isolated low diastolic pressure

[JEEE]

Hello,

Are there symptoms pertained to isolated low diastolic pressure. For example, if the systolic is normal but the diastolic is low. What would pt in dialysis exhibit if the diastolic pressure is low? Dailysis nursing is my first RN job. So far, I noticed there are a lot of different bp variations. Also, how would you chart the low diastolic bp?

Thank you very much for your help. :)

[Chisca, RN]

When you say an isolated low diastolic pressure do you mean one instance? Remember that a non invasive BP cuff does not measure pressure the same way as when you listen to it with your stethoscope. A NIBP device measures the peak pulsation and uses a formula to calculate the systolic and diastolic numbers. They have a hard time with irregular heart rhythms. If in doubt use a manual cuff and listen with your own ears.

If you really have a low diastolic pressure you are going to have a lower mean pressure and that's what is really important for organ perfusion. Assess organ perfusion, is the pt alert and oriented, is their skin warm and dry, do they look pale? There was a study published last year that linked lower diastolic pressures with higher mortality and it stands to reason because a lower diastolic is going to give a lower MAP and less tissue perfusion.

JAMA Network | JAMA | Low Diastolic Blood Pressure and Chronic Kidney Disease Are Associated With Increased Mortality

Low Diastolic Blood Pressure as a Risk for All-Cause Mortality in VA Patients