A diastolic blood pressure below 60 mmHg, when your systolic (top number) stays normal, is considered isolated diastolic hypotension. Raising it involves a combination of fluid intake, dietary changes, physical strategies, and sometimes medication. The approach depends on what’s causing the low reading in the first place.
Why Low Diastolic Pressure Matters
Your diastolic number reflects the pressure in your arteries between heartbeats, when your heart is refilling with blood. This is also the phase when your heart muscle itself receives most of its oxygen supply through the coronary arteries. When diastolic pressure drops too low, that blood flow to the heart can become inadequate, a process called impaired coronary perfusion.
The risks are not abstract. In a large study of cardiac patients, those with diastolic pressure below 50 mmHg had significantly higher rates of arrhythmias, new-onset heart failure, stroke, and major bleeding compared to those with higher readings. Long-term mortality in that group was 29%, compared to 11% in the rest of the study population. The 2025 AHA/ACC blood pressure guidelines note that a diastolic pressure between 70 and 80 mmHg (when systolic is under 130) is associated with reduced cardiovascular events without increased side effects.
Common Causes to Rule Out First
Before trying to raise your diastolic pressure, it’s worth understanding what’s pulling it down. The most common culprits fall into a few categories.
Medications are a frequent cause, particularly blood pressure drugs. Beta-blockers, diuretics, and ACE inhibitors all lower diastolic pressure as part of their overall effect. Calcium channel blockers deserve special attention: research in patients with chronic kidney disease found that calcium channel blocker users experienced a wider gap between systolic and diastolic pressure (a 15 mmHg widening) compared to non-users (6 mmHg), suggesting these drugs may disproportionately drop the bottom number. If you take any blood pressure medication, your prescriber can review whether your current regimen is contributing to the problem.
Dehydration reduces total blood volume, which lowers the pressure your blood exerts on artery walls during the resting phase of each heartbeat. Even mild, chronic under-hydration can keep diastolic readings low.
Aging naturally stiffens arteries, which tends to push systolic pressure up while letting diastolic pressure drift down. This is why isolated diastolic hypotension is especially common in older adults and why it’s linked to increased heart failure risk in that population.
Increase Fluid and Salt Intake
The simplest intervention is drinking more water. The American Heart Association’s general recommendation for people with low blood pressure and fainting episodes is 2 to 3 liters of fluid per day. Even a single large glass of water (about 500 mL, or 16 ounces) can measurably improve blood pressure and reduce fainting within 15 minutes. The mechanism is straightforward: more fluid in your bloodstream means more volume pressing against artery walls.
Salt works alongside water by helping your body retain that fluid rather than filtering it out through the kidneys. Adding salt to meals, or eating salty snacks like pickles, olives, or broth, can support higher blood volume throughout the day. Most people with low blood pressure are advised to consume more sodium than the standard dietary recommendation, but the right amount varies depending on your kidney function and other health conditions.
Use Caffeine Strategically
Caffeine reliably raises both systolic and diastolic blood pressure. In controlled studies, a dose of roughly 250 mg (about two cups of brewed coffee) produced significant increases in both numbers within 45 to 60 minutes. The effect is large enough that some participants’ readings crossed into the hypertensive range after caffeine intake, particularly those who already had elevated baseline pressure.
If your diastolic pressure tends to dip at specific times of day, timing a cup of coffee or tea before those periods can help. The effect is temporary, lasting a few hours, so caffeine works best as a targeted strategy rather than a long-term fix. People who drink caffeine daily do develop some tolerance, which blunts the blood pressure effect over time.
Physical Strategies That Help
Compression stockings are one of the most effective non-drug tools for raising blood pressure. They work by squeezing the veins in your legs, pushing blood back toward your heart and increasing the volume available in your central circulation. For meaningful results, dysautonomia specialists recommend waist-high stockings rated at 20 to 30 mmHg or 30 to 40 mmHg of compression. Knee-high stockings are easier to put on but significantly less effective because so much blood pools in the thighs.
Certain body positions also make an immediate difference. Crossing your legs while standing, squatting, or tensing your abdominal muscles can temporarily boost blood return to the heart. Elevating the head of your bed by a few inches (rather than lying flat) helps your body retain fluid overnight, which can prevent morning dips in pressure.
Exercise and Diastolic Pressure
Regular aerobic exercise, like walking, cycling, or swimming, strengthens the heart’s pumping ability and improves the tone of blood vessels, both of which support healthier diastolic pressure over time. The key is starting gradually if your pressure is very low, since sudden exertion can cause lightheadedness.
One specific exercise worth noting: isometric handgrip training has been studied for its effect on blood pressure. In a controlled trial, participants squeezed a handgrip device at 30% of their maximum strength for 2 minutes, rested 4 minutes, and repeated for 4 sets, three times per week. After 8 weeks, the training group saw a diastolic change of about 3 mmHg. However, in that study the change was a reduction, not an increase, so handgrip training is better suited for people trying to lower blood pressure. For raising diastolic pressure, general cardiovascular conditioning and strength training that improves vascular tone are more appropriate.
When Lifestyle Changes Aren’t Enough
If fluid, salt, compression, and caffeine don’t bring your diastolic pressure into a comfortable range, medications exist that raise blood pressure directly. The most commonly prescribed is midodrine, which tightens blood vessels throughout the body. It’s typically started at a low dose three times daily and gradually increased based on how your standing and lying-down blood pressure readings respond. The last dose of the day needs to be taken at least 4 hours before bed, because the drug can push pressure too high while you’re lying flat overnight.
Another option is fludrocortisone, a synthetic hormone that causes your kidneys to retain more sodium and water, expanding blood volume. Both medications require monitoring because they can overshoot, raising pressure too much in certain positions or at certain times of day. For older adults, dose increases are typically spaced further apart to reduce the risk of side effects.
Tracking Your Progress
A home blood pressure monitor is essential if you’re actively trying to raise your diastolic pressure. Take readings at the same times each day, ideally morning and evening, after sitting quietly for 5 minutes. Record both numbers along with notes about what you ate, drank, or did differently that day. Patterns usually emerge within a week or two, showing you which strategies produce the most consistent results.
Pay attention to how you feel, not just the numbers. Dizziness when standing, persistent fatigue, or feeling faint are signs your diastolic pressure is functionally too low for your body, even if the reading isn’t dramatically below 60. Conversely, headaches, visual changes, or a pounding heartbeat when lying down could mean you’ve pushed pressure too high, particularly if you’re using medication or consuming large amounts of salt and caffeine together.