Last Updated: April 30, 2015
Blood pressure can be seen as a barometer of overall circulatory
health. Someone with high blood pressure is at a significantly
greater risk for heart failure, stroke, chronic kidney disease and
damage to the arteries (similar to the damage caused by high
cholesterol), which can cause heart
It's no different for those reaching their senior years. While
nearly one in three Americans suffers from hypertension, as high
blood pressure is often called, blood pressure typically increases
with age, especially once one has passed middle age. According to
the National Heart, Lung,and Blood Institute, someone with healthy
blood pressure at age 50 has a 90% chance of developing
hypertension later in life.
Fortunately, the senior years are not too late to take an active
role in lowering blood pressure. Managing blood pressure can be as
simple as increasing physical activity and regulating one's diet.
In those cases when a change in lifestyle doesn't significantly
impact hypertension, prescription drugs have proven very effective
in regulating blood pressure.
Blood Pressure: What It Is and Why It's Important
In "The Blood Pressure Book: How To Get It Down and Keep It
Down," Dr. Stephen P. Fortmann compares blood pressure to a garden
hose. The heart pumps blood throughout the body in a network of
arteries. When those arteries become too narrow (often caused by
plaque build-up from high cholesterol), the volume of blood that
the arteries can handle is restricted. Like water in a narrow
garden hose, narrow arteries lead to an increase in blood
pressure-and high blood pressure can cause damage to artery walls
and the heart itself. Damage to the circulatory system-and the
complications that can result from it-is the primary reason to
maintain one's blood pressure at a healthy level.
But what is a healthy blood pressure level? The exact range
considered acceptable can vary. For those individuals with a family
history of hypertension or with related complications, like chronic
kidney disease, it's even more important to stay at a low level. A
blood pressure reading is composed of two numbers that measure the
pressure in your arteries when the heart beats (called systolic
pressure) and the pressure in your arteries between heartbeats
(called diastolic pressure). A healthy blood pressure should
measure below 120/80 (the numbers represent millimeters of
mercury). The National Heart, Lung, and Blood Institute provides
the following guidelines for understanding normal blood pressure
- Normal blood pressure
120/80, though the risk of heart disease can begin to increase
once blood pressure reaches levels of 115/75.
A systolic pressure range of 120 to 139 and a diastolic pressure
range of 80 to 89. Diagnosis with prehypertension provides an
opportunity to work hard-through physical activity, diet, and
possibly medication-to reduce blood pressure to a healthy level.
Within four years of diagnosis with prehypertension, one in three
adults ages 35 to 64 will develop definite high blood pressure. One
in two adults over age 65 will develop definite high blood
- Stage 1 hypertension
A systolic pressure range of 140 to 159 and a diastolic pressure
range of 90 to 99.
- Stage 2 hypertension
A systolic pressure of 160 or higher and a diastolic pressure of
100 or higher.
It should also be noted that systolic pressure-the blood
pressure measured during heartbeats-becomes increasingly important
for those individuals past age 50. The most common form of blood
pressure in these individuals is a condition called isolated
What Causes High Blood Pressure in the Elderly
Surprisingly, there hasn't been a great deal of research that
looks at the elderly as a separate population in terms of blood
pressure control, says Dr. Suzanne Watnick, a professor of medicine
at Oregon Health Sciences University. Watnick advises strict
monitoring of prehypertension in order to ensure that it doesn't
have a more serious impact on health. She also warns that rising
blood pressure is common in the elderly: "For a 70-year-old person,
as you age your blood pressure does go up a bit," she says. "People
think that it's because your blood vessels are a bit more fibrotic
[meaning they develop excess connective tissue] and there's more
damage to the blood vessels over time." Above-average blood
pressure in the elderly is still a concern, but it should still be
considered in the context of age. A 40-year-old with a blood
pressure of 150/70 is much more likely to develop complications
from hypertension than a 70-year-old with the same blood
According to Watnick, the risk factors for the elderly are very
similar to those for the population at large. "Those at highest
risk of high blood pressure are those who suffer from obesity,
those suffering from diabetes,
and those with chronic kidney disease," she explains. In fact, the
risk factors for hypertension are very similar to the risks
associated with high cholesterol. Any restrictions or blockages in
the circulatory system negatively impact overall heart health. But
the kidneys, the primary organ that regulates blood pressure, also
become at risk when blood pressure rises. Severe hypertension can
cause chronic kidney disease, which in turn limits the kidneys'
ability to continue regulating blood pressure. As Watnick says,
"It's a chicken or the egg thing. You can have high blood pressure
which causes kidney disease. Or you can have kidney disease, and
that will cause high blood pressure." But regardless of whether
hypertension is simply the result of genetic predisposition or the
result of an unhealthy lifestyle, it doesn't have to mean the end
of good health.
