What You Should Know About Fluctuating Blood Pressure In The Elderly
As you help monitor your loved ones blood pressure, keep in mind that numbers fluctuate slightly throughout the day thats normal. Several factors influence your blood pressure numbers. For example, your blood pressure may be lower if youre resting and higher if youre stressed. This means you may have a normal reading in the morning and an elevated number in the afternoon.
If youre concerned about excessive fluctuation in your loved ones blood pressure numbers:
- Read instructions to ensure youre using your home blood pressure monitor equipment correctly. Variations in how you measure your loved ones blood pressure can result in different readings.
- Bring your home monitor to your next doctors appointment to compare readings.
- Be aware of white coat hypertension. In some cases, a persons blood pressure may be high at a doctors office but normal at home. This could be attributed to the stress related to a doctors appointment.
Your loved ones doctor may want you to keep a blood pressure diary with several readings a day for a couple of weeks to monitor any variations.
What Causes Low Blood Pressure
The cause of low blood pressure isn’t always clear. It may be associated with the following:
- Some prescription medicines such as for high blood pressure, depression or Parkinsonâs disease
- Heart failure
- Heart arrhythmias
- Widening, or dilation, of the blood vessels
- Severe dehydration from vomiting, diarrhea, or fever
- A reaction to medication or alcohol
- A severe allergic reaction called anaphylaxis that causes an irregular heartbeat
Who Gets Postural Hypotension?
Postural hypotension, which is low blood pressure when standing up suddenly, can happen to anyone for a variety of reasons, such as dehydration, lack of food, or being overly fatigued. It can also be influenced by genetic make-up, aging, medication, dietary and psychological factors, and acute triggers, such as infection and allergy.
Postural hypotension occurs most frequently in people who are taking drugs to control high blood pressure . It can also be related to pregnancy, strong emotions, hardening of the arteries , or diabetes. The elderly are particularly affected, especially those who have high blood pressure or autonomic nervous system dysfunction.
Hypotension after meals is a common cause of dizziness and falls after eating. This is most common after large meals containing a lot of carbohydrates. Itâs believed to be caused by blood pooling into the vessels of the stomach and intestines.
Common causes of naturally occurring postural hypotension include:
Serious Injuries And Shock
Low blood pressure can also be caused by serious injuries or burns, particularly if you have lost a lot of blood. This can mean that there is less blood being pumped around your body. Low blood pressure can also occur if you go into shock after having a serious injury.
Other kinds of shock are described below.
Anaphylactic shock, or anaphylaxis, is caused by an allergic reaction to something – for example, a wasp sting or a peanut. During an allergic reaction, your body produces a large amount of a chemical called histamine, which causes your blood vessels to widen and leads to a sudden, severe drop in blood pressure.
Cardiogenic shock occurs when your heart cannot supply enough blood to your body, so your blood pressure drops. This can happen during a heart attack.
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What To Do If You Have High Blood Pressure
If you have heart disease, you may want to check that your diastolic blood pressure doesn’t fall too far below 70 mm Hg, which can happen when you try to reach a low systolic number. “For a systolic blood pressure goal, I tend to be comfortable with a value of around 130,” Dr. Conlin says. Going lower than that carries an increased risk of side effects and other adverse events.
Everyone is unique. Your medical history, current state of health, lifestyle, and willingness to take additional medication and accept certain risks all play a role in determining your blood pressure goal and how to achieve it. Talk to your doctor about the strategy that makes the most sense for you.
Symptoms Of Low Diastolic Blood Pressure
Symptoms of isolated diastolic hypotension include tiredness, dizziness, and falls.
Because low diastolic pressure decreases blood flow to your heart, you may also have chest pain or symptoms of heart failure. Heart failure symptoms may include shortness of breath, swelling of your feet or ankles, confusion, and heart palpitations.
Seek immediate medical attention if you have chest pain or difficulty breathing.
Symptoms of low diastolic blood pressure along with low systolic blood pressure include:
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Your Diet Or Dehydration Could Make You Dizzy
Even mild dehydration may be why youre feeling dizzy or light-headed, according to the American Heart Association . Dehydration can also cause blood pressure to drop, which can lead to dizzy spells, notes the AHA. Dieting can also result in feelings of dizziness, because some diets cause dehydration, says Dr. Blau. According to the AHA, mild dehydration that follows the loss of just 1 to 2 percent of your body weight can cause dizziness.
Research And Statistics: How Many People Have High Blood Pressure
Hypertension is a very common condition, in both developing countries and industrialized nations.
According to the AHA, more than 100 million Americans have high blood pressure. That equates to nearly half of all adults in the United States.
High blood pressure is more common in men than in women, the Centers for Disease Control and Prevention reports. About 47 percent of men in the United States have high blood pressure, compared with 43 percent of women.
Only one in four Americans with hypertension have the condition under control.
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Dangers Of High Blood Pressure
Dangers of untreated high blood pressure include stroke, heart attack, heart failure, vision loss, kidney failure, vascular dementia and sexual dysfunction, says Dr. Desai. Its one of the top risk factors for developing atrial fibrillation, which is the most common heart rhythm disorder worldwide and can lead to stroke, heart failure and reduced quality of life.
Causes Of Secondary Hypertension
When high blood pressure arises suddenly due to an identifiable condition, its called secondary hypertension.
Some conditions and drugs can lead to secondary hypertension, including the following:
- Kidney problems
Examples include pseudoephedrine and phenylephrine .
HormonesBirth control pills can also affect blood pressure. Women who take birth control pills usually experience a small rise in systolic and diastolic blood pressure .
