High Blood Pressure (Hypertension)
High blood pressure is easy to find and control for most people. So measuring blood pressure regularly is important. Finding and treating high blood pressure can prevent heart attacks, strokes, problems with thinking and memory, kidney disease, eye disease, and other serious problems.
Groups at Higher Risk
- Over 70 percent of people age 60 and older have high blood pressure. About half of them had control over it. For people age 75 and older the percentage of people with high blood pressure is 81 percent for women and 73 percent for men.
- Black people have a higher rate of hypertension than any other racial or ethnic group.
Blood Pressure Measurement
Blood pressure is measured by two numbers. An example of a blood pressure reading is 130 over 90. (It is written out as 130/90 mm Hg).
- The first number measures your blood pressure when your heart squeezes or contracts. This is called systolic pressure.
- The second number measures your blood pressure when your heart rests between contractions, or beats. This is called diastolic pressure.
Blood Pressure Categories
Recommendations for blood pressure levels vary by age and health. In general, the goal for systolic blood pressure is 130 mmHg or lower for most healthy older adults.
Normal blood pressure is less than 120/80 mm Hg. The stages of hypertension are:
- Elevated: Systolic between 120-129 and diastolic less than 80.
- Stage 1: Systolic between 130-139 or diastolic between 80-89.
- Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg.
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120. This requires quick changes in medication, if a person has no other health problems. If a person has signs of organ damage they need to go to the hospital.
Blood Pressure Goal
The person with hypertension and their healthcare professional need to find a blood pressure goal that works. For example:
- Older adults with heart disease or some circulation problems have better outcomes with a lower systolic blood pressure goal of 120 mmHg or less without increasing the risk of falls.
- Frail adults, including residents in long term care facilities, need to avoid lowering their blood pressure too much. This can cause falls and fainting
Among the problems high blood pressure can cause or make worse are:
- Peripheral edema, which is buildup of fluids usually in the ankles, feet, lower legs, hands, arms, and lungs. Buildup can happen because of heart failure or some blood pressure medications.
- Pulmonary edema, which happens when fluid builds up in the lungs because of high blood pressure. People find it difficult to breathe.
- Vascular ulcers, which are skin sores that can appear in the feet, lower legs, or calves. These ulcers may take a long time to heal and can come back often.
- Heart failure, which is the main cause of illness and death associated with hypertension. In older adults, about 70 percent of all heart failure cases are caused by high blood pressure.
- Stroke, which is an interruption of the blood flow to or in the brain. This damages the brain.
- Transient Ischemic Attacks (TIAs), which are sometimes called “mini-strokes.” They occur when the blood flow to part of the brain is briefly interrupted.
- Dementia, which is a loss of brain function. It can cause memory loss, confusion, mood and personality changes, physical disabilities, and difficulty carrying out daily activities. Vascular dementia is second only to Alzheimer’s disease as a cause of dementia in older adults. About half of all cases of vascular dementia are caused by high blood pressure.
- Kidney problems, where high blood pressure causes extra stress on the blood vessels throughout your body, including in the kidneys.
- Chronic anxiety and anxiety medications can raise blood pressure.
Last Updated March 2023
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