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January 19, 2020
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Navigating the aging journey

Julie Ann Soukoulis
 How to keep an aging adult’s blood pressure in the green zone
November 1, 2019

The mid-morning telephone conversation between Madeleine and her 88-year-old dad always seemed to begin the same way. “I’m so dizzy I’m afraid I’ll fall when I stand up from the chair,” father complained to daughter. After a visit to the doctor, Madeleine’s father learned that fluctuations in his blood pressure are making him dizzy in the mornings soon after he takes his medication. To help, the doctor adjusted his prescription in an effort to keep his blood pressure within his personal green zone.

Despite our best efforts, controlling blood pressure as we get older can be a challenge for many. Furthermore, these issues could put family caregivers at a loss for how to help their senior parents and loved ones.  Blood pressure issues can be complex since causes and treatments may vary from one individual to the next. What is blood pressure? What’s normal and what isn’t?

What is blood pressure?

According to the National Institute on Aging (NIA), blood pressure is the force of blood pushing against the walls of arteries. When the doctor measures blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by your heart contracting and pushing out blood. The second number, called diastolic blood pressure, is the pressure when your heart relaxes and fills with blood. Your blood pressure reading is usually given as the systolic blood pressure number over the diastolic blood pressure number. Normal blood pressure for adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80, or 120/80.

Is Dad’s blood pressure too high?

Updated guidelines from the American Heart Association and the American College of Cardiology have changed the definition of high blood pressure or hypertension for most people, the NIA reports. High blood pressure is now generally defined as 130 or higher for the first number, or 80 or higher for the second number (previously it was 140/90). However, there are important considerations for older adults in deciding whether to start treatment for high blood pressure, including other health conditions and overall fitness. Generally, if Dad’s blood pressure is above 130/80, his doctor will likely evaluate his health to determine what treatment is needed to balance risks and benefits in his particular situation.

Everyone, not just seniors, should monitor their blood pressure. The stress of family caregiving, for example, could be taking a toll on your own health, so be sure to check yours as well as to encourage Dad to stay on top of his with regular doctor visits. High blood pressure may be referred to as the “silent killer” because oftentimes there are no symptoms, the NIA notes. If there’s an indication Dad’s blood pressure is high at two or more checkups, the doctor may advise your father to check his blood pressure at home at different times of the day or ask you to assist him. If his pressure stays high, even when he is relaxed, the doctor may suggest exercise, changes in diet, and, most likely, medications, the NIA notes.

What if Dad’s blood pressure is low?

If your father is complaining of being dizzy, his blood pressure may be dropping too low. Generally, blood pressure readings lower than 90/60 could be an indication of low blood pressure or hypotension. He may feel lightheaded, weak, dizzy or even faint, nauseous and have problems with concentration. Low blood pressure can be caused by not drinking enough liquids (dehydration), blood loss, some medical conditions or too much medication, the NIA explains. Low blood pressure may be normal for many people, particularly those with a strong heart and well-developed circulatory system.  If no symptoms are present, low blood pressure is not normally a problem. However, if certain symptoms persist, your father’s blood pressure may be too low.

Dad’s first number (Systolic) is high, but the second number (Diastolic) is in the normal range

For older people, often the first number (systolic) is 130 or higher, but the second number (diastolic) is less than 80. This problem is called isolated systolic hypertension, which is due to age-related stiffening of the major arteries. It is the most common form of high blood pressure in older people and can lead to serious health problems (stroke, heart disease, eye problems and kidney failure) in addition to shortness of breath during light physical activity, lightheadedness upon standing too fast and falls. Isolated systolic hypertension is treated in the same way as regular high blood pressure (130 or higher for the first number, or 80 or higher for the second number) but may require more than one type of blood pressure medication.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

Julie Ann Soukoulis is the owner of Home Instead Senior care office in Rohnert Park, mother of two and passionate about healthy living at all ages. Having cared for her own two parents, she understands your struggles and aims, through her website, www.homeinstead.com/sonoma to educate and encourage seniors & caregivers. Have a caregiving or aging concern? She’d love to hear from you at 586-1516 anytime.