How to Manage Hypertension

In this article...
  • Up to 70% of people age 65 and up have high blood pressure, a dangerous precursor to heart disease. Learn more about hypertension management in older adults.
Home health nurse measures patient's blood pressure

The management of high blood pressure is fairly standard across the lifespan; hypertension management in older adults is essentially the same as it is for any adult.

Aging brings its own special set of health issues, however. Changes occur to the vascular system as the body grows older, causing arteries to stiffen and hypertension to set in.

Hypertension, the clinical term for high blood pressure, affects as many as 70% of adults over age 65. The statistics for high blood pressure, which is a risk factor for cardiovascular disease, are only slated to get worse as the population of aging people grows. For instance, in 2014, 15% of the U.S. population was older than 66 — a figure that will reach 20% by the year 2050, according to the U.S. National Health and Nutrition Examination Survey (NHANES).

How Is Hypertension Diagnosed?

High blood pressure is a tricky condition. You can feel perfectly fine and still suffer from it because not all people with the disease exhibit symptoms. This has led to its reputation as a silent killer. Left unchecked, high blood pressure can result in stroke, kidney failure, heart disease and vision problems. Because so many sufferers are asymptomatic, doctors and medical professionals rely on diagnostic screenings to determine if a person has hypertension.

The American Heart Association and the American College of Cardiology recommend that people over 65 years of age maintain a blood pressure target of no more than 120/80 mmHg. Any readings greater than that establishes the threshold for initiating pharmaceutical intervention, based on the individual’s specific circumstances. Elevated blood pressure is defined as 120-129/80 mmHg or more. This is an indicator of pre-hypertension.

Screenings that regularly show numbers above these levels can be indicative of Stage 1 or Stage 2 hypertension.

  • Stage 1. Readings of 130-139 mmHg systolic and/or 80-89 mmHg diastolic.
  • Stage 2. Readings of greater than 140 mmHg systolic and/or greater than 90 mmHg diastolic.

How Is Hypertension Managed?

Luckily, despite the glum outlook, there are things that can be done to manage hypertension in older adults. Diet and lifestyle changes play a big part in managing high blood pressure and the symptoms it causes while reducing the risk factor for stroke, heart disease and other serious conditions. Individuals diagnosed with hypertension should consider:

  • Reach and maintain a healthy weight
    Losing weight is important if you’re overweight because being overweight can add to your risk for developing heart disease and stroke.

  • Get exercise
    Check with your doctor to make sure you’re healthy enough for your chosen type of exercise, and then, set a goal of getting at least a moderate amount of exercise most every day. Health experts recommend working up to 30 minutes of exercise every day of the week.

  • Watch what you eat
    Many patients have success lowering and managing hypertension by eating the right foods. A diet that includes fruit and veggies, whole grains, lean meats and fat-free dairy is standard fare for hypertension sufferers.

  • Reduce salt
    As the body grows older, it becomes more sensitive to sodium, particularly the sodium found in processed foods like baked goods and soups. To get hypertension under control, be watchful of how many milligrams of sodium are packed into the foods you eat. Make healthier low- or no-salt choices, and consider the DASH diet, a special low-salt diet that has been shown to help reduce blood pressure over time.

  • Skip the alcohol
    Alcohol can have a dramatic effect on your blood pressure. Skip it altogether if possible. If not, limit yourself to no more than one drink per day for women and two drinks per day for men to lower your risks of hypertension.

  • Stop smoking
    If you smoke, stop. It increases your high blood pressure risks and can lead to a variety of negative health outcomes, including stroke, heart disease and cancer of the lung and throat.

  • De-stress
    Find ways of coping with stress to reduce your blood pressure numbers. Guided medication and acupressure may help.

  • Get some sleep
    A good night's sleep facilitates healthy blood pressure levels. If you’ve been made aware that you snore or if your partner fears you may stop breathing at night, you may have sleep apnea. See a health care provider right away.

Once diagnosed with high blood pressure, keep in mind that monitoring and managing your condition is important because it often causes no symptoms. Measure your blood pressure regularly to know your numbers, advises the Centers for Disease Control.

Another important aspect of blood pressure management is managing diabetes if you have it. Around six in 10 people with diabetes also have hypertension. Keep a close watch on your blood glucose levels and keep your numbers under control.

Will I Need Medication for Hypertension?

Most doctors try to avoid placing individuals on blood pressure controlling medications unless it is clear that the condition exists and that it’s not being taken care of through lifestyle medication. There are many kinds of blood pressure medications on the market, and only your doctor can recommend the right one for your particular needs. Blood pressure medicine is useful in controlling blood pressure, but it is not a cure for the problem. Most people who begin taking meds for blood pressure stay on them for the rest of their lives.

There are several ways blood pressure medication works to lower your blood pressure. Some of them cause the body to release excess water and salt, which reduces the amount of fluid your heart must pump throughout the body. Others work by relaxing your blood vessels, letting fluids move without exerting as much pressure on your veins. Others cause the heart to beat with less force than usual, and still others block nerve activity that may be restricting your blood vessels.

If you are prescribed medicine for high blood pressure, take it. Be sure to ask any questions about your medicine or report any side effects to your doctor. Never stop taking prescribed blood pressure medicine without the knowledge and advice of your doctor.

Is Hypertension Preventable?

Living a healthy lifestyle can help you keep your blood pressure numbers at a healthy level, reducing your risk for stroke and heart disease. Eating a healthy diet, controlling salt and getting exercise are important cornerstones in the prevention of hypertension. Avoiding smoking and controlling stress are also important.

Being diagnosed with high blood pressure is never fun. However, the more you know about hypertension management in older adults, the easier it will be to control your condition and live your best life.