High blood pressure, also called hypertension, is a very common health issue. Anyone can have high blood pressure, but the risk rises with age. About 72% of adults aged 60 and over have high blood pressure. 

Keep reading to learn more about hypertension in seniors. We’ll cover what causes it, what to look out for, ways you can lower your risks, and how to manage high blood pressure.

What is high blood pressure?

High blood pressure (or hypertension) happens when the blood in your body pushes too hard against the walls of your arteries (tubes that transport blood). This means your heart needs to work harder to move blood around your body. 

A blood pressure measurement is made up of two numbers:

• Systolic blood pressure is the top number. It measures the pressure of your blood against your artery walls when your heart is beating.
• Diastolic blood pressure is the bottom number. It measures the pressure of your blood against artery walls when your heart is resting between beats. 

Taking your blood pressure is a routine part of most health care appointments. You can also check your blood pressure at home using an at-home cuff. 

Blood pressure categories

The American College of Cardiology says blood pressure readings fall into 4 categories. The numbers below are used to label blood pressure numbers for large groups of adults, but remember that everyone is different. What’s “normal” and “elevated” for you will depend on your typical blood pressure readings. 

Normal

• Top number: Under 120 
• Bottom number: Under 80

Elevated

• Top number: 120-129 
• Bottom number: Under 80

Stage 1 hypertension

• Top number: 130-139
• Bottom number: 80-89

Stage 2 hypertension

• Top number: 140 or above
• Bottom number: 90 or above

Hypertensive crisis

• Top number: 180 or above
• Bottom number: 120 or above

If you see numbers this high, wait one minute, then take another reading. If the numbers stay high during that second reading, get medical attention right away.

Your blood pressure naturally rises and lowers throughout the day, so one high reading isn’t enough to make a diagnosis.

Bold provider Dr. Mitul Desai, MD, says that blood pressure variability (BPV) is another issue to look out for. “BPV is defined as significant sudden drops or spikes in blood pressure that may be temporary over hours, days, or months,” Dr. Desai explains. “BPV has been recognized as a risk factor for heart disease, cognitive decline, and other long-term health conditions.”

When monitoring your blood pressure at home, Dr. Desai suggests measuring your blood pressure twice a day (in the morning and evening) for at least 5-7 days in a row. “If you see dramatic, consistent fluctuations in your blood pressure, discuss this with your doctor for further recommendations.” 

Two specific blood pressure problems seniors should know about:

1. Isolated systolic hypertension in seniors. This is when your top blood pressure number is 130 or higher, but the bottom blood pressure number is 80 or lower. . About 30% of people over 60 have this condition. It happens because our arteries get stiffer as we age, and it raises the risk of other heart disease. 
2. Orthostatic hypotension in seniors, also called postural hypotension. This is a form of low blood pressure that happens when you stand up after sitting or lying down. It can cause dizziness, feeling lightheaded, and sometimes fainting or falling. It’s important for seniors to know about because it can make you more likely to fall. 

About 10% of people with high blood pressure also have orthostatic hypotension. If you sometimes feel lightheaded or “see stars” when you stand up, check in with your doctor to see if blood pressure changes could be causing this and talk about options for treatment. A few other tips:

• Take your time when you move from lying down to sitting up or standing.
• Consider using the back of a study chair or a wall for support when you stand up.
• Drink plenty of water.

What are the symptoms of hypertension in seniors?

Most people with high blood pressure don’t have any symptoms. They only know they have it due to regular blood pressure readings.

“Symptoms of high blood pressure can look like the symptoms of stroke or a cardiac (heart) event,” Dr. Desai says.

When blood pressure spikes dangerously high, it can cause:

• Sudden headaches
• Confusion
• Dizziness
• Blurry vision
• Chest pain
• Shortness of breath
• Weakness or numbness on one side of the body

If you have these symptoms, Dr. Desai says you need to get medical attention to determine what may be going on. She stresses that high blood pressure symptoms can often be treated and long-term damage is often preventable.

Is hypertension in seniors connected to other health issues?

Health problems like diabetes and kidney disease are risk factors for high blood pressure. But remember, risk factors only mean that you’re more likely to have high blood pressure, and not that you’ll definitely get it. 

