“Am I right to assume you don’t hear much about seniors with high blood pressure? My father was just diagnosed, and I didn’t realize it was a big deal at his age. Why should we be concerned about hypertension in the elderly?”—Joseph in Dunwoody

I understand your point; it does seem that people are usually younger when first diagnosed, but according to the American Heart Association, the risk for developing high blood pressure does increase with age. It’s also seen more often in men until women reach menopause; at around 55-64, men and women have the same risk of developing it, and that risk only increases as people get older.

A separate concern isn’t just who gets high blood pressure, but how often it goes untreated. The Center for Disease Control indicates that while over 75 million Americans have hypertension, it is uncontrolled in about 54% of seniors.

Danger Zone

Medical consensus has recently changed on what blood pressure level is too high. While it used to be that 140/90 was borderline high blood pressure, now that number indicates treatment should begin, and of course, anything higher than that increases risks of heart attack, stroke, heart failure, kidney failure, and even vision loss. Hypertension in the elderly only compounds other existing medical conditions, which in turn can lead to a significant health event and possibly a shorter life expectancy.

Explaining the Numbers

Let’s talk a bit more about what the top and bottom numbers mean. The top number, the systolic number, refers to the pressure exerted on arteries when your heart muscle contracts, while the diastolic, the bottom number, is the measure of pressure between heart beats. The higher the number, the more pressure on your circulatory system, which over time can cause damage to any of the major organs.

Age Is More Than A Number

Most people think high blood pressure is more of a problem if the diastolic number is too high, but for seniors, the first number, or systolic pressure, is what seems to be more of an issue. Systolic hypertension reflects stiffening in the major arteries in the heart, and it can more than double the risk of a heart attack, aneurysm, or stroke. It can also be tricky to treat, especially because elderly people tend to take other conditions and medications that can trigger high blood pressure. Interestingly, elderly women are more likely to develop systolic hypertension, while men are more likely to have diastolic hypertension.

These are some of the other risk factors for hypertension in the elderly and younger individuals:

• Smoking
• Obesity
• Diabetes
• Kidney disease
• High-salt diet
• Alcohol consumption
• Low potassium

The Hard Part

High blood pressure has earned a reputation as a silent killer because it doesn’t have noticeable symptoms under a problem develops. Hypertension in the elderly should be monitored regularly to track any changes and treat it without delay. Aside from medicine, lifestyle changes can also help to keep blood pressure stable or reduce it to a healthier level.

It goes without saying, but diet and exercise are essential to improve overall wellbeing as well as lowering blood pressure. You may also want to limit alcohol and salt intake for your loved one, and of course, encourage smoking cessation if your senior smokes. Try to limit stress because anxiety can make blood pressure rise. Your father’s physician may also prescribe medication, and you can ask for a more comprehensive prescription review if you are concerned about interactions with other medicine he may be taking. You may also need to advocate for treatment options specific to which type of hypertension your loved one because systolic is less common and may respond better to a different regimen.

Older gentlemen can be a bit stubborn when it comes to changing behavior, so I encourage you to support your father in any way you can. After all, chances are good that if we are lucky, we too may have to deal with hypertension as we age, so any behavior changes you want to see in your dad are good for you too!

Best of luck, and thanks for your question.

–Lisa