Aa
Aa
A
A
A
Close
907968 tn?1292622204

Difference between systolic and diastolic

I have an inner ear problem where I hear and feel my heart beating in that ear. actually I hear a pulsing vain in my brain right next to my inner ear. Anyhow I've noticed the last couple days It takes quite a bit to hear my heart the way i used to hear it and worse, when I relax I no longer hear or feel my heart beat at all.  BP is low during these time, 106/70 and it's been over 6 hours since I took my 6mg carvedilol and over 18 hours since I took my 2.5mg lisinopril.  And I'm getting ready to take it for the night.

  Question, what should the BP differences be between the systolic and diastolic?  Shouldn't there be something like 60?  Here I have 36 and I wont doubt it's been much lower as don't even feel my heart beating in my chest late night through early morning.  It's like there is only a tinny difference between the two.  Next question, at what point should I be very worried?

Michael
9 Responses
Sort by: Helpful Oldest Newest
976897 tn?1379167602
"Cardiologist doesn't want anything over 110, So I think this kind of exorcising will be good for me. "

Good for you or not good for you? if the cardiologist want 110 or less.
Isn't it odd with a bike, I tried one last year. I assumed that because you are sitting down and just gently pushing some peddles around, it would be easier than walking. Wow, I found it far easier to get off the bike and sprint. Talk about shortness of breath, and I only managed to start moving. Downhill was fun, uphill (any incline) impossible, and on a flat, well, lets just say I was breathing faster than a cheetah does when running at 70mph.
Helpful - 0
367994 tn?1304953593
Q:"OK, this is all fine and good and understood.  What about the other side of the question, a small, or would it be considered "short"(?) pulse pressure such as below 40, say mid 30's (my stated 36) or even in the 20's?

  Got that bike. rode it till my legs hurt bad, maybe 200 foot.  rested and rode it more, made it around the block but had to walk it up the hills.  Eventually made it to a long uphill and I felt my heart beating faster than it has in nearly a year, my guess would be low 120's.  Cardiologist doesn't want anything over 110, So I think this kind of exorcising will be good for me".
________________________________________________
Ed has defined a compliant aterial tree!.

A: The question raised is similar to a thread that asked "does the blood pressure change when there is a heart attack?"  My response was there is a decrease in blood pressure and an increase in heart rate...my experience at ER after/during heart attack.  Another response to the thread was blood pressure was normal but HR was 118 bpm taken at a UK hospital.  Another response was no change, etc.

For some insight. Pulse pressure engages two factors: stroke volume and vessel compliance (resillent or lack thereof). A healthy cardiovascular system will raise the pulse pressure (PP) with exercise (more forceful contractions and increase in blood volume per stroke) destinquished by the increased systole metric and diastole stays about the same.  There is a return to normal PP (about 40) in several minutes.  

The following supports a change in blood pressure with a heart attack (stroke volume is decreased).  " In trauma a low or narrow pulse pressure suggests significant blood loss. In an otherwise healthy person a difference of less than 40 mmHg is usually an error of measurement. If the pulse pressure is genuinely low, e.g. 25 mmHg or less, the cause may be low stroke volume, as in Congestive Heart Failure (I had CHF) and/or shock, a serious issue. This interpretation is reinforced if the resting heart rate is relatively rapid, e.g. 100-120 (in sinus tachycardia), reflecting increased sympathetic nervous system activity as the body's response to low stroke volume and low cardiac output. A narrow pulse pressure can also be caused by aortic stenosis"
Examples for genuinely low pulse pressure <25mmhg:
Atherosclerosis
Chronic aortic regurgitation
Thyrotoxicosis
Fever
Anaemia
Pregnancy
Anxiety
Heart block".


Helpful - 0
976897 tn?1379167602
Maybe I'm not thinking right, I'm simply applying logic here, so I could end up before the headmaster. If your arteries are in very good condition, i.e. nice and elastic with great muscular action and no restrictions within them, I would assume the pulse pressure to be lower than normal. If you have very stiff vessels then I would assume the pulse pressure to be higher.
Imagine you have a balloon made of very thin/soft rubber and a balloon made of very thick/hard rubber, it's obvious that the thin/soft one would aborb my breath with less resistance. So I assume a healthy artery would swell more easily with each beat, absorbing blood pressure more greatly, keeping the pulse pressure lower.
Assuming that is, a flow rate with less resistance means less pressure.
Helpful - 0
907968 tn?1292622204
OK, this is all fine and good and understood.  What about the other side of the question, a small, or would it be considered "short"(?) pulse pressure such as below 40, say mid 30's (my stated 36) or even in the 20's?

