Scientists from NUI Galway and elsewhere have found no evidence that diastolic blood pressure—the bottom reading on a blood pressure test—can be harmful to patients when reduced to levels that were previously considered to be too low.
The finding may change how doctors treat some patients with high blood pressure—a condition that affects more than one in four men and one in five women.
High blood pressure is a major cause of premature death worldwide, with more than 1 billion people having the condition. It is linked with brain, kidney, and other diseases, but it is best known as a risk factor for heart attack.
More recently, high blood pressure has emerged as one of the major underlying conditions that increase the risk of poor outcomes for people who become infected with Covid-19.
In the study, the team analyzed genetic and survival data from more than 47,000 patients worldwide. They assessed data from 47,407 patients in five groups with a median age of 60.
They found there appears to be no lower limit of normal for diastolic blood pressure and no evidence in this genetic analysis that diastolic blood pressure can be too low.
There was no genetic evidence of increased risk of heart disease when a patient’s diastolic blood pressure reading is as low as 50.
The team also confirmed that values of the top, systolic, blood pressure reading above 120 increased the risk of heart disease and stroke.
The team says because doctors often focus on keeping the bottom blood pressure readings in the 70-90 range, they may have been under-treating some adults with persistently high systolic blood pressure.
The findings of this study free up doctors to treat the systolic value when it is elevated and to not worry about the diastolic blood pressure falling too low.
The researchers’ advice is to treat patients with high blood pressure to a systolic level of between 100-130mmHg, where possible and without side effects, and to not worry about the diastolic blood pressure value.
The study was conducted by Bill McEvoy et al and published in Circulation.
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