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Hypertension In The Older Adult


What is hypertension?

Hypertension is high blood pressure (BP). Your BP is the force of your blood moving against the walls of your arteries. Normal BP is less than 120/80. Prehypertension is between 120/80 and 139/89. Hypertension is 140/90 or higher. Hypertension causes your heart to work much harder than normal. This can damage your heart. Your blood pressure will increase as you get older. However, hypertension is not a normal part of aging. You can control hypertension with a healthy lifestyle or medicines. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys.

What causes hypertension?

The cause of hypertension may not be known. This type of hypertension is called essential or primary hypertension. Hypertension can sometimes be caused by other medical conditions, such as kidney disease. This type of hypertension is called secondary hypertension.

What increases my risk for hypertension?

  • Age older than 60 years
  • A family history of hypertension or heart disease
  • Obesity or lack of exercise
  • A medical condition, such as sleep apnea, kidney disease, thyroid disease, or high levels of aldosterone
  • Certain medicines, such as steroids, estrogen, or cold medicines
  • Too many high-sodium (salty) foods
  • Stress
  • Use of tobacco, alcohol, or illegal drugs

What are the signs and symptoms of hypertension?

You may have no signs or symptoms, or you may have any of the following:

  • Headache
  • Blurred vision or changes in your vision
  • Chest pain
  • Dizziness or weakness
  • Trouble breathing
  • Nosebleeds

How is hypertension diagnosed?

Your healthcare provider will take your blood pressure at several visits. You may also need to check your blood pressure at home. The provider will examine you and ask what medicines you take. He or she will also ask if you have a family history of high blood pressure and about any health conditions you have. You may need tests to check for causes of hypertension. Examples include blood or urine tests, an ultrasound, or an angiography.

How is hypertension treated?

Treatment may depend on other medical conditions and the cause of hypertension. Ask your healthcare provider what your blood pressure goal is. Your healthcare provider will recommend lifestyle changes to lower your BP. You may also need the following medicines:

  • Medicine may be used to help lower your BP. You may need more than 1 type of medicine.
  • Diuretics help decrease extra fluid that collects in your body. This will help lower your BP. You may urinate more often while you take this medicine.

What can I do to manage hypertension?

  • Check your BP at home 2 times a day or as directed. Take your BP at the same times each day, such as morning and evening. Take 2 readings each time. Ask your healthcare provider for more directions. Keep a record of your BP readings and bring it to your follow-up visits. Ask your healthcare provider what your BP should be.

  • Limit sodium as directed. Too much sodium can affect your fluid balance and make it hard to control your BP. Check labels to find low-sodium or no-salt-added foods. Some low-sodium foods use potassium salts for flavor. Too much potassium can also cause health problems. Your healthcare provider will tell you how much sodium and potassium are safe for you to have in a day. He or she may recommend that you limit sodium to 2,300 mg a day.

  • Follow the meal plan recommended by your healthcare provider. A dietitian or your provider can give you more information on low-sodium plans or the DASH (Dietary Approaches to Stop Hypertension) eating plan. The DASH plan is low in sodium, unhealthy fats, and total fat. It is high in potassium, calcium, and fiber.

  • Exercise to maintain a healthy weight. Exercise will also help decrease your BP. Exercise for 30 minutes a day on most days of the week. Start with 10 minutes at a time. Examples of exercise include brisk walking or riding a stationary bike. Talk to your healthcare provider before you start an exercise plan. He or she can make sure the exercise plan is safe for you.
  • Decrease stress. This can help lower your BP. Learn ways to relax, such as deep breathing or listening to music. Get plenty of sleep every night. A lack of sleep can increase your stress level.
  • Limit or do not drink alcohol. Ask your healthcare provider if it is safe for you to drink alcohol. Also ask how much is safe for you to drink.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can increase your BP and also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Manage any other health conditions you have. Health conditions such as diabetes can increase your risk for hypertension. Follow your healthcare provider's instructions and take all your medicines as directed.

What do I need to know about BP medicine?

  • Take your medicine at the same time every day.
  • Do not stop taking your medicine if your BP is at the target goal. A BP at the target goal means that the medicine is working correctly.
  • Know the name and dose of your medicine.
  • Refill your medicine before you run out.
  • Blood pressure medicine can make you feel dizzy. Stand up slowly from a sitting or lying position. This will help prevent dizziness or your risk of falls.
  • Ask your healthcare provider if you should take your blood pressure medicine on the day of a surgery or procedure.

Call 911 or have someone else call for any of the following:

  • You have discomfort in your chest that feels like squeezing, pressure, fullness, or pain.
  • You become confused or have difficulty speaking.
  • You suddenly feel lightheaded or have trouble breathing.
  • You have pain or discomfort in your back, neck, jaw, stomach, or arm.
  • You faint or lose consciousness.

When should I seek immediate care?

  • You have a severe headache or vision loss.
  • You have weakness in an arm or leg.
  • You get dizzy and fall.

When should I contact my healthcare provider?

  • You feel faint, dizzy, confused, or drowsy.
  • You have been taking your BP medicine and your BP is still higher than your healthcare provider says it should be.
  • Your blood pressure is lower than your healthcare provider said it should be.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.