Most people know that blood pressure is a common measure of cardiac health they need checked whenever they visit a doctor — the higher the numbers, the higher the risk of heart disease. But many factors can contribute to changes in blood pressure, especially as you age, and it’s important to know a bit more about it as you think about your heart health.

Simply defined, blood pressure measures the elasticity of your arteries, and how hard your blood pushes against the walls of your arteries as it is pumped through your body. It’s a reliable basic measure of cardiac health because it is impacted by how hard your heart is pumping, how constricted your blood vessels are, and how stiff the vessels may be — all factors that can be signs of potential heart disease. And elevated blood pressure is itself a risk factor for cardiovascular and other diseases. But blood pressure can also be impacted by stress, emotions, temperature, and activity — even just getting your blood pressure checked at a doctor’s office can cause your blood pressure to rise. The most useful measure for doctors is your resting blood pressure, when you’re relaxed, calm, and comfortable.

Blood pressure has two measurements. The high number, your systolic blood pressure, is the maximum amount of pressure in the system as the blood pushes on those arteries during a heartbeat. A healthy resting systolic pressure for most adults is under 120. The lower number, diastolic, is the minimum pressure, and a healthy resting number for adults here is under 80. The instrument for measuring blood pressure is called a sphygmomanometer (so you can see why people usually just call it a “blood pressure monitor”). These can be manual, with a bulb for pumping air into the cuff on your arm and mercury bar resembling a thermometer, or an automated system with a digital readout. They’re commonplace at health care centers but can also be used at home.

When blood pressure is elevated, it’s called hypertension. According to the CDC, 9 out of 10 Americans will develop high blood pressure in their lifetimes. Hypertension is a risk factor for a slew of cardiovascular diseases, including  stroke, coronary artery disease, heart failure, atrial fibrillation, and peripheral arterial disease. It can even lead to problems outside the cardiovascular system like vision loss, chronic kidney disease, and dementia.

Your blood pressure changes as you do, so it’s important to understand what happens to your blood pressure throughout your life — and what it means along the way.

  1. Does blood pressure change as you age? In a word: yes. It’s very common to see increases in blood pressure as we age. People can have high systolic blood pressure, high diastolic blood pressure, or both, and the different numbers may have different causes. Sometimes having both numbers elevated in your younger years can later develop into isolated systolic hypertension.
    • Isolated systolic hypertension. This is the most common type of hypertension for people over 50, and is characterized by rising systolic blood pressure but unchanging diastolic blood pressure. The difference between these two numbers is called your pulse pressure, and a widening pulse pressure is a common but dangerous occurrence in this age group. This type of hypertension is often associated with the structural changes that happen over time in arteries, particularly stiffening of large arteries.
  2. What’s a healthy blood pressure for my age? Even in heart-healthy adults, blood pressure can vary over time. For most adults the healthy range is under 120/80. Some evidence suggests patients over the age of 65 with systolic blood pressure below 140 may not require treatment, with an even higher threshold past the age of 80. But a doctor-lead cardiac analysis like Forward’s Heart Health program is the best way to make sure you’re in the healthy range.
  3. What factors impact blood pressure as you age. There are lots of things that can cause your blood pressure to rise over time. Here are a few reasons — some within your control, some not:
    • Lifestyle. Diet, exercise, smoking, sleep, and stress patterns can all contribute to high blood pressure over time. Luckily, these can be changed! 
    • Gender. Men have a higher likelihood of having high blood pressure under the age of 55. But women face a higher risk after menopause.
    • Family history. Whether from genetics, lifestyle, or some combination of both, some families are just predisposed to higher blood pressure as they age. Doctors will ask about your family history as part of any comprehensive heart exam.
    • Race. Due to genetics, Black Americans are at higher risk of high blood pressure as they age.
    • Medications. Certain medications can raise your blood pressure. Make sure your doctor knows about everything you take as they work to identify potential causes — and solutions — of high blood pressure.
  4. How to improve your blood pressure with age. Just as there are a number of things that can contribute to worsening blood pressure, that are lots of opportunities to help it improve. Here are some recommendations from the National Institutes of Aging:
    • Dietary changes. NIA recommends you incorporate lots of fruits, vegetables, whole grains, and low-fat dairy products into your diet to help lower blood pressure. On the flipside, lowering the amount of salt/sodium — which most people get through highly processed foods like soup and baked goods — can be a big help too. And studies suggest limiting alcohol consumption to two drinks for women, and one for men, per day.
    • Quit smoking. Smoking is linked to many health problems, but is specifically a risk factor for high blood pressure, heart disease, and stroke. What people don’t realize is that it doesn’t matter how old you are or how long you’ve been smoking — quitting at any time has great health benefits.
    • Exercise every day. Check with a doctor, for instance through Forward’s Heart Health program, for the right exercises and activity level for you. But for the most benefit, work your way up to at least 150 minutes per week.
    • Sleep well. Your sleep schedule and the amount you need can change as you age. But sleep quality is important too: if you snore or it sounds like you stop breathing while you sleep, it can be a sign of sleep apnea, which greatly increases the risk of heart disease.
    • Manage stress. Stress is a less concrete factor in heart health but it can be managed. If your stress levels are impacting your health, speak with a doctor about ways to mitigate the negative effects.
    • Medication. Sometimes lifestyle changes just aren’t enough. There are several classes of antihypertensive medications that may be helpful as you work to lower your blood pressure. Your doctor can help guide you as part of a heart health program. 
  5. How to monitor your blood pressure as you get older. Programs like Forward’s Heart Health program integrate data from sensors like at-home blood pressure monitors into a comprehensive screening and treatment approach. As you age and your risks for — and from — hypertension increase, a doctor may recommend at-home blood pressure monitors. Otherwise, blood pressure is monitored regularly at doctors’ visits, and you can often find automated blood pressure monitors in stores like a pharmacy. 
    • One note: hypertension is consistently elevated blood pressure and can only be diagnosed by a doctor. But a severe increase in systolic blood pressure reading to above 180, and/or a diastolic blood pressure reading higher than 120, can be a potential sign of a medical emergency called a hypertensive crisis, especially if coupled with other symptoms like severe chest pain, severe headache accompanied by confusion and blurred vision, nausea and vomiting, severe anxiety, shortness of breath, seizures, or unresponsiveness. Consult your doctor immediately if you think you may be experiencing a hypertensive crisis.

Anyone can develop high blood pressure. But it’s usually very treatable, and often without medicine. Forward’s Heart Health program is a great way to diagnose problems, connect with doctors, and develop a personalized and ongoing treatment plan. The program covers blood testing, counseling, doctor check-ins, at-home monitoring and more.

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