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Hypertension and Aging

Treating High Blood Pressure in Older Adults

iStock 000011669482SmallOne goes to the doctor and finds out that their blood pressure is elevated. What does this mean? Do you need to start taking blood pressure medication immediately? Not necessarily. 

First, a single elevated blood pressure does not signify that someone has high blood pressure.  There are a variety of factors that can lead to a single elevated blood pressure reading:

  • Did you have a cup of coffee that morning?
  • Did you smoke a cigarette?
  • Are you under a lot of stress?

High blood pressure is a serious medical condition which, over the course of time, can lead to heart disease and strokes. These are dangers which occur from blood pressure that is uncontrolled for a number of years. It is definitely important to make an accurate diagnosis of high blood pressure. Your doctor should check your blood pressure at least two or three times over the course of two to three months before making a diagnosis and starting you on medical treatment.

As noted above, some of the things that can raise blood pressure include caffeine, cigarettes and stress. Reducing your intake of caffeine and stopping smoking are immediate priorities. Stress reduction is an important part of the initial treatment. Most people are familiar with the need for reduction in salt intake and weight loss if you are overweight. Exercise is also beneficial in the management of hypertension. One should speak with their physician about beginning a regular exercise program.

Aging does not reduce the need for treatment of high blood pressure. Recent studies suggest that treatment of older adults with high blood pressure can be of benefit. On the other hand, over treatment of high blood pressure can also cause problems by lowering the blood pressure too much and causing decreased blood flow to the brain, for example. Thus, there is definite reason for some amount of caution as one initiates the treatment of hypertension with medications.

If one has been on medications for a number of years and their blood pressure remains normal, it is actually possible to reduce medication use. In fact, sometimes medications can be stopped completely. Up to fifty percent of people with normal blood pressure who have their medications stopped, are still able to be off of medications after one year.

Another difficult area in hypertension control is for people with blood pressures that are difficult to manage. Their blood pressure may range from the low to the high range at any given time. This can be an indications of a number of disease processes which make the blood pressure difficult to control. It can also be an indication of what is called by some as ‘pseudohypertension’. This is a condition where the blood vessels are too stiff for accurate blood pressure readings. This should always be considered when multiple medications have no major impact on the blood pressure reading and the patient is suffering from side effects from the medications such as lethargy and dizziness.

Overall, it is clear that diagnosing and treating high blood pressure are very important. On the other hand, a balanced approach to treatment is necessary in the older person.

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