Healthy blood pressure does not change with age. Normal blood pressure is below 120/80. The top number is systolic pressure (when the heart beats and pumps blood). The bottom number is diastolic pressure (when the heart rests between beats). Numbers below 120 and 80 are ideal, as this means a lower risk for heart attack and stroke. High blood pressure starts at 140/90. Anything in between is considered prehypertension.

High Blood Pressure in the Very Old: Why it May Not be Treated

While the guidelines for healthy blood pressure do not change as you get older, the treatment protocol does. There is some debate over how high blood pressure in older adults should be treated. Let’s explore why.

First, some research shows that high blood pressure in the eight or ninth decade of life may lower the risk of mental decline. Higher blood pressure in very old adults may also lower the risk for frailty and disability.

Second, medications that treat high blood pressure have side effects that are not good for seniors. Many of the medications used for this treatment can cause dizziness, increasing the risk for slips and falls. These drugs can also interact with other medications that seniors need to take to manage symptoms of chronic disease.  

Maintaining Normal Blood Pressure without Medication

The American College of Cardiology advises people over the age of 80 to maintain healthy blood pressure readings under 140/90. The American Heart Association also recommends that seniors should keep their blood pressure under 140/90 until the age of 75. After that, there could be more leeway.

High blood pressure may not be as much of a concern if the onset is later in life, but that doesn’t mean that it should be ignored. To manage blood pressure without medications, seniors can do the following:

  • Exercise to lose weight
  • Eat healthy foods
  • Cut down on salty foods
  • Quit smoking
  • Limit drinking

If your doctor feels that your blood pressure is too high, medications may be considered. Possible medications include beta-blockers, diuretics, ACE inhibitors, ARBs, CCBs, alpha-blockers and alpha-beta blockers. Your doctor will weigh the pros and cons to the treatment as well as your personal risk factors and other medications you may be taking to make a final decision.