Hypertension In The Elderly: Are You At Risk?

Most people believe that high blood pressure is a disease of young people only, but nothing could be further from the truth. As we age, our blood vessels start to stiffen, the body organs start to deteriorate and several disorders start to appear, of which one is hypertension.

In fact high blood pressure is quite common in elderly people and accounts for nearly 7-10 percent of visits to the primary care physician, just behind cold and sinus problems.

These numbers are probably an underestimate because high blood pressure has no symptoms and many elderly patients have no idea that they have this medical disorder.

Traditionally hypertension is said to be present in the elderly when the blood pressure reading reaches 140/90 mmHg. Once high blood pressure develops in seniors it rarely disappears, it is for life. And while it may not have any symptoms, the condition still needs treatment.

The good news is that there are many blood pressure medications that can be used to treat hypertension in elderly people and countless studies have shown that if high blood pressure is treated promptly, then the quality of life is improved and survival is prolonged.

Furthermore, sometimes medication is not required at all, just a healthier lifestyle.


What Are The Symptoms Of High Blood Pressure In Elderly People

In general high blood pressure does not cause any symptoms. However, if the condition is neglected the individual may develop the following:

  • Chest pains
  • Blurred vision
  • Headache
  • Decreased urine production
  • Shortness of breath
  • Fatigue
  • Generalized malaise
  • Poor circulation in the legs
  • Poor exercise endurance

If you start to experience any of these symptoms over a prolonged period of time you should consult your doctor. If left unchecked high blood pressure can result in a stroke, heart attack or even death.


What Causes Hypertension In The Elderly?

The exact cause of high blood pressure in seniors is not known; in fact, in more than 95% of cases, no cause is ever found. This is what is known as essential or primary hypertension.

In about 5% of elderly people the cause of high blood pressure may be related to problems with the kidney, adrenals, the peripheral vascular system or the heart.  This is known as secondary hypertension but the treatment is the same as in primary hypertension.

Not all elderly people develop high blood pressure. Risk factors to be aware of include:

  • Being overweight
  • Having a family history of high blood pressure
  • Eating too much salt in the diet
  • Consuming excess alcohol
  • Not being active
  • Taking certain medications
  • Smoking
  • Having emotional stress


What Are Complications Of High Blood Pressure?

If high blood pressure is not diagnosed or treated it can lead to the following complications:

  • Heart Failure. The heart gets bigger and will eventually fail leading to heart failure.
  • Aneurysm. The blood vessels in the abdomen, chest and brain can balloon and rupture. This is known as aneurysms.
  • Kidney Failure. Blood vessels in the kidney become thick and narrow, eventually leading to kidney damage. When the kidneys fail to make urine, the individual will need dialysis.
  • Amputation. Blood vessels in the legs tend to become narrow and thick which leads to decreased blood supply to the foot and toes. This can lead to amputation of the leg or toes because of lack of blood circulation.
  • Blindness. Blood vessels in the eyes can bleed or burst which can result in vision loss.


How Is A Diagnosis Of Hypertension Made?

Before treatment can begin it is important to make sure that the elderly patient actually has high blood pressure.

In most cases, the healthcare provider will measure the blood pressure at least three different times over a few weeks to confirm that the blood pressure is high. Additionally, you will be asked to record your blood pressure at home and bring the numbers to the doctor.

Traditionally a diagnosis of hypertension is made if the repeated readings are 140/90 mmHg or higher. Measurement of blood pressure is done with a blood pressure gauge and does not take more than a few minutes.


Treatment Of Hypertension In The Elderly

In the past, blood pressure for elderly citizens of 140/90 mmHg was considered to be high, but today there is evidence that it should remain below 120/80 mmHg. As such most healthcare providers now start treatment if the blood pressure is above 120/80 mmHg.

There are many effective medications to treat blood pressure and the type of medication will depend on your response. These medications work right away but have to be taken for life.

Unlike young people, seniors with high blood pressure tend to respond quite well to certain medications. The healthcare provider will start you on the lowest dose of blood pressure medication and monitor you for response.

The dose of the medication is gradually titrated depending on your response. Most elderly people require two or more blood pressure medications.

There are also a number of alternative, non-medical, treatments available. Many health supplements and herbs and spices claim to help lower blood pressure, but it is important that these are not used as a substitute for your regular medications.

Some of the herbs and spices that you can take, in addition to your medications, include cinnamon, cardamom, basil, garlic and flaxseed. It is important to understand that these herbs may only decrease blood pressure slightly and should never replace prescription medications.

Before you use any supplement, speak to your healthcare provider to make sure there are no interactions. Herbs and other supplements are only complimentary therapies.

Once treatment for your high blood pressure begins, you will also be asked to:

  • Eat a healthy diet. This includes low fat dairy products, plenty of fruit and vegetables and cutting down on salt.
  • Exercise regularly. Staying active and performing some type of exercise, even walking, is good for you as long as you do it for 45-60 minutes every day.
  • Give up smoking. Nicotine both raises your blood pressure and increases your heart rate.
  • Cut down on drinking alcohol. While the odd drink is nothing to worry about, three drinks in one sessions has been shown to increase blood pressure and heavy drinking can lead to hypertension.


How To Take Your Blood Pressure At Home

Seniors with high blood pressure should learn to monitor their blood pressure at home. This avoids unnecessary visits to the healthcare provider, is more convenient and it also gives you a guide as to how the medications are working.

Before you measure your blood pressure it is important you do the following:

  • Refrain from drinking caffeinated beverages or alcohol at least 30 minutes before measuring your blood pressure
  • Make sure that you are relaxed, comfortable and do not have to use the bathroom

When taking your blood pressure,

  • Make sure you are sitting straight with your legs uncrossed
  • Measure the blood pressure in the upper arm each time. You will need to roll up your sleeves to do this.
  • Follow the guide on the device which you are using to measure your blood pressure
  • Always take two readings each time so that you know they match.
  • Make it a habit of recording your blood pressure, the time and date.

At least once or twice every year, take the device to the healthcare provider’s office to ensure that the readings are the same as those recorded at the clinic.



Hypertension in the elderly can be effectively managed with medications and changes in lifestyle. Unlike young people, seniors tend to have a much more favorable response to the medications, with a marked improvement in their quality of life.

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