Blood Pressure in Elderly

Studies by the American Heart Association show between 70-80% of older people in the United States have high blood pressure (also known as hypertension).  Coined as the silent killer, high blood pressure generally exhibits no symptoms.  Blood pressure levels are a key indication of overall circulatory system health, as the blood is responsible for carrying oxygen and other important nutrients throughout the body.  The development of high blood pressure in the elderly can lead to the following: Higher heart attack and stroke risk, kidney issues, heart enlargement and failure.  Monitoring your blood pressure can help prevent these deadly results. 

What is a Normal Blood Pressure by Age?

What is blood pressure? Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood throughout your body. Your blood pressure is highest when your heart beats harder, pumping the blood faster, for example: exercising.

According to www.heart.org:  “Your blood pressure is recorded as two numbers:

Systolic blood pressure (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.

Diastolic blood pressure (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.”

The American Heart Association uses the following chart to determine how “healthy” your blood pressure is:

Causes of High Blood Pressure in Seniors

What causes high blood pressure?  Common factors that can include: A diet high in salt, fat, and/or cholesterol, chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol. Family history can also contribute to high blood pressure. 

• Aging - Due to Arteriosclerosis a natural hardening of the arteries with age, seniors can  experience an increase in blood pressure. The prevalence of the condition is quite common in people over 60. In fact, two out of three people over the age of 75 are affected by hypertension.

• Weight - Being overweight, or diagnosed with obesity is an established risk factor concerned with hypertension. A sedentary lifestyle, unhealthy diet, and raised sodium levels can result in thickening of the arteries, and ultimately, high blood pressure.

• Diabetes - Diabetes can also affect your blood pressure.  Over time diabetes damages the small blood vessels in your body, causing the walls of the blood vessels to stiffen. This increases pressure, which leads to high blood pressure.

• Genetics - Family history is an important predictor of hypertension in any individual. Genetic factors can contribute majorly to high blood pressure and related problems. One reason is that all the family members are likely to share a common environment and those influences add to the risk.

• Diet - A diet high in salt content is responsible for approximately 20% to 40 % of cases of hypertension in the US, according to the Institute of Medicine. It has also been found that Americans consume 10 to 15 times more salt than they actually need.  Considering seniors gradually lose their sense of taste with age, they are more likely to use (and overuse) salt.  

• Smoking - Smoking is bad for you.  Not only does smoking raise blood pressure, but there are harmful chemicals in the cigarette that can also damage artery walls. The lining of your arteries can become thin, which may result in hypertension.

• Lack of Exercise - Inactive people also typically have higher heart rates. Daily physical activity can bring down your blood pressure by 6 to 8 mm Hg. You will need to work out consistently, for about 25 to 30 minutes each day, though.  Walking, cycling, and yoga are safe and easy ways to complete those 30 minutes a day!

Ways to Lower Blood Pressure in Elderly

• Healthier Diet - Adjusting eating habits is an effective way to lower blood pressure.  A resident should focus on whole foods, less fat, and more fruits and vegetables.  Reducing the use of salt also helps control high blood pressure. The American Heart Association recommends staying below 1500 mg of sodium per day.

• No Smoking - When someone smokes, the nicotine raises blood pressure and heart rate. Smoking also causes arteries to tighten, which also increases blood pressure.  There are more ways to quit smoking today than ever before.  

• Exercise - Seniors who are overweight could lower blood pressure by losing just 10 pounds. In doing so, that could even allow them to take less blood pressure medication.  Try walking 15 minutes a day to start!  Even some light activity is good exercise.

• Use Medication - If you are in need of medication to lower your blood pressure, your physician may prescribe them.  When prescribed make sure you use them properly.  Take your pills on time, don’t skip doses, and don’t cut pills in half.

• Less Alcohol - Drinking alcohol increases blood pressure. If your older adult drinks, limit it to 2 drinks a day for men and 1 drink a day for women.  Moderation is the key.

• Manage Stress - Blood pressure rises when someone is feeling stressed, so it’s best to keep stress levels low to reduce blood pressure.  Some people may benefit from meditation and relaxation exercises.  Others might relax with exercise or by immersing themselves in calming activities like art, gardening, or word and number puzzles.

Causes of Low Blood Pressure in Seniors

As dangerous as High Blood Pressure or Hypertension is, Low Blood Pressure or Hypotension is just as concerning for seniors.  Low blood pressure is not a condition that is usually treated except if it occurs in the elderly or occurs suddenly. In patients over 65, it could indicate the brain and limbs are not receiving adequate blood supply.  There are many possible causes for this drop in blood pressure:

• Getting up quickly - Be careful when you get up.  Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even cause you to fall down or even faint.

