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High Blood Pressure in Seniors: Risks, Complications and Treatment

High blood pressure, also known as hypertension, affects 30-50% of persons over the age of 50. Once hypertension develops, it usually lasts a lifetime.

Much like stress, high blood pressure is called a silent killer. It presents no noticeable symptoms until the damage is already done. Most seniors have no idea that they have high blood pressure until they start experiencing problems with their kidneys, heart and brain.

While hypertension is a troubling condition, seniors can manage their blood pressure by taking medications and making lifestyle changes.

What is Blood Pressure? Why Does it Matter?

The heart pumps blood through a network of arteries in the body. Think of these arteries as a garden hose. When they become narrow, the flow of blood is restricted. Arteries typically narrow because of plaque build-up caused by cholesterol.

The narrow arteries, much like a garden hose, increase blood pressure. Over time, the higher pressure can damage the artery walls and the heart.

Complications of High Blood Pressure

Keeping your blood pressure in the normal range can help lower your risk of many serious health issues, including:

  • Stroke: About 8 out of every 10 people who have their first stroke also have high blood pressure.
  • Heart Attack: About 7 out of every 10 people who have their first heart attack also have high blood pressure.
  • Kidney Disease: A risk factor for high blood pressure.
  • Chronic Heart Failure: About 7 out of every 10 people who have chronic heart failure also have high blood pressure.

What is Considered Normal Blood Pressure in Seniors?

It’s normal for blood pressure to fluctuate throughout the day. It stays at its lowest level when you’re sleeping, and it can rise if you’re active, excited or nervous. For the most part, however, your blood pressure should remain stable while you’re awake.

What is considered normal blood pressure for seniors?

  • Systolic pressure: less than 120/80 mmHg

What happens if your blood pressure is higher than this level? Does that automatically mean that you have hypertension? No.

  • Elevated Blood Pressure: 120-129/80 mmHg
  • Stage 1 Hypertension: 130-139/80-89 mmHg
  • Stage 2 Hypertension: 140+/90+ mmHg
  • Hypertensive Crisis (Medical Emergency): 180+/120+ mmHg

These guidelines are used for the general population, but experts agree that the needs and benchmarks of seniors differ from younger adults. Other health conditions can further complicate matters.

The target blood pressure for very old people is still unclear, mainly because there is little research on this topic focused on this age group. Some evidence actually suggests that lowering blood pressure too much in older seniors can do more harm than good.

Many people over the age of 65 feel dizzy upon standing, which can cause them to fall or pass out quickly and without warning. This dizzy feeling occurs when there’s a sudden drop in blood pressure and is known as orthostatic hypotension. Falls can cause serious injury or fractures.

While the guidelines above are helpful, many medical experts agree that blood pressure targets should be set on an individual basis.

How to Take Your Blood Pressure

It’s common for doctors to take a blood pressure reading at the start of a medical appointment. If your reading is high, your doctor may want to recheck your blood pressure several times on different days.

The way in which the reading is taken is important.

Seniors should:

  • Be relaxed
  • Sitting upright with both feet on the floor
  • Avoid drinking caffeine or smoking cigarettes 30 minutes before the reading

Some seniors experience minor anxiety when visiting the doctor. This type of anxiety can cause blood pressure to rise, a condition known as white coat hypertension. If your doctor suspects that your anxiety may be elevating your blood pressure, you may be asked to have your blood pressure taken at home.

What are the Causes and Risks of Hypertension?

Seniors can develop hypertension for a number of reasons. In some cases, elevated blood pressure is a normal part of the aging process.

While there is still some disagreement on the matter, many experts believe that blood pressure naturally rises as we age due to a natural thickening of the arteries.

Hypertension can also be caused by the same factors that cause this condition in younger adults:

  • Obesity
  • Diabetes
  • Chronic kidney disease

The risk factors for hypertension are very similar to those of high cholesterol.

High blood pressure can harm your overall health, but it can also do some serious damage to your kidneys, the organ in charge of regulating blood pressure. Many people with severe hypertension develop kidney disease. Kidney disease itself can cause high blood pressure.

The two conditions often go hand-in-hand.

Hypertension is the result of an unhealthy lifestyle and/or a genetic predisposition to the condition.

What are the Risk Factors of High Blood Pressure?

  • Women over the age of 55
  • Men over the age of 45
  • Family history of high blood pressure
  • Overweight or obese
  • Sedentary lifestyle
  • Certain medications
  • Lack of potassium
  • Drinking too much alcohol
  • Consuming too much salt
  • Smoking
  • Long-term stress

Treating High Blood Pressure in the Elderly

High blood pressure can typically be managed through a combination of lifestyle changes and medication. Depending on the severity of the hypertension, lifestyle changes may be all that’s needed.

Some lifestyle changes have been proven to be effective at lowering blood pressure:

  • Exercise
  • Weight loss
  • Reducing salt (sodium) intake
  • Following the DASH (Dietary Approaches to Stop Hypertension) diet
  • Quitting smoking

Seniors with no mobility issues should aim for 150 minutes of moderate aerobic exercise each week as well as two or more days of strength exercises (working all major muscle groups).

Exercise and healthy diet changes, such as those recommended in the DASH diet, can go a long way in keeping blood pressure under control.

In addition to lifestyle changes, your doctor may also prescribe anti-hypertensive medications, such as:

  • Beta-blockers
  • Diuretics
  • Calcium channel blockers
  • Angiotensin-converting enzyme inhibitors
  • Alpha-blockers
  • Angiotensin II receptor blockers
  • Alpha-beta blockers

Seniors should ensure that they are taking their blood pressure medications at the same time every day.

High blood pressure in seniors may not be as dangerous as it is in a middle-aged person, but steps should still be taken to get hypertension under control. Healthy blood pressure contributes to a healthy overall life as a senior.