Some health problems increase your risk of getting high blood pressure:

• Diabetes. The CDC explains that about 60% of people living with diabetes also have high blood pressure. When you have diabetes, levels of glucose (blood sugar) build up in your blood. This can damage your blood vessels and kidneys over time, leading to high blood pressure.  
• Kidney disease. Your kidneys help manage fluid levels in your body. If your kidneys can’t properly remove sodium and extra fluid from the body, that can raise your blood volume and your blood pressure.
• High cholesterol. Cholesterol builds up in your arteries, making them stiff and narrow. This makes it harder for blood to move through them, increasing your blood pressure.

Untreated hypertension in seniors can also raise your risk of other health problems. A few health problems caused by high blood pressure:

• Vision problems. High blood pressure can damage the blood vessels in your eyes or cause nerve damage that affects your optic (eye) nerves. If you know you have high blood pressure, your health care team will closely watch your eye health. 
• Heart health problems. High blood pressure can lead to blocked arteries and put extra strain on the heart. This can lead to heart disease or sometimes heart failure. 
• Kidney disease. High blood pressure can damage the arteries around your kidneys. This can prevent your kidneys from working properly. 
• Brain health issues. High blood pressure is linked to a higher risk of stroke and cognitive impairment. 
• Frailty. Frailty is what happens when your body has a hard time recovering  after injury or illness. Research shows that hypertension can cause frailty because it causes cardiovascular complications (heart problems). 

“Heart health problems lead to muscle loss, fatigue, and lower physical activity,” Dr. Desai explains. “This accelerates frailty, which is characterized by muscle weakness, fatigue, low activity levels, and slow walking speed. Addressing heart health risk factors like high blood pressure, high cholesterol, and sedentary lifestyle, can help to prevent or delay the onset of frailty.”

Frailty affects your energy levels, muscle tone, stamina, and speed. This can make it harder for you to do everyday things like walking, bathing, or doing chores.

What lifestyle factors are connected to hypertension in seniors?

How you move, eat, sleep, and treat your body all play a role in your health.

Here are some lifestyle factors connected to high blood pressure, and ideas for how to change them:

Physical activity

A sedentary lifestyle (spending a lot of time sitting) is linked to high blood pressure. “The heart is a muscle and regular exercise leads to a stronger heart,” Dr. Desai says. “A strong heart pumps blood more efficiently and improves the function of arteries. Physical activity lowers the risk of stroke and overall cardiovascular disease by about 20-30%. Consistent physical activity is important for preventing, treating, and controlling high blood pressure.”

It’s never too late to start an exercise routine. Bold has hundreds of online exercise classes which you can take anytime, anywhere.

Regular aerobic (cardio) exercise is one proven way to lower your blood pressure. The Physical Activity Guidelines for Americans suggests the following for adults over 65:

• At least 150 minutes per week of moderate-intensity aerobic activity. This means your heart is beating faster, you’re breathing faster, and you might start sweating.
• At least 2 days a week of a muscle-strengthening activity 
• A mix of activities to help improve balance

Try to find activities you enjoy! Some ideas for moderate-intensity aerobic activity for seniors:

• Walking fast
• Fast-paced yoga
• Riding a bike, indoors or outdoors
• Yard work
• Dancing
• Water aerobics
• Hiking

Research shows that isometric exercise can also help lower blood pressure. During isometric exercise, you tighten (contract) a muscle group or muscle without moving your joints. 

• Examples of isometric exercises for seniors: Calf raises, glute squeezes, wall planks, or holding a squat.

Studies also show that resistance training can lower blood pressure in seniors. During resistance training, you challenge your muscles by making them work against a weight or force. 

• Examples of resistance training exercises for seniors: Bodyweight squats or calf raises, weight training exercises like bicep curls, or exercises using a resistance band.

Bold has classes for every fitness level, whether you’re interested in chair exercise classes for seniors, Tai Chi, and more. We make it easy to exercise safely and comfortably from home, giving you all the physical and mental health benefits of exercise for seniors. 

