Q. I have systolic hypertension and diastolic hypotension. What does that mean?

Answered by
Dr. Tanmai Yermal (jain)
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 10, 2021

Hi doctor,

I have a good diet, exercise, normal BMI. I have been taking my blood pressure for a while, using a reliable device with all the correct procedures. My systolic pressure is a bit higher than it should be, ranging between 127 to 140 mm Hg when resting, while my diastolic is a bit lower than it should be, at rest ranging between 48 to 65 mm Hg, usually in the low to mid 50's. I am just confused. I know isolated hypertension and isolated hypotension exist. But what is this called if the top reading shows hypertension and the bottom reading shows hypotension? Sometimes I get dizzy when I stand up, but equally, I get palpitations and weird pains when my systolic is a bit high. I had an echocardiogram, ECG, exercise stress test, and the doctor said they are all normal. All he said was my heart was a bit larger than normal. He did not really have time for questions and just seemed to rush and said I do not need a blood test because I am too young. In some ways, I would feel more comfortable if my blood pressure was 135 / 90 mm Hg or something because then I could see it must be essential hypertension, and I could work to lower my blood pressure, but in this case, I do not know what to do? If I try to lower my blood pressure, the diastolic will become even lower; equally, If I try to raise my diastolic, my systolic will also become too high. Can you please help me with my concern?



Welcome to icliniq.com

I went through your query and can understand your concern. I also appreciate the detailed history you have described. I went through the BP (blood pressure) recordings that you have shared.

Blood pressure and pulse rate are dynamic variables, and they are never the same or constant at any point in time. That is natural physiology. It also varies depending on the time of the day when you are checking it. Various factors affect the blood pressure and pulse rate. The most important is the activity level of your body. For example, when you run or do exercise, your heart rate, and BP increase, and when you are resting or sleeping, both decrease.

Most people will have increased or decreased BP or pulse rate due to some diseases. In your case, we need to rule out cardiac or any other cause for BP variation. I want to review your ECG (electrocardiograph), Echo (echocardiography) report, and all available blood reports if you have done any. Along with it, I need to know some more details about your symptoms.

  1. Do you get palpitations when you feel dizzy?
  2. Any history of chest pain or breathlessness on exertion?
  3. Do you smoke or drink alcohol?
  4. Do you have a family history of hypertension?
  5. Do you have work stress or any other stress and anxiety?

Kindly get back with the above details for further discussion and management.

Take care. You do not have very high BP, so do not worry about it.

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