What Are the Causes of High Blood Pressure in the Elderly?

A paper published by the American Medical Association points out that doctors may see more people with health problems related to high blood pressure in the coming years. Surveys indicate that at least one in every four Americans has high blood pressure with the risk factors increasing even more after age 50. With the nation's population aging, as many as two out of every three adults age 70 or older could be affected by high blood pressure in the future. Since it is not uncommon for individuals to develop hypertension as they get older, it helps to understand the causes.

Isolated Systolic Hypertension (ISH)

• ISH is the most common form of high blood found in the elderly. Even though diastolic blood pressure may remain normal, hardening of the arteries raises systolic blood pressure. Blood flowing through the vessels at high pressure causes plaque buildup, narrowing the inside of arteries. As a person gets older, the arteries lose elasticity making blood vessels more susceptible to damage. This is a case where age is the cause of high blood pressure.

Diabetes

• Diabetics have an increased risk of developing high blood pressure. Because diabetes can damage the blood vessels, older adults who have the disease are more likely to suffer from atherosclerosis, which can cause high blood pressure. Atherosclerosis also puts elderly individuals at higher risk for coronary artery disease. In a fact sheet published by the National Kidney Foundation, high blood pressure is highlighted as a major health concern. Diabetics usually have to maintain lower blood pressure to decrease the risk of heart disease and stroke, both frequent complications of high blood pressure. Physicians typically rely on a class of medications referred to as ACE inhibitors to treat hypertension in older patients. Generic drugs like Benazepril, Enalapril, Quinapril, Fosinopril, and Moexipril are just some of the ACE inhibitors doctors prescribe to lower blood pressure. These medications work by relaxing blood vessels. ACE inhibitors may also delay the progression of kidney disease in people who have diabetes. Kidney disease is another primary cause of high blood pressure. While kidney disease can cause high blood pressure, high blood pressure in turn can cause permanent kidney damage.

Medication

• Certain prescription and over-the-counter medications can cause high blood pressure. For elderly individuals who already have high blood pressure, this can produce a serious complication if blood pressure rises to extremely high levels. Other drugs a person takes can interfere with the effectiveness of blood pressure medications. Over-the-counter analgesics such as aspirin and ibuprofen, both medications that are commonly used by the elderly to alleviate the pain associated with arthritis, can cause the body to retain fluid. This puts pressure on both the heart and kidneys, causing blood pressure to rise. Always check with your doctor before taking any OTC drugs in combination with prescription medications. In certain cases, your doctor may recommend that you take acetaminophen for pain rather than aspirin or ibuprofen. Medications used to treat severe headaches or migraines can also cause blood pressure to rise to dangerous levels. These medications are designed to constrict blood vessels in the head, but they constrict blood vessels in other parts of the body as well.

Herpes Virus

• A recent study published in the May 2009 issue of PLoS Pathogens suggests that cytomegalovirus (CMV), a member of the herpes virus family, can lead to increased blood pressure. Researchers say that most adults contract the virus by the time they reach their 40s; however, individuals often show no symptoms when they are infected with the virus. After the initial infection, the virus usually remains dormant unless the immune system is compromised. The CMV virus is suspected to increase secretion of certain enzymes involved in causing high blood pressure. Like other strains of the herpes virus, CMV is transmitted through body fluids including blood, saliva, semen, urine, tears and breast milk. Previous studies indicated a link between the virus and the development of atherosclerosis.

Prevention

• Older individuals can help to prevent high blood pressure by eating a well balanced diet, and maintaining a healthy weight. Blood pressure tends to rise as people put on more weight. The elderly should remain as physically active as they are able, as even mild exercise helps to keep blood pressure down. Limit consumption of alcohol to no more than one drink a day for women, and two for men. Smokers should quit smoking. Nicotine causes the heart to beat faster, raising blood pressure. Reduce salt intake to no more than a total of six grams, or the equivalent of one teaspoon per day. You can find the number of grams per serving on a product's food label. Eat a diet low in saturated fat and cholesterol.

Caution

• Careful use of blood pressure medications is required in the elderly. One reason is because of possible interactions with other medications. Health care providers typically monitor older patients closely, as medication dosage often needs to be adjusted. When medication is needed, doctors usually begin by prescribing a minimal dose and then gradually increase the dosage, as it can be unsafe to lower an elderly patient's blood pressure too much.

Blood Pressure Readings

• Because older individuals normally have fluctuating blood pressure throughout the day, blood pressure readings often have to be taken at different times when hypertension is suspected. Hypotension, a condition where a person can have low blood pressure when standing, is another condition common among the elderly. To make an accurate diagnosis, blood pressure readings should be taken in the standing, sitting, and lying down positions.