Maintaining a Healthy Blood Pressure
For how confusing hypertension can be, learning how to maintain
a healthy blood pressure is surprisingly simple. As with other
types of circulatory health, like cholesterol, the first step to
lowering blood pressure is lifestyle change. "Whenever you're
dealing with hypertension, the first thing you need to deal with is
lifestyle change," Watnick explains. "Exercise is essential, weight
control is essential. Eating a low-salt diet is quite important."
National guidelines recommend at least 30 minutes of exercise each
day. For seniors, exercise can involve simple changes to everyday
routine, like walking more often and engaging in household chores.
In addition to improving overall cardiovascular health and
cholesterol, the presence of which can increase blood pressure by
narrowing arteries, exercise can also help with weight loss.
Related to weight loss is developing a healthy diet, another
essential tool for lowering blood pressure. Healthy nutrition is
important for all of the standard reasons (positive cardiovascular
health, additional energy, etc.) and a few unique reasons as well.
A low salt diet is particularly important for lowering blood
pressure, as salt indirectly increases the volume of blood (by
adding water to the bloodstream), which in turn increases blood
One of the most common diets recommended for those individuals
who struggle with hypertension is called the DASH diet, which
stands for Dietary Approaches to Stop Hypertension. The DASH diet-a
low-sodium, low-fat diet that emphasizes fruits, vegetables, and
grains-is the result of a study by the federal government. Compared
to two control groups, one that followed a "normal" American diet
and the other a traditional diet high in fruits and vegetables,
people on the DASH diet reduced their blood pressure by an average
of 6 points of systolic pressure and 3 points of diastolic
pressure. Those people in the study who already had been diagnosed
with hypertension reduced their blood pressure by 11 systolic
points and 6 diastolic points. According to Fortmann, the DASH diet
shows the importance of diet, especially a significant reduction in
salt, to lowering blood pressure. Under the DASH diet, an
individual is advised to eat no more than one-quarter teaspoon of
salt per day. By comparison, the average American eats about four
teaspoons of salt daily, nearly fifteen times more.
But as many people know, diet and lifestyle change can often be
very difficult. Medication is also an option for many people,
sometimes because an individual has a difficult time achieving
significant lifestyle change, and sometimes because hypertension is
severe enough to mandate a combination of lifestyle change with
medication. For many, treating their high blood pressure with
medication can be a difficult subject-one that should always be
considered under the guidance of your doctor.
According to Dr. Watnick, blood pressure medication can be
categorized into three main groups:
Often the first course of action in terms of drug treatment, these
medications focuses on the kidneys by helping the body eliminate
sodium, or salt, and water.
- Beta Blockers
These medications cause heart to beat slower and with less force,
working to reduce blood pressure by focusing on the center of the
circulatory system itself. Often beta blockers will be prescribed
along with thiazide diuretics (combining drugs is a common practice
that can lower blood pressure).
- Angiotensin-converting Enzyme (ACE)
Commonly prescribed along with thiazide diuretics, ACE inhibitors
counteract a natural chemical that narrows blood vessels, which in
turn eases pressure on vessels.
Of course, other types of drugs can be effective against
hypertension as well. Finding the right combination varies with
In the fight against hypertension, the best strategy is to
recognize one's individual risks-which might include genetic
history, obesity or simple physical inactivity-and act accordingly.
For the elderly, moderately high blood pressure might be less
serious than it is in a middle-aged person. But even when blood
pressure rises minimally past age 50, it's still important to take
the proper steps to ensure healthy senior years. A normal blood
pressure is an important first step toward achieving long-term
health. Hypertension might be a common problem-but fortunately it
has plenty of solutions.