Avoiding High Blood Pressure

How to Keep Hypertension Under Control as We Age

Controlling blood pressure, known as “the silent killer” among medical professionals, is essential to healthy aging. Untreated, this condition can lead to many serious health problems, including heart disease, stroke, eye problems, and kidney disease. And, according to the CDC, high blood pressure can have few physical symptoms, leaving many unaware, undiagnosed, and untreated. But must we suffer from high blood pressure as we age? And is medication to control it always necessary?

High Blood Pressure: An Inevitable Part of Aging?

The American Heart Association (AHA) tells us that about half of all adults in the US have high blood pressure, also known as hypertension. With each decade of life, the likelihood of developing hypertension increases. The percentage of hypertension among women in their 20s and early 30s is about 13% and about 26% for men in the same age group. With time, those numbers rise to almost 86% of women and 80% of men in the US suffering from high blood pressure by the time they are in their mid-70s.

This data clearly illustrates that high blood pressure is common among older Americans—but does this mean that developing the condition is unavoidable? According to Samuel Durso, MD, director of the Division of Geriatric Medicine and Gerontology at Johns Hopkins, “Doctors no longer consider hypertension inevitable or untreatable with age.” And prevention is all about making smart lifestyle choices.

What is High Blood Pressure?

According to the National Institute on Aging, hypertension occurs when the vascular system, or the network of pathways transporting blood through our bodies, changes as we age, becoming less resilient, meaning they are more stiff and less able to expand and contract.

A medical device called a sphygmomanometer, or blood pressure gauge, was the long-time “gold standard” in measuring blood pressure readings. Concern over the presence of mercury in the measuring column has led to the use of electronic alternatives, with some remaining controversy regarding their reliability.

Understanding and Categorizing Blood Pressure Readings

Blood pressure readings measure the force of blood pumped by the heart as the blood pushes against the walls of blood vessels and consist of two numbers expressed as a fraction. The first number, which is higher, is called systolic blood pressure and measures arterial pressure as the heart pumps blood during a heartbeat. The second number, called diastolic blood pressure, is lower and measures pressure as the heart relaxes between beats. A systolic (heart pumping) blood pressure reading of 130 or higher or a diastolic (heart resting) reading of 80 or greater indicates high blood pressure.

According to Francisco Lopez-Jiminez, MD, of the Mayo Clinic, an elevated systolic reading and a normal diastolic reading can indicate a type of high blood pressure called “isolated systolic hypertension,” and is the most common type of high blood pressure in older adults.

Less common is “isolated diastolic hypertension,” which occurs when the lower, or diastolic, number is high but the systolic number is within the normal range. Blood pressure specialist Dr. Stephen Juraschek explains in the Harvard Health article “A Look at Diastolic Blood Pressure,” that diastolic pressure helps coronary vessels supply oxygen to the heart muscle; therefore, elevation in either systolic or diastolic readings indicates high blood pressure.

A High Blood Pressure Culprit: Sodium

Yes, aging is a risk factor for developing hypertension. But the link between sodium (salt) consumption and high blood pressure is also well documented. The World Health Organization (WHO) defines excessive salt consumption as more than five grams per day; however, many other guidelines suggest less than two grams–and many consumers, unaware of the sodium levels in food products, are ingesting well in excess of recommended levels.

Sodium consumption is problematic because it causes the body to retain fluid, increasing the volume of fluid in the body and therefore the pressure against artery walls, explains Johns Hopkins Medicine.

According to the Mayo Clinic, even a small reduction in sodium can result in significant improvements in blood pressure and heart health, information confirmed by multiple scholarly sources, such as the National Library of Medicine, the National Institutes of Health (NIH), and the American Heart Association (AHA).

A Johns Hopkins Health article entitled Hypertension: What You Need to Know as You Age notes that staged healthy lifestyle changes enabled 40% of the nearly 1,000 men and women with hypertension participating in a study to stop taking blood pressure medication.

According to the Mayo Clinic, lifestyle changes play a critical role and can prevent, delay, lessen, or even eliminate the need for medication. Similarly, a 2021 article in The American Journal of Hypertension entitled Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication notes that lifestyle changes can eliminate the need for medication, particularly for those patients with mildly elevated blood pressure.

Other Ways to Reduce the Need for Medication

Focus on Healthy Eating: a diet low in sodium and saturated fat and high in potassium, fiber, protein, and fresh fruits and vegetables is recommended. Introduced in 1997 by the National Heart Lung and Blood Institute, a division of the NIH, DASH (Dietary Approaches to Stop Hypertension) is a flexible, heart-healthy eating plan focused on including healthy foods and eliminated or reducing the intake of unhealthy foods. Scholarly research by many well-respected institutions since the diet’s introduction supports its efficacy not only for controlling hypertension but also for lowering cholesterol and controlling weight.

Maintain a Healthy Weight: being overweight or obese increases the risk of high blood pressure

Prioritize Physical Activity: the CDC recommends getting about 33 minutes of moderate exercise five days per week to help with weight control and lowering blood pressure

Avoid Smoking: smoking increases blood pressure and the risk of heart disease

Drink Alcohol in Moderation: alcohol consumption can raise blood pressure and interfere with the effectiveness of blood pressure medication

Strive for Quality Sleep: ongoing poor sleep quality can contribute to high blood pressure; treating sleep apnea and other conditions that interrupt sleep can improve sleep quality, blood pressure, and overall health

Manage Stress: finding healthy ways (yoga or tai chi, gratitude journal, avoiding situations that trigger stress) to reduce stressors and chronic, or long-term, stress may help control blood pressure

Of course, your doctor is the best place to start for more information on avoiding or reducing high blood pressure. Since race, family history, and gender are factors affecting high blood pressure in addition to age, your doctor will be the source of personalized medical information.

An International Perspective

According to the NIH, an aging global population and the increased popularity of unhealthy dietary choices has created a high blood pressure epidemic the WHO calls a “significant global health concern.” The medical journal The Lancet notes that more than a billion people worldwide suffer from high blood pressure—and the number of people with high blood pressure has doubled over the past 30 years.

Canada, says the NIH, has initiated a well-organized campaign to reduce sodium additives in food in a coordinated effort to both decrease the prevalence of hypertension and improve blood pressure control. The WHO notes that Switzerland, Peru, Taiwan, Spain, and Japan also have low rates of hypertension, all with rates just below or slightly above 20% compared to an overall rate of nearly 48% in the US, according to the CDC.

Why are some countries better than others at controlling the “silent killer”? The answer lies in healthier living choices and opportunities, including lower-sodium diets, regular physical activity, and better access to quality healthcare, explains the NIH.

Where and How We Live Makes a Difference

Clearly, the area in which we live and the lifestyle decisions we make affect our health, wellbeing, and aging process. Controlling blood pressure involves a multitude of factors, all of which can be addressed by living in a community providing access to fresh, healthy food, clean air and water, opportunities to exercise, socialize, and reduce stress, and superior health care.

Come explore Plymouth Harbor and learn more about this extraordinary community where the health and wellbeing of residents is an everyday commitment. Call 941-361-7512 to schedule your private tour and discover why life truly is better on Sarasota Bay!