Other things you can focus on that impact your blood pressure

Sleep

Regularly sleeping less than 6 hours a night is linked to high blood pressure. To get better sleep, you could try following a regular sleep routine or cutting down on screen time at night. Check out our guide on how seniors can get better sleep. 

Weight

A higher body weight can raise your blood pressure, because your heart needs to work harder to move blood around your body. Your Bold Care team might suggest weight loss to help you manage your blood pressure. Learn more about weight management for seniors here. 

Nutrition

High-calorie diets and diets high in sodium (salt), saturated fats, trans fats, and sugar can raise blood pressure. Following the DASH (Dietary Approaches to Stop Hypertension) eating plan can help you manage your blood pressure. 

• Prioritize: Fruits, vegetables, whole grains, fish, poultry, seeds, beans, and low-fat or fat-free dairy. 
• Limit: Full-fat dairy, fatty meats, high sodium (salt) intake, and foods high in added sugar. 

Check out our resource on nutrition information for seniors for more information. 

Alcohol use

Blood pressure rises in the short term when you have more than three alcoholic drinks in one sitting. Long-term alcohol use can raise your baseline blood pressure levels over time. Remember, there’s no completely safe amount of alcohol to drink. Learn more: How seniors can cut back on alcohol.

Tobacco use

Smoking increases your risk of plaque buildup inside the arteries (atherosclerosis). This buildup can narrow your arteries, raising blood pressure. It’s never too late to stop smoking, and the health benefits of quitting start right away. We’re here to support you. Check out our resource on how seniors can quit smoking. 

Stress

High stress can cause your blood pressure to spike. To lower your stress levels, try to find accessible ways to practice self-care as you age. Ideas range from meditating to spending time in nature to interacting with pets. Mindfulness practices may help lower your blood pressure. You can check out our Bold yoga classes, try Tai Chi, or look for breathing exercises. 

Medication for hypertension in seniors

Because everyone is different, some people may be able to manage their blood pressure with lifestyle changes, and other people might need to take medication. You can talk about medication with your Bold Care team. 

One thing you should know: Some blood pressure medications can raise your risk of falling. That's why it's important to keep any health care provider you work with informed on the medications you're currently using. They can help you manage any additional unintended risks, including falls considerations

Your top questions about hypertension in seniors, answered. 

Question: What’s the best time to check my blood pressure?

Answer: If your doctor wants you to track your blood pressure at home, they might ask you to do it twice a day. Once in the morning (before you eat or take any medicine), and again in the evening. Your Bold Care team may ask you to take your readings at the same time each day and keep a diary of the numbers. 

Question: Can hypertension in seniors be genetic?

Answer: Yes, there are some genetic conditions that cause hypertension. If high blood pressure runs in your family, you may be more likely to have it too. But remember, it’s not a sure thing, and there are ways to prevent and manage high blood pressure. 

Question: What are the best treatment options for hypertension in seniors?

Answer: Making lifestyle changes can help you manage high blood pressure. That’s why the American Heart Association says lifestyle medicine is the first line of treatment for high blood pressure: Changing your habits can make a difference. 

Question: How can I talk to my doctor about high blood pressure?

Answer: If you have high blood pressure, your doctor may ask you to track it at home and keep a diary of the readings. Bring this diary to your health care appointments so your care team knows what’s going on with you. 

Question: Is high blood pressure reversible?

Answer: “High blood pressure can often be brought down through dedicated lifestyle changes including diet, exercise, weight management, stress reduction, and limiting alcohol and tobacco use,” Dr. Desai says. “However, sometimes high blood pressure isn’t fully reversible.”  High blood pressure may not be reversible if:

• It’s caused by serious, underlying health conditions
• Genetics and family history play a major role

Dr. Desai explains that if your blood pressure stays high after trying different lifestyle changes and medications, your medical team will work with you to find other options. “It’s important to treat high blood pressure, since when left untreated it can lead to serious organ damage,” she says. 

The bottom line

Hypertension in seniors is a common health condition that often has no symptoms. It’s important to track your blood pressure over time and look out for trends. There are many ways to manage the condition, and we’re here to help. Check out our Resource library for more health information, and find ways to get moving with Bold classes.