Normal diastolic blood pressure
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Understanding Normal Diastolic Blood Pressure: Insights from Recent Research
Definition and Importance of Diastolic Blood Pressure
Diastolic blood pressure (DBP) is the pressure in the arteries when the heart rests between beats. It is a critical component of overall blood pressure measurement, typically represented as the lower number in a blood pressure reading (e.g., 120/80 mm Hg). Normal DBP is generally considered to be less than 80 mm Hg, with values between 60 and 80 mm Hg being optimal for most adults .
Normal Ranges and Variability
A meta-analysis of 23 studies involving 3,476 normotensive subjects found that the mean 24-hour DBP ranged from 70 to 75 mm Hg, with daytime DBP averaging 75 to 80 mm Hg and nighttime DBP averaging 60 to 65 mm Hg. These findings provide a comprehensive reference for what can be considered normal DBP in various daily contexts.
Diastolic Blood Pressure and Cardiovascular Risk
Long-term Cardiovascular Outcomes
Research indicates that cumulative DBP burden can predict major adverse cardiovascular events even in individuals with normal systolic blood pressure (SBP). A study involving 15,979 participants found that each standard deviation increase in cumulative DBP was associated with a higher risk of cardiovascular events, suggesting that long-term DBP monitoring is crucial for risk stratification.
Age-Related Differences
The impact of DBP on mortality varies with age. For individuals over 50, DBP above 90 mm Hg did not independently predict mortality when adjusted for SBP. However, in those under 50, higher DBP was a significant predictor of mortality, highlighting the importance of age-specific blood pressure management .
Global Trends in Diastolic Blood Pressure
A comprehensive analysis of global blood pressure trends from 1975 to 2015 revealed that mean DBP has decreased in high-income countries but remains high in low-income regions such as sub-Saharan Africa and South Asia. In 2015, the global age-standardized mean DBP was 78.7 mm Hg for men and 76.7 mm Hg for women. This shift underscores the need for targeted public health interventions in regions with persistently high DBP.
Implications for Blood Pressure Management
Treatment and Monitoring
The importance of both SBP and DBP in classifying hypertension and guiding treatment has been emphasized by recent guidelines. Studies suggest that using both measures provides a more accurate classification and helps in making informed treatment decisions. Additionally, the development of diastolic hypotension (DBP < 55 mm Hg) during intensive SBP treatment has been associated with adverse outcomes, indicating the need for balanced blood pressure management.
Redefining Normal Blood Pressure
Redefining normal blood pressure to account for age-specific risks could prevent the unnecessary labeling of millions of individuals as hypertensive. For younger adults, maintaining a DBP below 80 mm Hg is crucial, while for older adults, the focus should be more on controlling SBP .
Conclusion
Normal diastolic blood pressure is a vital indicator of cardiovascular health, with optimal values generally ranging between 60 and 80 mm Hg. Long-term monitoring and age-specific management of DBP can significantly impact cardiovascular outcomes. Global trends highlight the need for continued efforts to manage blood pressure, particularly in low-income regions. Understanding and redefining normal blood pressure parameters can lead to better health outcomes and more effective use of healthcare resources.
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