Hypertension: What You Should Know As You Get Older

High blood pressure, also known as hypertension, cannot be seen. And most of the time, you don’t even notice it. However, if you are one of the 78 million Americans who have hypertension or one of the 70 million who have prehypertension (higher-than-healthy blood pressure levels), you must understand its effects on your health and take action today to lower your numbers to healthier levels.
The force of blood against the inner walls of your arteries is referred to as blood pressure. It fluctuates naturally throughout the day, falling when you’re relaxed or asleep, rising naturally in the morning, and temporarily increasing when you’re stressed, excited, or exercising. When your resting blood pressure rises too high, your blood vessels can scar, stiffen, and/or weaken. This effect can double your risk for a heart attack; quadruple your odds for a stroke; raise your risk for heart failure, vision loss, kidney problems, dementia, and circulation problems such as peripheral artery disease (which causes pain in your legs); weaken your bones, and contribute to erectile dysfunction in men.

Causes and Risk Factors

If you smoke, are overweight, eat a diet low in produce and fiber and/or high in fat and salt, drink alcohol excessively, live with chronic stress, or don’t get enough physical activity, you may be at a higher risk for high blood pressure. Some causes of hypertension are uncontrollable, such as your genes and race (African-Americans are at higher risk). Aging also has an impact. Even if you do not have hypertension by the age of 55 to 65, your lifetime risk is a whopping 90%.
“However,” says Samuel Dunhen, M.D., director of the Division of Geriatric Medicine and Gerontology, “doctors no longer consider hypertension inevitable or untreatable with age.”

Prevention

A healthy lifestyle is an effective defense against high blood pressure and its harmful effects. These steps can help lower your risk of developing prehypertension or hypertension, as well as help lower your numbers if you already have prehypertension or hypertension.

Lose a few pounds. Excess weight, particularly abdominal fat, can raise blood pressure by increasing blood volume and altering the balance of pressure-regulating hormones. Even modest weight loss can make a world of difference, citing research that shows losing 7.7 pounds can cut your risk of high blood pressure by half or more.

Reduce your alcohol consumption. Moderating alcohol consumption is critical. Cut back if you are a man who has more than two drinks per day or a woman who has more than one drink per day. While a small amount of alcohol may relax arteries, excessive amounts appear to have the opposite effect.

Move around more. Exercise and other forms of physical activity help to keep arteries flexible while also decreasing sympathetic nervous system activity, which can tighten blood vessels and raise blood pressure. According to the American Heart Association, if you already have high blood pressure, regular exercise can reduce it by 8 to 10 points.

Maintain healthy blood pressure. Calcium, magnesium, and potassium (found in low-fat and fat-free dairy products such as milk and yogurt, as well as produce and dried beans) aid in blood pressure regulation. Too little can cause your blood pressure to rise. High levels of sodium, which are found in many processed foods, can also cause your body to retain water (which increases blood volume) and even tighten small blood vessels. Saturated fat (found in meat, cheese, butter, full-fat dairy products, and many processed foods) has been linked to an increase in blood pressure.

Stop smoking. Cigarette smoking causes artery damage and increases the risk of heart disease. While you’re smoking, the chemicals in tobacco products raise your blood pressure.

Relieve stress. It is unclear whether mind-body therapies have a long-term effect or reduce the risk of high blood pressure, but it is known that the body’s stress response releases hormones that temporarily raise blood pressure. If you regularly practice a stress-relieving technique such as breathing exercises, progressive relaxation, or fitness activities, you will feel better and find it easier to make other healthy changes. Meditation, for example, has been shown to lower the risk of heart attacks and strokes in people with high blood pressure.

Diagnosis & Treatment

Your doctor will most likely recommend healthy lifestyle changes, medication, or both to bring your high blood pressure down to a healthy level. The decision to start blood pressure medication, as well as the amount and type prescribed by your doctor, will be determined by the severity of your hypertension. If you have prehypertension or have mildly elevated blood pressure, lifestyle changes may be the first step. Losing 5% to 10% of your body weight, lowering your sodium intake, improving your diet, and exercising regularly will usually result in a reduction in your blood pressure. If your blood pressure is higher, your doctor will still advise you to make these changes in addition to taking blood pressure medication.

Blood pressure medications are classified into six types:

• Diuretics work by helping the body eliminate extra water and sodium.
• Beta-blockers reduce your heart rate and output of blood, which lowers blood pressure.
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• Vasodilators, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and calcium-channel blockers work by relaxing constricted blood vessels.

Your doctor will determine which medications are best for you. Doctors frequently prescribe multiple medications to control blood pressure. To lower your blood pressure, you may need medications that work on multiple mechanisms. Alternatively, by combining two or three medications, your doctor may be able to give you lower medication doses while reducing the likelihood of side effects.

There are two critical things you should know about your treatment:

Your doctor may gradually increase your dose. It may take a month to six weeks to reduce your blood pressure by gradually increasing your medication doses. Too quickly lowering blood pressure can cause dizziness and increase the risk of falling.

Please report any side effects. Do not discontinue medications on your own. Call or make an appointment with your doctor to discuss any side effects you are experiencing. He or she may be able to make changes or change your medication. Tiredness, cold hands and feet, impotence, depression, sleep problems, heartbeat changes, and a dry cough are all possible side effects.

Living With

Symptoms of high blood pressure are not always present. This can make it difficult to stick to healthy lifestyle changes and medication—you may not notice a difference. These steps can help you maintain your commitment to daily blood pressure control:

Invest in a medication reminder system. Use whatever reminder system works best for you, whether it’s a daily pill dispenser, electronic pill bottles that beep when it’s time for your next dose or a note on your refrigerator. One in every two hypertensive people does not take their medications as prescribed, which increases your risk of heart disease, stroke, and other health problems.

Watch at home. You are the most vital member of your blood pressure management team. A home blood pressure monitor will allow you to see if your medications and lifestyle changes are working and will keep you on track. Monitors are available at pharmacies for a reasonable price.

Consult your doctor as directed. For the first few years after your diagnosis, your doctor may want to see you every three to four months to ensure that your medications and lifestyle changes are working and to make adjustments. A checkup every six months may be sufficient for someone whose high blood pressure is well-managed and who monitors at home. If your blood pressure is normal and you do not require medication, you may only need to keep an eye out.

Keep an eye out for lows and highs. Blood pressure medications can sometimes cause your blood pressure to drop too low. Contact your doctor if you experience symptoms of low blood pressure such as dizziness, fainting, blurred vision, or nausea. If your systolic (top) blood pressure rises to 180 or higher, or your diastolic (bottom) blood pressure rises to 110 or higher, seek immediate medical attention.

For Caregivers
Here’s how you can help if you’re a partner or caregiver to someone who has high blood pressure.

Inquire about how you can help with medications. You can provide “medication time” reminders and assist your loved one in taking prescribed medications as needed.

Encourage healthy endeavors. Cheerleading a new habit can motivate your loved one to keep it up. Trying to control behavior, on the other hand, can backfire. If your loved one is not making healthy changes, find out how you can assist.

Get healthier as a group. Couples who commit to losing weight and exercising together are more likely to succeed. Upgrading your habits together can be motivating, create some healthy competition, and is also more convenient because you can both eat the same foods and set the same exercise schedule.

This blog is not an exhaustive list of suggestions to hypertension at bay but suggestive of the measures to be taken when aging starts.