blood pressure in older adults

Overview

Blood pressure is the force of your blood pushing against the walls of your arteries. As we age, our arteries can become stiffer, which often causes blood pressure to rise. High blood pressure (also called hypertension) means this force is too high for too long. It is a common condition that often has no symptoms but can be managed well.

Yes, high blood pressure is very common in older adults. In the UK, more than half of people over 60 have high blood pressure.

It mostly affects adults over 60, especially those with a family history of high blood pressure, who are overweight, eat too much salt, do little physical activity, or smoke.

Symptoms

Common symptoms

• High blood pressure usually has no obvious symptoms. This is why it is sometimes called a 'silent killer'.

Symptoms in children

• Blood pressure problems in children are different and often related to other medical conditions. This article focuses on older adults.

Symptoms in older adults

• Most older adults with high blood pressure have no symptoms at all. Some may experience headaches, shortness of breath, or nosebleeds, but these are not common.

Causes

Main causes

• As we age, arteries naturally become less flexible (stiffer). This increases blood pressure.
• Long-term buildup of fatty deposits (plaque) in the arteries
• Kidney problems that affect fluid and salt balance
• Certain medicines, such as some pain relievers or decongestants

Risk factors

• Age (over 60)
• Family history of high blood pressure
• Being overweight or obese
• Eating a diet high in salt and low in fruits and vegetables
• Not doing enough physical activity
• Drinking too much alcohol
• Smoking or using tobacco
• Long-term stress

When to see a doctor

See a doctor urgently if:

• If you have symptoms of a hypertensive emergency (severe headache, chest pain, vision changes) call emergency services immediately.
• If your home blood pressure monitor shows a very high reading that does not come down after resting for 15 minutes.

Book a routine appointment if:

• If you are over 40, you should get your blood pressure checked at least every five years. Some people need more frequent checks.
• If you have a family history of high blood pressure or heart disease, ask your doctor how often you should be checked.
• If you have been diagnosed with high blood pressure, you will need regular check-ups to monitor your levels.

Diagnosis

High blood pressure is diagnosed by measuring your blood pressure with a cuff (sphygmomanometer). Usually, several readings are taken on different days to confirm the diagnosis.

Tests that may be done

• Blood pressure measurement at your doctor's surgery or clinic
• Ambulatory blood pressure monitoring: wearing a portable monitor for 24 hours to get a more accurate picture
• Home blood pressure monitoring: you can check your own blood pressure with a validated device
• Urine tests to check kidney function
• Blood tests to check for underlying causes (e.g., kidney disease, diabetes)
• Electrocardiogram (ECG) to look for heart strain

What to expect at your appointment

Your doctor or nurse will explain what your numbers mean. They will likely recommend lifestyle changes and may suggest medication if needed. You will have regular follow-ups to see if your treatment is working.

Treatment

Treatment for high blood pressure aims to lower your numbers to a safe level and reduce your risk of complications. It usually starts with lifestyle changes, and if that's not enough, medications are added.

Self-care at home

• Reduce salt in your diet – aim for less than 6g (about a teaspoon) per day
• Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and low-fat dairy
• Get regular physical activity – at least 150 minutes of moderate activity per week (e.g., brisk walking)
• Maintain a healthy weight – losing even a small amount can help
• Limit alcohol – no more than 14 units per week for both men and women
• Stop smoking – ask your healthcare team for support
• Manage stress with relaxation techniques, hobbies, or talking to someone

Medical treatments

If lifestyle changes are not enough, your doctor may prescribe blood pressure-lowering medications. There are several types that work in different ways, such as helping your blood vessels relax or reducing fluid in your body. You will usually take one or more tablets once a day. It is important to take them as prescribed and not stop without speaking to your doctor. Your doctor will decide the best option based on your age, other health conditions, and how your body responds.

When is surgery considered?

Surgery is rarely needed for high blood pressure itself. In some cases, if an underlying condition (like a narrowed kidney artery or a hormone-producing tumour) is causing high blood pressure, surgery to fix that condition may be considered.

Living with this condition

Living with high blood pressure means making healthy choices a part of your daily routine. Check your blood pressure regularly at home if your doctor recommends it, and keep a record to share during appointments. Take your medications exactly as prescribed. Most people feel fine day to day – the goal is to prevent future problems.

Lifestyle tips

• Monitor your blood pressure at home with a validated device
• Keep a log of your readings and bring it to appointments
• Eat a balanced diet – the DASH diet (Dietary Approaches to Stop Hypertension) is often recommended
• Stay physically active – find activities you enjoy, like walking, swimming, or dancing
• Limit alcohol and avoid smoking
• Reduce stress – try deep breathing, meditation, or talking with friends

Diet and exercise

A heart-healthy diet is important. Eat plenty of fruits, vegetables, whole grains, and lean proteins. Cut back on salt, processed foods, and sugary drinks. Aim for at least 30 minutes of moderate exercise most days. Even small increases in activity can help lower blood pressure. Talk to your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Having a long-term condition like high blood pressure can sometimes cause worry or stress. It's normal to feel anxious about your health. If you feel overwhelmed, talk to your doctor or a counsellor. Stay connected with family and friends. Taking care of your mental health is just as important as your physical health.

Prevention

You cannot change your age or family history, but you can reduce your risk by living a healthy lifestyle. Eating well, staying active, not smoking, limiting alcohol, and managing stress all help prevent high blood pressure or delay its onset.

Screening programmes

Regular blood pressure checks are the best way to catch high blood pressure early. For adults over 40, the NHS recommends a check every five years. If you have risk factors, you may need more frequent checks.

Complications

If left untreated

• Heart attack or heart failure
• Stroke
• Kidney damage or kidney failure
• Vision loss (due to damage to blood vessels in the eyes)
• Dementia and memory problems (from reduced blood flow to the brain)

Long-term outlook

With the right treatment and lifestyle changes, high blood pressure can be controlled. Most people can reduce their risk of serious complications and continue to live a full, active life. The key is to work closely with your healthcare team and stick to your treatment plan.

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