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I am a 34 year old woman. I am 116 pounds and workout at least a couple of times a week. I consider my stress level normal to low and don't smoke and drink only socially. For the past couple of months I've had high diastolic blood pressure but totally normal if not low systolic readings. A typical reading for me is 114/92. I went to one doctor who seemed reluctant to do anything but gave me a prescription for low dose atenolol "just in case things get worse" before I could get in to see an internal medicine doctor. I've decided not to start the atenolol because I worry I'll just be light headed. I'm confused as to what can be causing this... Any ideas.


Dear Guest,

A higher diastolic BP in the setting of a low or normal systolic BP can be a physiologic response to a low stroke volume. I would recommend making sure you are well hydrated and then repeating BP measurements (with appropriate BP measurement technique: seated in a chair with back supported, upper arm BP cuff, automated machine). Importantly, epidemiologic studies have repeatedly shown that isolated diastolic hypertension carries the same cardiovascular risk as normotension. For this reason, doctors focus on systolic blood pressure for treatment purposes.