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Updated: June 9, 2025
As previously stated, the diastolic pressure may be read at the beginning of the fourth phase, or at the end of the fourth phase, that is, the beginning of the fifth; but the difference is from 3 to 10 mm. of mercury, with an average of perhaps 5 mm.; therefore the difference is not very great.
The patient, being at rest and removed as far as possible from all excitement, may be conversed with to take his mind away from the fact that his blood pressure is being taken. He also should not watch the dial, as any tensity on his part more or less raises the systolic pressure, the diastolic not being much affected by such nervous tension.
If such patients have the systolic blood pressure raised even a small amount, or if the diastolic pressure, which is very low, is raised even a small amount, they immediately feel better. If the kidneys are normal, they should have meat as part of their diet. If they are not nervous and irritable, coffee and tea should be allowed, except at the evening meal.
Serious illness and infections will lower the blood pressure sometimes to a dangerous point. Of course, hemorrhages lower the blood pressure. Jour. Of course, if the difference between the systolic and the diastolic pressure is diminished to the vanishing point, the patient cannot stand it, and dies.
However, it should be again urged in making insurance examinations that psychic disturbance or mental tensity very readily raises the systolic pressure. MacKenzie believes that a diastolic pressure over 100 under the age of 40 is abnormal, and anything over the 110 mark above that age is certainly abnormal. Int.
If there is a low systolic pressure and a high diastolic pressure, this shows impairment of the heart, whether or not any other organic lesion is present. Generally speaking, a low systolic pressure shows a weak acting heart muscle, and a very low diastolic pressure shows a dilated condition of the arterioles.
When, after some minutes of repose, he assumes the erect posture again, the systolic pressure will diminish and the diastolic pressure increase, and the pressure pulse shortens. Excitement can raise the blood pressure from 20 to 30 mm., and if such excitement occurs in high tension cases there is often a systolic blow in the second intercostal space at the right of the sternum.
If there is a diastolic murmur, there can be no question of serious endocarditis having occurred. Unexplainable palpation during acute illness liar been thought to be a distinct symptom of endocarditis. As mild endocarditis rarely occurs primarily but is almost always secondary to some acute disease, its immediate treatment is only a slight modification of that of the disease which is causing it.
The strenuous measures that should he used to lower a high diastolic pressure are contraindicated when the diastolic pressure is already low, even if the systolic pressure 1s high. If a high systolic pressure begins to fall more or less rapidly the heart shows fatigue, and should be stimulated by digitalis or strophanthin.
It should be remembered that the diastolic pressure represents the pressure which the left ventricle must overcome before the blood will begin to circulate, that is, before the aortic valve opens, while the pressure pulse represents the power of the left ventricle in excess of the diastolic pressure.
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