How much does diastolic blood pressure fluctuate

May is High Blood Pressure Education Month

People on blood pressure medication often record readings with a home monitor and in most cases the results show frequent fluctuations but few surprises.

When blood pressure is higher than usual, it is usually because salty foods have been eaten. When it goes too low, it could be because of not drinking enough water to make up for fluids lost because of diuretic medication.

“If there are some wider than normal fluctuations with no ready explanation, which can be a cause for concern and your primary care clinician or specialist can order some heart tests to provide valuable insight into the situation,” says Maria (Noel) Mercado, APNP, a nurse practitioner with Aspirus Stevens Point Clinic-Hoover Road.

Blood pressure represents the force that blood exerts against the walls of blood vessels as it is pumped by the heart muscle. Your blood pressure should be 120/80 mm/Hg or lower; hypertension is defined as any reading of 140/90 or higher.

“It’s normal, of course, for a person’s blood pressure to rise and fall from minute to minute with changes in posture, exercise, stress, or sleep,” says Mercado. “As a result, health care professionals consider an average reading more important than that at any one time.”

There are many reasons for a short-term increase, these include…

• SALT: People who are salt sensitive will retain fluid after eating a very salty meal, resulting in a short-term weight gain and a rise in blood pressure. Persons with hypertension are advised to restrict their sodium intake, and many are prescribed diuretic medications to help establish fluid balance.
• STRESS: If you are stressed, emotionally or physically, your breathing gets quicker and deeper, your heart beats faster and your arteries constrict, making the heart work harder to pump blood throughout the body. The result is higher blood pressure. Everyone experiences occasional stress, but if you feel you are constantly battling stress, you might benefit from relaxation or stress reduction therapy.
• CAFFEINE: Caffeine is a stimulant, designed to get your system revved up. One cup will not affect your blood pressure; three or four cups might. If you have a home blood pressure monitor, take a reading before and after drinking coffee or tea, and see what happens. If you see a significant increase, then maybe you should cut back on your caffeine.
• MEDICATIONS: Some medications and supplements can increase your blood pressure or interfere with your blood pressure medications. NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and naproxen can cause you to retain fluids and, as a result, contribute to high blood pressure. Decongestants and acetaminophen can also have a negative effect.
• CALCIUM/CHOLESTEROL DEPOSITS are the most common reason for hypertension. When arteries are narrowed or clogged, the heart must pump harder to get good circulation. High blood pressure and high cholesterol often go together.

“All of these can cause blood pressure to go up; dehydration can cause it to go down,” says Mercado. “What’s important is how high the blood pressure goes and how long it stays there and if the wide fluctuations continue, talk to your primary care clinician right away.”

In the United States, one out of every three deaths are caused by cardiovascular disease. Most who die suddenly from cardiovascular-related disease have no previous symptoms. Because of this, it is important to be aware of your heart health risks.

Learn your heart’s biological age and discover tips on risk factor reduction at https://www.aspirus.org/health-assessments.

My blood pressure readings vary throughout the day. Sometimes they’re high and sometimes they’re low. So I’m not sure if I have high blood pressure or not.

Moshi

Santa Monica

Blood pressure varies throughout the day and is influenced by a number of factors, says Dr. Joshua Penn, a cardiologist with Cedars-Sinai Medical Group and in private practice in Beverly Hills.

For starters, all humans have a natural daily rise and fall in blood pressure that corresponds with their circadian rhythm.

For most people, blood pressure will be at its lowest in the early morning hours and then rise through the late morning and peak in midafternoon.

Typically, this range will be about 10 to 15 millimeters of mercury on the upper, or systolic, value, which represents the peak pressure in the arteries; and five to 10 millimeters of mercury on the lower, or diastolic, value, which represents the lowest pressure at the resting phase of the cardiac cycle.

Thus, a person with a resting blood pressure of 125/70 at 3 a.m., might have a reading of 140/80 by late afternoon.

Other factors contribute to fluctuations in blood pressure, but the most common one is hypertension, a condition characterized by chronic high blood pressure.

“When a person has a history of hypertension, or if the blood pressure has not been well-controlled over a period of years, then the vessels themselves become more reactive, meaning they tighten up with less provocation than they would in an average person,” Penn says.

One of the manifestations of poorly controlled blood pressure is a high degree of variability, he says. A person with a lot of variation could easily have a blood pressure of 140/90 in the morning and a reading of 200/100 later in the day.

Other factors, such as stress, emotional upsets and food sensitivities can cause an increase in blood pressure. Someone who is salt sensitive, for example, could get a double-digit boost from a big dose of salt. Certain street drugs, such as cocaine and methamphetamine, can cause a spike.

Finally, there’s a phenomenon known as “white coat hypertension,” in which the stress of a visit to the doctor’s office causes an elevation in blood pressure.

On the other side of the coin, alcohol, cessation of exercise and a warm environment can lower blood pressure.

Penn has found home blood pressure devices (particularly the ones that measure blood pressure at the biceps, rather than the wrist or finger) to be reasonably accurate — “usually within 10 points on the upper and five on the lower. They can actually be quite helpful,” he says.

Many physicians think that optimal blood pressure is below 120/80 and that blood pressure from 120/80 to 139/89 signifies that the patient may be at risk for hypertension. Blood pressure above 139/89 in several readings would be considered mild hypertension.

“We know from data that lower natural blood pressure is associated with longevity,” Penn says.

Hypertension, which is partly genetic and tends to increase with age, can usually be controlled with proper medical attention, diet and exercise.

— Janet Cromley

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