You are probably used to checking your blood pressure. Did you know that in 2017 the American College of Cardiology (ACC) and the American Heart Association (AHA) issued new hypertension guidelines based on the latest science? They are the most significant change yet in these guidelines.
Nearly half of American adults, 46 percent, will be determined to have hypertension under these new clinical guidelines, up from 32 percent under the old benchmark. Previously, high blood pressure was defined as BP readings persistently at or above 140 mm Hg systolic or 90 mm Hg diastolic but is now defined as persistently at or above 130/80 mm Hg.
This new guideline does not mean these newly classified patients with hypertension will face dramatic new risks or that physicians need to immediately begin medication treatment for most. The guideline is meant to prevent strokes, heart attacks and other cardiac problems through earlier action—a combination of lifestyle changes for all these patients, and medications for some, depending on the circumstances—to control high Blood Pressure.
| Blood pressure categories for adults 65+ | Systolic mm Hg | Diastolic mm Hg |
| Low blood pressure | 90 or lower | 60 or lower |
| Normal blood pressure | Lower than 120 | Lower than 80 |
| Elevated blood pressure | 120-129 | Lower than 80 |
| High blood pressure stage 1 (severe) | 130-139 | 80-89 |
| High blood pressure stage 2 (more severe) | 140 or higher | 90 or higher |
| High blood pressure crisis (see your doctor immediately) | 180 or higher | 120 or higher |
If you are over 65 years of age, it is more important than ever that you should know and understand your blood pressure. You should know that blood pressure is measured in two numbers: systolic and diastolic. The top number is the systolic blood pressure, which measures the pressure caused by the heart contracting and squeezing out blood. The bottom number is diastolic blood pressure, which measures the pressure when the heart relaxes and fills with blood. The abbreviation mm Hg stands for millimeters of mercury, the chemical element used in the first accurate blood pressure gauges.
If your blood pressure falls within a normal range of 91/61 mm Hg to 119/79 mm Hg, you should maintain your healthy habits.
Older adults whose blood pressure is elevated but lower than 130/80 mm Hg can usually help regulate their blood pressure through lifestyle changes such as increasing physical activity, eating a heart-healthy diet that’s low in salt, and limiting alcohol.
This change aims to reduce the risk of heart disease in older adults. However, your doctor will assess your overall health and any other conditions before determining the best course of action to help you or your aging parent control their blood pressure.
Because blood pressure tends to increase with age, and doctors don’t completely understand why, some medical societies disagree about the effectiveness and safety of treating older adults for high blood pressure.
Blood pressure is the force of blood as it flows through the arteries. As you age, your arteries may narrow and become stiff. Narrow arteries lead to an increase in blood pressure. High blood pressure can damage the walls of the arteries and the heart itself.
In some cases, high blood pressure could be a result of lifestyle, the environment, certain medications, or other conditions such as sleep apnea, kidney disease, or thyroid problems.
As you help monitor your blood pressure, keep in mind that if numbers fluctuate slightly throughout the day, that’s normal. Several factors influence your blood pressure numbers. For example, your blood pressure may be lower if you’re resting and higher if you’re stressed. This means you may have a normal reading in the morning and an elevated reading in the afternoon.
If you’re concerned about excessive fluctuation in your blood pressure numbers, keep the following tips in mind:
Read the instructions on your home blood pressure monitor to ensure you’re using the equipment correctly. Variations in how you measure your blood pressure can result in different readings.
Bring your home monitor to your next doctor’s appointment to compare readings. Many pharmacies can also calibrate home blood pressure monitors.
Be aware of white coat hypertension. In some cases, a person’s blood pressure may be high at a doctor’s office but normal at home. This could be attributed to the stress related to a doctor’s appointment.
Your doctor may want you to keep a blood pressure diary with several readings a day for a couple of weeks to monitor any variations.
Maintaining healthy blood pressure doesn’t have to be complicated. Simple lifestyle changes can help:
Exercising. National guidelines recommend adults of all ages engage in at least 150 minutes of moderate physical activity each week. This might include walking, outdoor chores, or weight training. If mobility or health conditions are a problem, older adults should try to be as physically active as possible.
Losing weight. If you are overweight, every 2 pounds lost can help reduce blood pressure by 1 mm Hg.
Eating a heart-healthy diet low in salt. The DASH diet is rich in fruits, vegetables, whole grains, poultry, fish, and low-fat dairy foods. It was designed specifically to help lower blood pressure. Try to limit sodium to no more than 2,300 milligrams per day.
Avoiding alcohol. Drinking alcohol can raise your blood pressure. If you choose to drink alcohol, limit it to no more than one drink a day for women and up to two drinks a day for men.
Not smoking. Tobacco damages your artery walls. If you smoke, find out how you can help them quit by asking their doctor.
Managing stress. Try simple relaxation techniques, such as deep breathing exercises or meditation.
You can help an older relative take an active role in lowering their blood pressure with simple lifestyle changes such as increasing physical activity and eating healthy, balanced meals. If your aging parent lives in an assisted living community, ask about exercise programs and meal options that are low in sodium. But if changes in lifestyle don’t help, prescription medications have proven very effective in lowering blood pressure.
In some cases, diet and lifestyle changes aren’t enough to lower blood pressure. You may have a difficult time achieving significant changes in their lifestyle, or their hypertension may be too severe to treat with diet and exercise alone.
Several types of medication are available to treat high blood pressure. Talk to your doctor about whether a combination of medication, diet, and lifestyle changes may help control their blood pressure.
Above all be aware of the new target blood pressure numbers for your age and take your blood pressure regularly.