  Got that bike. rode it till my legs hurt bad, maybe 200 foot.  rested and rode it more, made it around the block but had to walk it up the hills.  Eventually made it to a long uphill and I felt my heart beating faster than it has in nearly a year, my guess would be low 120's.  Cardiologist doesn't want anything over 110, So I think this kind of exorcising will be good for me.
Helpful - 0
367994 tn?1304953593
Some further insight: Vessel physiology as it relates to pulse pressure can be attributed to stiffness (artherosclerosis) of main arteries as has been stated and can be determined by the interaction of stroke volume (each heartbeat) and compliance (ability to expand) of the aorta.  For example, the ability of the aorta to expand (less stifffness) under pressure, the aorta absorbs some of the force of the blood flow surge from the heart during a heart beat, and as a consequence pulse pressure is reduced from what it might have been if the vessel was non-compliant.
Helpful - 0
976897 tn?1379167602
Yes the pulse pressure is basically the sudden stress imposed on the arteries each time the heart beats. However, if blood pressure is high and you still have normal pulse pressure, this is not good either because the stress on the arteries is basically there all the time. For example, if your bp was 200/160 the pulse pressure is ok, but the diastolic and systolic are way too high, inflicting too much pressure on the arteries all the time.
Helpful - 0
159619 tn?1707018272
COMMUNITY LEADER
The number you are mention is called pulse pressure. The difference should be under 60 mm Hg. I have read that number on many sites including this one. If the usual resting pulse pressure is consistently greater than 40 mm Hg, e.g. 60 or 80 mm Hg, the most likely basis is stiffness of the major arteries, aortic regurgitation, arteriovenous malformation hyperthyroidism or some combination. Again, this would be indicated if you normal pulse pressure is above 40 mm Hg.

Hope this helps,

Jon
Helpful - 0
907968 tn?1292622204
Having the beating heart in the ear since 2006, even during the initial phase of the heart attack is a b**ch.  However, living with it for so long it is scary to go without it, pretty much as you say.  However, I hear that vain pulsing because I have a hole between the two, inner ear and brain, so If anything changes with the heart I hear and feel it, it's nearly a direct link.  So, there is a problem I just don't know how much of a problem and since I just lost my insurance I need to take the chance and get some info before deciding to go to the Dr.

I have been very sedentary all winter long, no job and no energy.  In fact it was just this past week where it was warm enough to walk around the block, so you can say the heart has not been worked for quite some time which gets me nervous.  The good side is that I get a bike to ride tomorrow and I already have plans for it.  I just hope nothing happens between now and then.

114/75 /53 30 minutes after lisinopril.  Still 39.  I should have thought about that one, differences between the normal pressures.
Helpful - 0
1045086 tn?1332126422
The customary absolute normal BP is 120/80.  That's only a spread of 40.  I think the name for this difference between systolic and diastolic pressures is the PULSE PRESSURE.  I don't think it usually has a lot of significance except when it widens as a sign of increased pressure in the brain after head injury.

It seems to me that your medications are working and your heart isn't carrying such a heavy load these days.  It's interesting to note that people with elevated blood pressure often don't even realize it.  There are often no noticable signs to warn us.  Therefore, I suspect your awareness of your heartbeat has more to do with your ear condition.

Once we get used to things being one way, it can be difficult to make an adjustment, even if it's in the direction of normal.  I don't think most people expect their heartbeat to lull them to sleep at night.  They would be alarmed to hear it and it would probably keep many awake.  Maybe you should get one of those Mama's Heartbeat Bears they make for newborns (they mimic uterine heartsounds) to help you at bedtime?  (Only half kidding)

I don't think you need to worry at all but you could ask your doctor if you should decrease your dose or skip a dose if your BP goes below a certain number (usually 100 systolic).
Helpful - 0
Have an Answer?

You are reading content posted in the Heart Disease Community

Top Heart Disease Answerers
159619 tn?1707018272
Salt Lake City, UT
11548417 tn?1506080564
Netherlands
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.