Many older Americans see blood pressure levels start to creep up, especially after age 60 when nearly three-quarters of people reach the level of hypertension, putting them at high risk for stroke, heart disease, kidney disease, cognitive impairment and even eye problems. So, if your doctor starts talking to you about getting your numbers under control, it’s important to take it seriously.
Blood pressure numbers are measured in millimeters of mercury (mm Hg). Your blood pressure is considered elevated when it rises above 120 mm Hg systolic (the top number) and above 80 diastolic mm Hg (the bottom number). You then move into higher stages of high blood pressure as the numbers rise. The numerous hypertension stages and types are complex, yet understanding what risks lie behind the numbers is vitally important, especially as we age.
It’s important to talk with your doctor about the ideal blood pressure target for you, as it can vary by age and other health conditions that you face. Your doctor will also consider what may be causing your hypertension, including genetics and lifestyle factors, and your risk of having a serious cardiovascular event when determining a treatment plan, which could include lifestyle changes, medication or a combination of both.
Risk calculators can guide blood pressure treatment
Doctors sometimes use a risk calculator to determine a patient’s chances of having a stroke or heart attack. For example, there’s the American Heart Association’s Predicting Risk of Cardiovascular Disease Events (Prevent) risk calculator, which considers cholesterol levels, age, sex, body mass index (BMI), where you live, if you are a smoker and your blood pressure to determine your risk for cardiovascular disease and complications.
While your blood pressure target goal and treatment plan will be determined by your doctor, there are some industry standard recommendations. For example, the Mayo Clinic recommends a blood pressure treatment goal of less than 130/80 mm Hg if:
• You’re a healthy adult age 65 or older
• You’re a healthy adult younger than age 65 and your doctor determines that you have a 10 percent or higher risk of developing cardiovascular disease in the next 10 years
• You have chronic kidney disease, diabetes or coronary artery disease
“Blood pressures over 140/90 definitely need treatment,” said Beverly Green, M.D., senior investigator for Kaiser Permanente Washington Health Research Institute. However, sometimes when people are getting close to their blood pressure targets, they back off on their treatment. This can be dangerous because blood pressure is quite variable, so it’s best to aim for an average blood pressure that is a little lower than your target BP. “You want the majority of your blood pressures to be in the right range,” Green added.
If you are having difficulty staying on your treatment regimen, your doctor may want to discuss any barriers to taking your medication regularly, including cost, side effects or not remembering to take your dose. Reducing or suddenly stopping certain medications can cause sudden sharp increases in blood pressure.
For more information on high blood pressure treatment and prevention, from AARP, CLICK HERE.
