Diastolic Blood Pressure

[Atlas]

Ok,

So what factors go into a diastolic blood pressure measurement?

For example, you have a patient that is hypertensive, but the diastolic is normal. Let's say 136/74. How can this be????

 

[Atlas]

anyone care to take a crack at it?

 

[stomper627]

More of a clinical picture would be appreciated....
For your example it very well could be a response to exercise. You will get a slight increase in arterial pressure (systolic) but a decrease in TPR (vasodiltation of skeletal muscle).

 

[Non-Trad DO]

Is the patient on an antihypertensive? Did they take it today?

 

[Goofyone]

Originally posted by Atlas
anyone care to take a crack at it?

Cool thought excercise. Here's a guess.

The diastolic pressure is a constant pressure, determined by the tone of your vessels.

Systolic simply represents the pressure during contractions.

If your diastolic is normal then your vascular tone is ok. This tells me it's not a problem with sympathetic discharge. That also tells me that the heart is not beating too hard because of sympathetic discharge. The only thing left is the vessels.

If you hady non-compliant vessels, for whatever reason, that would explain it. Instead of the arteries stretching when the heart beats, the remain firm causing high systolic pressure. There are many diseases that could cause chronic vessel inflammation, with damage and scarring of arteries.

Very simplified but then I am a simple man.

 

[Atlas]

I will agree with you in that sympathetic tone of the vessel is key. That is essentially what you are measuring when you take someone's BP.

 

[stomper627]

Atlas....
you still have to give more info...
your only listing 1 BP....what does this patient normally run? How old? Smoking hx? etc....
Give us more of the history....this COULD be hypotensive for this particular patient, but is still clinically Hypertensive.
stomper

 

[Kalel]

Isolated systolic hypertension is actually a very common condition in the elderly population. Like essential hypertension, it's exact etiology is not well understood, but it's thought to arise mainly due to arterial atherosclerosis and loss of arterial compliance. When the heart contracts into a stenotic vessel (high systemic vascular resistance), the systolic pressure will rise to high levels. When the heart is not contracting, loss of large vessel elasisticity/compliance (eg aorta is no longer pushing blood out in the periphery since it has a low compliance and doesn't have that extra reserve anymore) is thought to let the diastolic BP fall to the lower then expected levels. Here's a website that explains it better then I can:
http://www.cvphysiology.com/Blood Pressure/BP003.htm

 

[Idiopathic]

calcification of the proximal aorta