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Hypertension in Seniors

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.


Blood Pressure Facts

Blood pressure is actually the force of blood pushing against artery walls as the heart pumps. The blood pressure reading consists of two numbers, which are the systolic blood pressure (pressure due to your heart contracting) and the diastolic blood pressure (pressure when the heart relaxes and fills with blood).

A normal blood pressure for most adults is a systolic pressure of less than 120, and a diastolic pressure of less than 80. An elevated blood pressure has a systolic pressure from 120-129 but a diastolic pressure of less than 80. Hypertension (high blood pressure) is defined as a systolic pressure above 130 and a diastolic of 80 or even higher.

About 95% of those with high blood pressure have primary hypertension, and the rest have secondary hypertension (caused by another identifiable source). For instance, about 8-10% of pregnant women will have high blood pressure during their pregnancy.

Senior citizens often have a systolic pressure of 130 or higher, but the diastolic pressure is less than 80. This is referred to as systolic hypertension, and stiffening of the arteries in older adults causes systolic hypertension. This is the most common form of hypertension in older adults.

High blood pressure may lead to serious health problems if left untreated. It can cause shortness of breath during light physical activity and lightheadedness when standing too quickly and also to falls. Heart disease, a stroke or other medical problem can also occur with untreated hypertension.


Hypertension Statistics

It is estimated that 70% of adults will have hypertension. In the 65 to 74 year old patient the percentage of hypertension is 70.5%, but in the 75-84 age group the percentage of people with high blood pressure increases to 79.9%.

Over the last 30 years the number of people adults aged 30-79 year with hypertension has nearly doubled as of 2022. This is particularly true in low-and middle-income countries, especially in sub-Saharan Africa.

Intensive Blood Pressure Control in Adults Aged 75 Years or Older

Treatment Protocols

he American College of Cardiology and American Heart Association recommended in 2017 that drug treatment should be prescribed for anyone with a blood pressure over 130/80 in order to prevent cardiovascular disease. The targeted blood pressure should be under 140/90 mm Hg. Treatments are always aimed at decreasing the systolic blood pressure, not the diastolic blood pressure.

There are several protocols to estimate the 10-year risk of hypertension. These protocols include: age, cholesterol profile, blood pressure and several other markers. While the risk of hypertension increases with age, the protocols are inaccurate once someone reaches the age of 80 years. However, the guidelines give the physician 2 points to consider:

  • Senior citizens tolerate intensive blood pressure treatment and standard treatments
  • Senior citizens have an improved cardiovascular outcome when their systolic blood pressure is less than 130 mm Hg

The elderly population is also more sensitive to salt intake.


There are several types of medical tests your physician may order in addition to just taking a resting blood pressure. Those tests include:

  • Ambulatory monitoring - 24-hour blood pressure monitoring test
  • Lab test - Blood, urine and cholesterol tests
  • Electrocardiogram (ECG or EKG) - measuring your heart’s electrical activity
  • Echocardiogram - looks for further signs of heart disease
Factors that Impact Blood Pressure

Factors that Impact Blood Pressure


Drug therapy is indicated for resistant hypertension, but it is started at the lowest possible dose. This will gradually increase if necessary. The list of medication types will include a couple of examples of the medication. There is a variety of possible medications including:

  • Angiotensin-converting enzyme (ACE) inhibitors - (Prinivil, Zestril)
  • Angiotensin receptor blockers (ARBs) - candesartan (Atacand), losartan (Cozaar)
  • Calcium Channel Blockers (CCBs) - (Cardizem, Tiazac) - do not eat grapefruit
  • Diuretics (water pills) - (Dyazide, Maxide)

Beta-blocker medications are considered inferior as compared to the above list. However, there are some additional medications that are sometimes ordered.

There are several lifestyle modification that are recommended as first-line treatments, and they include:

  • Weight loss (Ideal normal body weight (BMI, 18.5–24.9 kg/m)
  • Following the Dietary Approaches to Stop Hypertension (DASH)
  • Restricting sodium (salt) intake
  • Limiting alcohol intake
  • Quit smoking
  • Maintain a healthy glucose level for diabetics

Resistant Hypertension

Final Conclusions

If you have hypertension, it is important to see a doctor and get properly treated. When you are on medication it is important to never miss a dose.

Blood pressure cuffs that you can use at home are quite common and not expensive. If you have hypertension it is a good idea to periodically check your blood pressure, particularly when you are starting new medications or if your blood pressure has been unstable.

Blood Pressure Information


This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Pamela Oglesby