We all know how important it is to monitor blood pressure, especially as we age. But why is it important? And, what do all those numbers mean anyway?
Blood pressure is the pressure on the walls of your arteries as your heart pumps blood around your body. Blood pressure will naturally fluctuate, calculating what you may be doing at any given moment, and adjusting to meet your heart’s needs.
Knowing your normal blood pressure range is really important, especially as we age. Having your blood pressure measured regularly is essential in being able to detect any issues or changes and respond to these accordingly. It is always best to get this done at your doctor’s clinic. There are home testing machines available, but there is no way to know the accuracy of these home tests, as machines may be calibrated differently, or simply not work as effectively as the one your doctor uses.
Blood Pressure and Dementia
High blood pressure is a known risk factor in vascular dementia, and in some cases also Alzheimer’s disease. Studies also find that there is an overlap of risk factors between vascular dementia and Alzheimer’s disease. In fact, this overlap raises the question about the possibility of vascular issues contributing to Alzheimer’s disease. (Vascular means ‘consisting of vessels, especially those that carry blood, such as arteries and veins’).
A 2008 study found that people living with Alzheimer’s disease experience a lowering of their blood pressure levels due to the cognitive decline, with failing memory being linked to low blood pressure.
Based on these studies we can understand that high blood pressure can be a risk factor in developing some forms of dementia. And, In the case of people already living with Alzheimer’s, failing memory is being linked to a drop in blood pressure. Either way, you can see how important healthy and stable blood pressure levels are to cognitive function.
Dangers of High Blood Pressure
The more blood that your heart pumps, and the narrower your arteries are, the higher your blood pressure will be.
Living in the western world has often meant that ageing and increased blood pressure have gone hand in hand. This high blood pressure, known as hypertension, can be the cause of heart disease. With little to no signs or symptoms, hypertension is sometimes referred to as the silent killer, and left undiagnosed or untreated, increases your risk of stroke and heart attack.
The very elderly are much more likely to suffer side effects of medication due to their frailty and low body weight. Medication dosages are often too high and can cause many adverse effects. This group of older adults are also at risk of an over-medication system due to a poorer nutritional status.
Did you know there has been a 7% increase in the number of adult Australians with high blood pressure? This equates to 1.3 million people living in Australia with high blood pressure.
A National Health and Nutrition survey in the USA found that 80% of people aged 50 and over, with high blood pressure, have systolic hypertension. This systolic type of hypertension was also found to be the least well managed, possibly due to the fact that it is more characteristic in older adults who may not report problems or visit their doctor regularly. Systolic hypertension is seen as an increase in the stiffness of the large arteries.
High blood pressure is strongly associated with increased risk of stroke, ischaemic heart disease and other vascular diseases in older adults. However, it is not just the disease that can cause high blood pressure. Some medications, or mix or medications, can also affect your blood pressure. Uncontrolled high blood pressure may also impact memory, thought processes and learning abilities.
Dangers of Low Blood Pressure
Low blood pressure is known as hypotension.
While in general terms low blood pressure is far more favourable than high blood pressure, it can also cause come health complications. Low blood pressure can cause us to feel tired, light-headed or dizzy. If you feel any of these symptoms regularly you should always ask your doctor to investigate any underlying conditions. In some cases low blood pressure can affect blood flow to your vital organs, and this may lead to stroke, heart attack or kidney failure. In the extreme low blood pressure can present as shock.
When blood pressure drops below 90/60 mmHg you may experience fatigue, dizziness, nausea, clammy skin, blurry vision, loss of consciousness, or depression.
Blood pressure can also drop during any of these conditions:
- Dehydration due to excessive sweating/exercise
- Blood infection
- Diabetes and thyroid disease
- Faulty heart valves, heart attack, heart failure or other heart damage
- Significant blood loss due to injury
- Many medications (beta blockers, nitro-glycerine, diuretics, tricyclic antidepressants, erectile dysfunction drugs)
Staying hydrated and seeking help for stress or shock will help your blood pressure stabilise. If you are in a job where you stand for long periods of time, and you have low blood pressure, it is important to have regular breaks where you sit. It is also suggested that uncrossing your legs when you sit will help avoid certain types of hypotension.
If you have been diagnosed with Orthostatic Hypotension (Postural Hypotension), please stand up slowly if you have been sitting or sleeping, as the sudden drop in blood pressure when you stand quickly can cause you to feel dizzy or faint.
A normal blood pressure reading is 120/80 mmHg.
If your systolic pressure is between 120 and 139 mmHg, OR your diastolic pressure is between 80 and 89 mmHg, this is a warning of pre-hypertension.
While both numbers are of course important in a blood pressure reading, as we age the systolic number becomes more significant. In older adults it is possible to have a high systolic reading (more than 140 mmHg) and a lower diastolic reading (less than 90 mmHg), known as systolic hypertension.
What is mmHG?
This refers to millimetres of mercury, and is a manometric unit of pressure.
What is Systolic?
This is the top number in your reading and refers to the amount of pressure in your arteries when your heart muscle contracts.
What is Diastolic?
This is the bottom number in your reading and refers to your blood pressure at the moments when your heart muscle is in-between beats.
What can I do to get my Blood Pressure in a normal range?
Not everyone can be treated with medications for hypertension. It can be detrimental in those aged over 85, or a person may have other conditions where medication for hypertension cannot be given.
So, the best course of action is to make life-style changes today. Ideally you would like to be making such changes in your 40’s or 50’s, but it is never too early, or too late, to make a positive change to lower your blood pressure, keep your heart healthy and lower your risk of death from heart disease:
- Reduce your salt intake (read labels carefully – salt is in just about every processed and packaged food)
- Increase your potassium intake (leafy greens, beans, sweet potatoes, bananas)
- Include citrus fruits (found to lower blood pressure and increase blood flow)
- Basic exercise daily (go for a daily walk, practice yoga)
- Get your weight into a healthy range for your body type
- Stop smoking
- Reduce alcohol intake
- Establish a meditation practice
- Keep well hydrated with water
- Nitrate-rich vegetables* – include these in your daily diet
*Nitrate-rich vegetables can be juiced, steamed, made into a salad, or a smoothie. Include some of these every day – Rocket, Rhubarb, Coriander, Butter Leaf Lettuce, Spring Greens, Basil, Beetroot leaves, Oak Leaf Lettuce, Swiss Chard, Beetroot. Scientists found that nitrate rich vegetables may prove the most cost-effective and affordable approach to hypertension. Increased consumption of vegetables, especially leafy greens, not only gives you your daily nitrate-fix, but has also been linked to improved blood flow to your most important organ – your brain.
By making some simple changes to your lifestyle you can positively impact your blood pressure. In fact, making these changes could save your life. If you have any concerns for yourself, or an older family member, please make an appointment with a trusted doctor. With a proper diagnosis an effective treatment plan can be put into place.
Thank you for reading our latest article.
 Greger, M, MD, 2015, How Not to Die, pp52
 Greger, M, MD, 2015, How Not to Die, pp158-162
 Greger, M, MD, 2015, How Not to Die, pp158-162