High blood pressure, also known as hypertension, occurs in about 20 percent of adults in the U.S. Hypertension among the elderly is more common. About 50 percent of those age 60 and over suffer from high blood pressure. That percentage rises to about two out of three for those aged 75 or older. Systolic hypertension is the most commonly diagnosed form of high blood pressure among seniors.
Hypertension is expressed in two numbers. The systolic number is the upper number, and the diastolic number is the lower. A systolic measurement depicts the pressure exerted on artery walls as the heart is beating. The diastolic number is the same pressure at a time the heart rests, which is the period in between beats. Some healthcare professionals consider 120/80 mmHg (millimeters of mercury) as a so-called standard or acceptable blood pressure level; however, what is acceptable can vary with different patients.
In general, high blood pressure is considered to be 140/90 mmHg or higher. The condition is usually broken down into three categories. If the cause of the condition is unknown, it is called essential hypertension. High blood pressure caused by a disease or occurring as a result of some other condition is called secondary hypertension. If only the systolic number is elevated, it is called systolic hypertension. That is the most common form of hypertension in the elderly.
As people age, the systolic number typically rises. For many years, hypertension in the elderly went undiagnosed because researchers believed an acceptable systolic level was 100 plus the patient’s age. This meant doctors considered the rising systolic number in older patients as normal. This is no longer the case.
The number of undiagnosed cases of hypertension in the elderly may result from how blood pressure is measured. When standing, blood pressure tends to drop for older people, a condition called postural hypotension. To compensate, doctors are advised to attempt to diagnose hypertension in the elderly by taking blood pressure readings when older patients are standing, sitting, and lying down.
Estimates are that only about 25 percent of elderly people with hypertension are on high blood pressure medication. Reducing systolic hypertension in the elderly even by as little as 12 mmHg may significantly lower the risk of heart attack and heart failure. On the other hand, some researchers say high blood pressure medicine can lower pressure too quickly in older patients and can potentially be harmful.