Controlling high blood pressure is a good thing—unless you are a frail older person. Then it might be harmful. That’s the surprising finding of a study of more than 2,000 seniors published online in the Archives of Internal Medicine.
Make no mistake: high blood pressure is a definite health hazard. It damages arteries in the heart, kidneys, and throughout the body, leading to heart attack, heart failure, stroke, kidney failure, and other serious health problems. That’s why many doctors recommend aggressive steps for lowering high blood pressure.
But as we are learning about other conditions, a one-size-fits-all approach doesn’t work. What is right for controlling blood pressure in a 50-year-old might not work for a frail 80-year-old.
How is high blood pressure diagnosed?
Your healthcare providers will want to get an accurate picture of your blood pressure and chart what happens over time. Starting at age 20, the American Heart Association recommends a blood pressure screening at your regular healthcare visit or once every 2 years, if your blood pressure is less than 120/80 mm Hg.
Your blood pressure rises with each heartbeat and falls when your heart relaxes between beats. While BP can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg (less than 120 systolic AND less than 80 diastolic) for an adult age 20 or over. About one in three U.S. adults has high blood pressure!
If your blood pressure reading is higher than normal, your doctor may take several readings over time and/or have you monitor your blood pressure at home before diagnosing you with high blood pressure.
A single high reading does not necessarily mean that you have high blood pressure. However, if readings stay at 140/90 mm Hg or above (systolic 140 or above OR diastolic 90 or above) over time, your doctor will likely want you to begin a treatment program. Such a program almost always includes lifestyle changes and often prescription medication for those with readings of 140/90 or higher.
If, while monitoring your blood pressure, you get a systolic reading of 180 mm Hg or higher OR a diastolic reading of 110 mm HG or higher, wait a couple of minutes and take it again. If the reading is still at or above that level, you should seek immediate emergency medical treatment for a hypertensive crisis. If you can’t access the emergency medical services (EMS), have someone drive you to the hospital right away.
Even if your blood pressure is normal, you should consider making lifestyle modifications to prevent the development of HBP and improve your heart health.