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Hypertension/Low diastolic bp


I'm 67 and have been running daily for almost 20 years-about 35 miles a week. I have an annual physical and an annual cardio exam. I'm considered in perfect health. All tests normal and low cholesterol and normal lipid profile. I have a resting heart rate of about 45 bpm which my cardiologist thinks is great. I do take Avapro for hbp - I often have had high systolic readings, particularly in the Drs office. The Avapro seems to be working well though. I used to worry a lot about my high systolic but lately my numbers seem to be fine. I've always had good diastolic numbers well below 80 and often in the 60's. Lately my bp has been around 120/60 and sometimes my diastolic dips to 58 or in that area. My Dr seems to think that it is fine and that the avapro is doing its job along with my exercise. I'm kind of worried though when my diastolic goes below 60. I feel fine, not dizzy, etc. wonder what you think. Thanks

Good morning, Don,

I agree with your Doctor.  Your diastolic BP is fine.

Theoretically, the systolic BP tends to correlate with the rigidity of the large blood vessels of the body and since the arteries at 67 years of age are going to be a bit stiffer than the arteries of an individual in his/her teens, it is to be expected that the systolic BP would lag behind the diastolic BP when hypertension is treated.

The diastolic BP correlates more with the "tension" in the smaller peripheral arterioles (smaller arteries) and produces the peripheral vascular resistance to the flow of blood. It often falls more quickly and more easily is patients who are in their 50's and above. Running and other aerobic exercise is most effective in reducing the peripheral vascular resistance.

In any event, I believe your physician is right on target and you appear to be receiving excellent care.

Keep your BP there if you want to live to a ripe old age.

Thanks for the question and keep up the good work.


Dr Falkinburg  


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Newell R. Falkinburg, M.D. FACP


Any question regarding hypertension or clinical nephrology


35 years of experience in the field of nephrology & hypertension. Emeritus Professor of clinical Medicine at a major medical school and director of Nephrology & Hypertension at a university affiliated medical center.

M.D. Board certified internal medicine Board certified Nephrology & hypertension

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Fellow, American College of Physicians

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