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On the other hand, it is now generally proved that persons with overweight have a systolic pressure greater than is normal for individuals of the same age. He believes that diastolic pressure may range anywhere from 60 mm. of mercury to 105, and the person still be normal.
The diastolic pressure is not much affected by food. This increased systolic pressure is the greatest about half an hour after a meal, and then gradually declines until the next meal. Any active, hustling man, or a man under strain, has a rise of blood pressure during that strain, especially notable with surgeons during operation, or with brokers or persons under high nervous tension.
On the other hand, if the diastolic is being raised by an increased venous pressure from a failing heart, digitalis, strychnin and caffein may be of benefit in lowering the diastolic as well as raising the systolic. However, if there is a high systolic and a low diastolic pressure, vasodilators are often contraindicated.
When the diastolic pressure is high, for relative subsequent readings, it is much better to read the diastolic at the beginning of the fifth phase. It is urged by many observers that the proper reading of the diastolic pressure is always at the beginning of the fourth phase.
It is often difficult to decide which is more in evidence, heart insufficiency or kidney insufficiency. The more the heart fails, the more albumin will generally appear in the urine, and the lower the blood pressure, especially the diastolic. The more insufficient the kidneys, the higher the blood pressure, especially the diastolic.
A low systolic pressure and a low diastolic pressure may not cause any symptoms or give any cause for anxiety. It does show, especially if the systolic pressure is below normal for the age of the person, a lack of reserve power, and such patients will not well stand serious illnesses, operations, injuries or serious physical and mental strains.
He believes that the important factors in the estimation of the circulatory strength are the systolic pressure, which shows the power of the left ventricle, the diastolic pressure, which shows the intravascular tension during diastole as well as the peripheral resistance, and the pulse rate, which designates the number of times the heart must contract during a minute to maintain the proper flow of blood.
During an intermittency of the pulse from a weak or intermittently acting ventricle, the diastolic pressure will reach its lowest point, and in auricular fibrillation the pressure pulse from the highest systolic to the lowest diastolic may be very great. In arteriosclerosis the systolic may be high, and the diastolic low, and hence a large pressure pulse.
No condition can be properly treated, no operation should be performed, and no prognosis is of value without a proper consideration of the sufficiency of the circulation, and the condition of the circulation cannot be properly estimated without an accurate estimate of the systolic and diastolic blood pressure.
If the systolic pressure is low and the diastolic very low, or when the heart is rapid, circulation through the coronary vessels of the heart is more or less imperfect. Any increase in arterial pressure will therefore help the coronary circulation.
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