Hypertension: What You Need to Know as You Age

Hypertension: What You Need to Know as You Age


You can’t see high blood pressure, also called hypertension. And most of the time, you can’t feel it. But if you’re among the 78 million Americans with hypertension or are one of the 70 million with prehypertension (higher-than-healthy blood pressure levels), it’s important to understand its effects on your health—and to take action today to bring your numbers down to healthier levels.

Blood pressure is the force of blood against the inner walls of your arteries. It has normal fluctuations throughout the day—falling when you’re relaxed or asleep, rising naturally in the morning, and increasing temporarily when you’re under stress, excited or exercising. But when your resting blood pressure level rises too high, it can scar, stiffen and/or weaken blood vessels. 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

You may be at an increased risk for high blood pressure if you smoke, are overweight, eat a diet that’s low on produce and fiber and/or high in fat and salt, drink alcohol to excess, live with chronic stress or don’t get much physical activity. Some causes of hypertension cannot be controlled—including your genes and your race (African-Americans are at a higher risk). Aging also plays a role. Even if you do not have hypertension by age 55 to 65, your lifetime risk for developing it is a whopping 90 percent.

“But doctors no longer consider hypertension inevitable or untreatable with age,” says Samuel Durso, M.D., director of the Division of Geriatric Medicine and Gerontology at Johns Hopkins. In one Johns Hopkins study of 975 older women and men with hypertension, healthy lifestyle steps helped 40 percent stop taking blood pressure medications. Other research has shown that lifestyle changes can lower the risk for hypertension in African-Americans and others at an increased genetic risk.


Blood vessels (veh-suls): The system of flexible tubes—arteries, capillaries and veins—that carries blood through the body. Oxygen and nutrients are delivered by arteries to tiny, thin-walled capillaries that feed them to cells and pick up waste material, including carbon dioxide. Capillaries pass the waste to veins, which take the blood back to the heart and lungs.
Dementia (di-men-sha): A loss of brain function that can be caused by a variety of disorders affecting the brain. Symptoms include forgetfulness, impaired thinking and judgment, personality changes, agitation and loss of emotional control. Alzheimer’s disease, Huntington’s disease and inadequate blood flow to the brain can all cause dementia. Most types of dementia are irreversible.
Diastolic (die-uh-stah-lick) blood pressure: The second, or bottom, number in a blood pressure reading. Diastolic blood pressure measures the force of blood in the arteries when the heart is relaxed between beats. A healthy reading is usually below 80 mm Hg. Higher readings may indicate that you have high blood pressure or are at risk for developing it.
Heart failure: When the heart cannot supply as much blood as the body needs, because it cannot fill completely or cannot pump with enough force. Diabetes, high blood pressure, heart disease and heart valve problems can cause heart failure. Heart failure does not mean the heart is about to stop. Medications and lifestyle changes can reduce symptoms.
Peripheral artery disease (puh-rif-er-uhl ahr-tah-ree dih-zeez): A build-up of fat and cholesterol deposits called plaque in arteries in your legs, arms, head or internal organs. This reduces blood flow, causing pain, numbness and a heavy, aching sensation when walking or climbing stairs. Peripheral artery disease can increase the risk for slow-healing infections, too. Treatments include quitting smoking and controlling blood pressure, cholesterol and blood sugar.
Saturated fat: A type of fat found in abundance in butter, whole milk, ice cream, full-fat cheese, fatty meats, poultry skin, and palm and coconut oils. Saturated fat raises levels of heart-threatening LDL cholesterol in your bloodstream. It can also interfere with your body’s ability to absorb blood sugar easily. Limiting saturated fat can help control your risk for heart disease.
Sympathetic nervous system: The system that produces the “fight or flight” response and prepares you for stress or an emergency. It’s responsible for readying the body for action: increasing the heart rate, breathing rate and alertness. The body’s parasympathetic nervous system does the opposite. It slows heart and breathing rate, bringing on a sense of relaxation.
Systolic (sis-tall-ick) blood pressure: The top, or first, number in a blood pressure reading. Systolic blood pressure is the pressure in the arteries during a heartbeat. For most people, a healthy systolic blood pressure reading is below 120 mm Hg. Rising systolic blood pressure may indicate that arteries are becoming stiff or that there’s a build-up of plaque.

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