every minute. The higher the blood volume in the veins near the heart, the more the heart fills and the more it pumps back into the periphery. When a larger amount of blood is pumped, the cardiac output also increases. Both of these lead to an increase in blood pressure, above all an increase in diastolic pressure. Therefore, blood volume and the “pre-filling” of the heart are the main targets of drugs that lower diastole. Because the blood volume plays a major role in this form of high blood pressure, it is called volume hypertension. The pre-filling or venous blood filling of the heart is also known as preload. In contrast, there is the afterload of the heart. It describes the pressure in the arteries that are downstream of the heart and against which the heart has to pump. An increase in afterload mainly leads to an increase in systolic pressure.

In the context of our heart action, one differentiates between two phases: the already mentioned systole and diastole. During systole, also known as the tension phase, the powerful heart muscle pumps blood into the body and lungs. In the diastole, also called the filling phase, the hollow organ slackens and fills with blood. Both phases of the heart create measurable pressure in the arteries of our body, also known as systolic or diastolic pressure. Ideally, the systolic blood pressure of an adult is between 100 and 140 mmHg (“first value”) and the diastolic blood pressure between 60 and 90 mmHg (“second value”).
For blood pressure values ​​of> 140 mmHg systolic and / or values> 90 mmHg diastolic, the doctor speaks of arterial hypertension- also known as high blood pressure. In Europe alone, around 30-45% of the population suffer from high blood pressure! Short-term and long-term consequences can be stroke, heart attack, kidney disease, blindness and many other serious diseases. Therefore, suitable therapy measures for lowering blood pressure are essential.

Read more on the topic: diastole

Typical symptoms of high diastolic blood pressure

Symptoms may be absent for a long time, especially with diastolic high blood pressure alone. Typical symptoms can include be:

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  • Early morning headache, especially around the back of the head
  • dizziness
  • tinnitus
  • sleep disorders
  • Epistaxis
  • nervousness

Unfortunately, the disease often only occurs through complications or emergencies, such as a stroke in sight.

diagnosis

The diagnosis is quite easy to determine with the help of a blood pressure monitor. In order to check whether the blood pressure is permanently high, regardless of the situation, measurements are not only taken at the doctor's or at home, but a 24-hour measuring device is used. You get this from the attending physician and carry it around with you for a day. Diastolic values ​​above 90 mmHg require treatment. High blood pressure is divided into three degrees of severity. Grade 1 has diastolic values ​​between 90-100 mmHg, grade 2 between 100-110 mmHg and grade 3 more than 110 mmHg.

prophylaxis

As in many things, a healthy and balanced lifestyle can prevent diastolic high blood pressure. Low-fat and healthy food, abstinence from nicotine, moderate alcohol consumption, regular exercise and stress reduction are the cornerstones of this.


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