Sometimes called “the silent killer,” hypertension or high blood pressure typically has no symptoms. Sometimes, a person may not find out they have the condition until it has already done significant damage to their body. The likelihood of having high blood pressure increases with age due to vascular system changes such as stiffer arteries. According to the Centers for Disease Control and Prevention’s National Center for Health Statistics, during 2015-2016, a survey found that 63.1 percent of people age 60 and older had high blood pressure. Because high blood pressure increases the risk of cardiovascular disease, it’s important that older people do everything possible to be proactive about avoiding or managing high blood pressure.

What is blood pressure?

Blood pressure is the force of blood pushing against the walls of arteries. When a doctor measures blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by the heart contracting and pushing out blood. The second number, called diastolic blood pressure, is the pressure when the heart relaxes and fills with blood. The blood pressure reading is usually given as the systolic blood pressure number over the diastolic blood pressure number, such as 138/72. According to the National Institute on Aging, normal blood pressure for adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80. This is stated as 120/80.

The risks and benefits?

High blood pressure is a systolic blood pressure of 130 or higher and a diastolic blood pressure of 80 or higher. For example, 140/90 would be considered a high blood pressure reading. For older adults, often the systolic blood pressure number may be higher than 130, but the diastolic number is less than 80. This problem is called isolated systolic hypertension, which is due to age-related stiffening of the major arteries. It is the most common form of high blood pressure in older people. Left undetected or uncontrolled, high blood pressure can be extremely damaging to the body over time. According to the American Heart Association, health threats from high blood pressure include: angina, heart attack, heart failure, kidney disease or failure, peripheral artery disease, sexual dysfunction, stroke and vision loss. Isolated systolic hypertension can also lead to the same health threats in addition to shortness of breath during physical activity, lightheadedness when standing too quickly and falls.

Despite the known dangers of high blood pressure, determining treatment options goes beyond simply looking at the number. For example, some studies have found that slightly higher blood pressure was beneficial to some elderly adults. An article published by Harvard Medical School details research done as part of the U.S. National Health and Nutrition Examination Survey. The article quotes the study’s author Michelle Odden who said, “Older frail adults might benefit from slightly higher blood pressure. As the blood vessels get more stiff with age, it may be necessary to have more pressure to keep blood pumping to the central organs, like the brain and heart.” Such findings warrant going beyond a one-size-fits-all approach to treating high blood pressure.

What can be done?

There is no cure for high blood pressure, but the disease can be managed through a number of options such as medication and healthy lifestyle changes. Factors such as age, health conditions and overall fitness should be evaluated when determining appropriate treatment. However, the most important part of being proactive about high blood pressure is knowing what your blood pressure should be and monitoring it often. Making regular doctor’s visits for check-ups and discussing your individual risk can be helpful for prevention. If you already have high blood pressure, regular doctor’s check-ups are vital for managing treatment options, such as medication. The following tips can also help you manage your blood pressure:

• Tell your doctor about all of the drugs you take, including vitamins and over-the-counter drugs.
• Take all medications as prescribed.
• Take blood pressure medication at the same time every day.
• Talk to your doctor to find out if you need to purchase a home blood pressure monitor and discuss which type would be best.
• If you buy a home blood pressure monitor, have your monitor checked at the doctor’s office to make sure it works correctly.
• Adopt healthy lifestyle changes such as eating a well-balanced diet that is low in salt and participating in daily physical exercise.
• If you smoke, quit.
• Drink in moderation.
• Get adequate rest.

If you are concerned about your blood pressure, consult your healthcare provider and discuss an examination.