• Eating - Another type of low blood pressure can occur after eating (as called postprandial hypotension).  Blood flows to your digestive tract after you eat. With this blood flood diverted, it can lower your blood pressure.  

• Dehydration - Dehydration can negatively affect your organs and bodily functions, especially a senior’s heart and cardiovascular system. When you are dehydrated your blood volume, or the amount of blood circulating through your body, decreases, thus decreasing your blood pressure. 

• Health issues - Other chronic health concerns such as thyroid disease, severe infection, bleeding in the intestines, or heart problems can cause a drop in blood pressure as your body fights those issues.  

• Medications - Taking some prescription medicines such as for high blood pressure, depression or Parkinson’s disease can reduce your blood pressure and, if not monitored, could result in dangerously low blood pressure.

Ways to Raise Blood Pressure in Elderly

Seniors with hypotension may be looking for a safe and healthy way to raise their low blood pressure. Here are a couple of suggestions. 

• Exercise - As you may have noticed throughout this article, exercise is often the cure, and lack of exercise is often associated with blood pressure issues. Today is as good a day as any to start walking!

• Eat slowly - Eating slower allows your body to digest your food at a more controlled pace, thus not lower your blood pressure.  Eating smaller, but more frequent meals can also assist.

• Drink water - Drinking more water is always a good thing.  But it is especially important to drink water when a senior’s low blood pressure is due to dehydration.  Try to drink 6-8 cups of water throughout the day.

• More salt - If a loved one’s blood pressure is too low, adding more salt, or salty foods to their diet can help balance that level out.  A bowl of salted nuts, a cup of soup, or a handful of pretzels may help immediately raise your blood pressure when it’s too low.  

• Get up slowly - Getting up too fast can cause dizziness, loss of balance, and even confusion.  Most of this is caused by a sudden drop in blood pressure.  Consider standing up, and staying there for a minute before you move away from the chair.  Have something to lean on or maintain your balance, as your body adjusts to being upright again.  Taking this extra minute will save you from a possible fall or injury.  

High Blood Pressure Complications 

• Enlarged heart - When you have high blood pressure, your heart may have to pump harder to deliver blood to the rest of your body, enlarging and thickening the muscle. High blood pressure can cause the portions of your heart to enlarge, causing the heart muscle eventually to weaken. 

• Aneurysms - Just like high blood pressure can place increased pressure on the walls of the blood vessels in the rest of your body, it is especially dangerous inside the brain.  This increases your chances of developing an aneurysm, A bulging aneurysm can put pressure on the nerves in the brain or brain tissue.  A ruptured aneurysm can cause serious health problems such as hemorrhagic stroke, brain damage, coma, and even death.

• Kidney failure - High blood pressure can constrict and narrow the blood vessels, which will damage and weaken those blood vessels throughout the body, including in the kidneys. The narrowing reduces blood flow.  If your kidneys’ blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body.  This can lead to kidney failure.

• Blindness - When your blood pressure is too high, the walls of the retina may thicken, which restricts blood flow to the retina and limits its function, resulting in potentially permanent vision problems, including blindness.

• Stroke - Similar to damaging blood vessels in the brain, high blood pressure can damage blood vessels throughout the body.  Blood vessels damaged by high blood pressure can narrow, rupture or leak. High blood pressure can also cause blood clots to form in the arteries leading to the brain, blocking blood flow and potentially causing a stroke.

Hypertension Medication

When looking at hypertension medications there are several different methods that they can use to reduce high blood pressure.  Beta-blockers reduce the heart rate, the heart's workload and the heart's output of blood, which lowers blood pressure.  Diuretics help the body get rid of excess sodium (salt) and water and help control blood pressure.  Alpha blockers reduce the arteries' resistance, relaxing the muscle tone of the vascular walls.   Your physician will explain which medications are best for you and how they work.
 

Final Thoughts

Blood pressure is something that needs to be monitored if it is an issue.  There is a wide range of blood pressure that is considered normal or healthy, but as you get outside of that range the risks to your health tend to increase exponentially.  We’ve shown that blood pressure can be dangerous if it is too high or too low.  All seniors should monitor their blood pressure and make sure their physician is aware of any changes.  

Blood Pressure Care at Ridgeline

One of the biggest advantages of living at a Senior Living community is the access to 24 hour nursing.  If you do not feel well, help is there onsite, and available.  Even when it’s not an emergency, having someone there to track your health day after day is an invaluable reward.  If you think you would benefit from such care, please make an appointment for a tour today!