Doctors: Beware of Low Diastolic Blood Pressure When Treating Hypertension - 09/01/2016

Doctors: Beware of Low Diastolic Blood Pressure When Treating Hypertension - 09/01/2016: A troponin value greater than or equal to 14 nanograms per liter of blood indicates heart damage. After controlling for age, race, sex, diabetes, drinking, smoking and other factors, the researchers found that some 1,087 people with diastolic blood pressure below 60 millimeters of mercury were statistically twice as likely to have troponin-indicated heart damage, compared to participants with higher diastolic blood pressures ranging from 80 to 89 millimeters of mercury.

Some 3,728 people with a diastolic blood pressure between 60 and 69 millimeters of mercury were 52 percent more likely to have heart damage as measured by the high-sensitivity troponin test, with some 120 people in this range showing elevated troponin levels. People with a diastolic blood pressure range from 70 to 99 millimeters of mercury showed no greater risk of troponin-associated heart damage.

The Johns Hopkins team also looked for evidence of a link among low diastolic blood pressure and coronary heart disease — characterized by a buildup of fatty plaque that blocks blood flow — stroke and overall mortality risk.

Of those with the lowest diastolic blood pressure (under 60 millimeters of mercury), 165 had coronary heart disease events, like heart attacks; 56 had strokes; and 345 people died. On average, those with the lowest diastolic blood pressure below 60 millimeters of mercury were 49 percent more likely to have heart disease and 32 percent more likely to die of any cause.

As expected by the researchers, there was no apparent link between stroke risk and low diastolic blood pressure because evidence is strong that elevated blood pressure overall is a major risk factor for stroke, and the bottom value alone doesn’t particular contribute to risk of this outcome.