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Re: High Blood Pressure Question

Posted By Dee on October 09, 1998 at 21:56:47:

In Reply to: Re: High Blood Pressure Question posted by CCF CARDIO MD - DLB on October 09, 1998 at 18:35:34:

Hi Doctor,
       I am a 59 yr old female-and have been on 20 mg of Zestrol for several years. Sometimes, my bp is good and other times it fluctuates. Latetly, it has been doing something different-specifically, the Systolic number has been
running fairly normal for me-138 to 150. It is the Diastolic one that has me puzzled, as it has been running higher-96 to 121. Example, it was 142/121.
My question is, why would the diastolic be high and the systolic be fairly normal. I understand the diastolic is the heartbeat at rest, could you elaborate on this for me a little? I don't know of a specific reason for my BP problems, as have general good health. I am 5' 5 1/2" tall, average abt 150 lbs., do have the one determent of smoking a pack of cigarettes a day.
Normally if my BP is up-both numbers are up. Someone told me also, that the closer the two numbers are together, the more risk of stroke, my Dr. says he has never heard of that. Both of my parents died of anyuerisms-Mother's in head, age 65 and Father's in stomach, age 74 plus my father had a Myocardal infarction at age 58. I have had the MRA of the head, and no problems. So my main question is what makes the diastolic BP higher than the systolic. Thank you so much for any help, Dee
Dear Dee
You should stop smoking. It is a risk factor for stroke (among other things).
A small difference between the systolic and diastolic blood pressure is not a risk factor for stroke; a very wide difference can be a risk for stroke in certain settings. Elevated systolic and/or diastolic blood pressure is a risk factor for stroke.
Some people have elevations of both systolic and diastolic blood pressure; some have elevation of only one. The bottom line is that all elevations need to be treated.
The systolic blood pressure is higher than the diastolic pressure because of the energy delivered to the blood vessels with each heartbeat.
The blood pressure of 142/121 is quite unusual. Where was this measurement taken and by whom? I wonder if it were an automated cuff or the wrong size cuff.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Dear Doctor,
          Thank you for your explanations. I have my own BP automatic unit, with which I have monitored my blood pressure for a long time. So the cuff does fit, and have had the monitor checked for accuracy. I have had the normal stystolic number a few times in the last few weeks, with the diastolic being higher, example, 138/101, etc. The one I wrote about, 142/121 was the higher bottom number of all of the times, and it caused me some concern. Normally my BP when higher, runs both systolic and diastolic high-examle 158/103 or 155/96, and been as high as 177/113,  etc. And when normal, it runs about 138/86 and sometimes, even 124/82.
These particular times when the systolic is fairly normal and the diastolic is fairly high are puzzling to me. When my numbers are above normal, I can tell, as get a loud pounding heartbeat in my right ear-so check the pressure. If this were a one time thing, then I wouldn't be concerned, but since it has happened several times, with the systolic normal and the diastolic high, in the past few weeks, then
I wondered why? it might be doing this. I know smoking doesn't help it and have been working with my Doctor, on trying to give up the smoking. I have an appointment with my Doctor in a couple of weeks, but was hoping to get some sort of an answer in the meantime, from your great forum. Thank you for any further help on this.
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