By Alan Lukazewski, Director of Clinical Pharmacy at NeuGen Health and SAIL Operating Council Member (volunteer)
Although we have made great strides in treating high blood pressure, also called hypertension, it still remains a problem in the U.S, especially in older adults. Uncontrolled hypertension is a major contributor to stroke. Strokes are the leading cause of disability in older adults and a major contributor to coronary heart disease, the leading cause of death in men. Approximately 50% of older adults have uncontrolled hypertension.
Blood pressure is ideal if kept to no more than 130/90, although blood pressure goals should be individualized. As we age, the lower number, called diastolic, is usually not the problem. In fact, that number can go down with age. What is more of a concern is the upper number, called systolic blood pressure. As this number goes up, your risk of cardiovascular disease and events also goes up. Bringing blood pressure down to a reasonable target level significantly reduces your risk of stroke or other organ damage, such as kidney disease or eye damage in those with diabetes.
So what can you do to control your blood pressure?
- Monitor your blood pressure somewhat routinely. Do this in your home, not just at the doctor’s office. Monitoring your blood pressure correctly at home and bringing those numbers to your doctor tells them more about what your blood pressure is doing over time, making it more relevant. This is especially true in those who experience false hypertension in the doctor’s office, called “white coat hypertension (even though my doctor wears no white coat and no tie. Go figure!)
- Use non-drug methods to manage your blood pressure. The DASH diet (Dietary Approaches to Stop Hypertension-click link for details) includes reducing weight, lowering salt intake, exercising, and eating more fruit and vegetables in place of calorie-rich/high-fat foods. Each of these is associated with a slight reduction in the upper number; 1mmHg for each pound lost, 4-5mmHg with moderate salt restriction, 4-6mmHg for exercise, and 5-6mmHg for the DASH diet. And these are additive effects!
- Work with your doctor to see if medications can help. Medications are well- established at effectively lowering blood pressure and reducing the risk of stroke and heart disease. They also protect the other organs that are vital to healthy living, such as kidneys and eyes. Your physician can help select the safest, most appropriate blood pressure medication to add to the non-drug methods of managing your hypertension if needed.
The wisdom is this: Hypertension in older adults is still wrought with negative consequences. Even if you’re older, it still pays off to work to a lower number.
Thanks, Alan, for sharing this useful information!