Hormone therapy used to relieve symptoms of menopause can also cause a small rise in systolic blood pressure.
If you know you have high blood pressure, but are considering hormone therapy, talk with your doctor about the risks and benefits of undergoing hormone therapy, as well as the best ways to control your blood pressure.
Additionally, some recreational and illegal drugs, such as cocaine, ecstasy , and amphetamines, are also known to increase blood pressure.
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Whats The Difference Between Blood Pressure And Pulse
While your blood pressure is the force of your blood moving through your blood vessels, your heart rate is the number of times your heart beats per minute.
- They are two separate measurements and indicators of health.
- For people with high blood pressure , theres no substitute for measuring blood pressure.
What The Studies Found And What They Mean
In one of the observational studies, published Oct. 16, 2016, in the Journal of the American College of Cardiology, researchers analyzed the medical records of more than 11,000 adults collected over a period of three decades as part of the Atherosclerosis Risk in Communities Study. They found that people who had low diastolic blood pressure were twice as likely to have subtle evidence of heart damage compared with people whose diastolic blood pressure was 80 to 89 mm Hg. Low diastolic values were also linked with a higher risk of heart disease and death from any cause over 21 years.
For the second, published Oct. 29, 2016, in The Lancet, researchers analyzed data from CLARIFY, a registry of more than 22,600 people with heart disease from 45 countries. They determined that, compared with people who had systolic blood pressure of 120 to 139 mm Hg and diastolic pressure of 70 to 79, people with a systolic blood pressure of 140 mm Hg or higher were more likely to experience heart attacks or strokes, to be hospitalized with heart failure, or to die within a five-year period. But the same was true for heart attacks, heart failure, and death in people with low blood pressure .
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Ptsd And High Blood Pressure
A growing body of research has linked post-traumatic stress disorder to high blood pressure.
Researchers arent sure about the mechanism underlying the relationship between PTSD and high blood pressure, but it may have something to do with higher levels of inflammation in patients with PTSD, which may increase blood pressure.
Since PTSD has a much higher incidence in veterans, experts say screening for high blood pressure should be routine not only in active soldiers who are at risk, but also for those who are no longer active and receive care from Veterans Affairs hospitals.
The AHA is the nations oldest and largest nonprofit organization dedicated to fighting heart disease, as well as its major risk factors, including high blood pressure. The AHA funds lifesaving research and advocates for people affected by all heart-related issues. You can also find diet and lifestyle tips for getting your blood pressure under control.
Million Hearts is a national initiative led by the CDC and the Centers for Medicare and Medicaid Services. Its goal is to prevent 1 million heart attacks and strokes within five years. It focuses on small steps people can take to reduce risk factors for these heart events, including blood pressure control.
When To Call Your Doctor
The risks of both high and low blood pressure make monitoring your blood pressure at home essential to your overall health and well-being. Both Dr. Wong and Dr. Desai recommend calling your healthcare provider if your self-monitored blood pressure readings are greater than 180/120 mmHgeven if you have no other symptoms.
You should call 911 if these blood pressure readings are associated with symptoms of organ damage, such as headache, vision changes, weakness, numbness, chest pain or shortness of breath, says Dr. Wong.
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Seeking Emergency Medical Attention
If a person experiences low blood pressure along with concerning symptoms such as a loss of consciousness, mental confusion, and a weak, rapid pulse and breathing pattern they should seek immediate medical attention.
In the emergency room, doctors may ask questions about a persons medical history, medications they may be taking, or any infections or accidents they may have had.
They may ask about or check for symptoms. They may also administer tests to check heart rate and blood pressure, and imaging tests to check the internal body and organs for other issues.
Even if a person is experiencing mild rather than severe symptoms along with low blood pressure, they should still seek guidance from a doctor.
Doctors may want to monitor the symptoms and test the blood pressure themselves to make any necessary diagnosis and administer treatment.
Aside from these events, a person may have low blood pressure and be in otherwise good health.
Low Diastolic Pressure: No Symptoms
“When your systolic blood pressure gets too low, it can manifest as lightheadedness, fainting, and weakness. But low diastolic pressure by itself doesn’t have any symptoms,” says Dr. Paul Conlin, professor of medicine at Harvard Medical School and chief of medicine at the VA Boston Healthcare System.
One of the new studies, which analyzed the medical records of more than 11,000 adults over a period of three decades, found that people who had low diastolic blood pressure were twice as likely to have subtle evidence of heart damage compared with people whose diastolic blood pressure was 80 to 89 mm Hg. Low diastolic values were also linked to a higher risk of heart disease and death from any cause. The findings appeared in the Aug. 30, 2016, Journal of the American College of Cardiology.
Another study, published in The Lancet, involved more than 22,000 people with heart disease, whom researchers grouped according to their blood pressure readings. People with well-controlled blood pressure values were considered the reference group.
Not surprisingly, people with high systolic blood pressure were more likely to experience heart attacks or strokes, be hospitalized with heart failure, or to die compared with people in the reference group. But the same was true for heart attacks, heart failure, and death in people with low blood pressure .
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What Numbers Mean High Blood Pressure What Numbers Mean Normal Blood Pressure
Normal blood pressure is at or under 120 over 80.
In November 2017, blood pressure guidelines were modified. Any blood pressure measurement at or above 130 over 80 is now considered high. And thats what we in the medical community call hypertension. These numbers are down from the old recommendation of 140 over 90.
In the past, many people in the United States were considered prehypertension. The new recommendations get rid of that category, and now almost half of U.S. adults fall into the category of hypertension. That could seem shocking. But patients who are in this category should already be discussing their blood pressure numbers with their primary care doctor. If they arent, now is a good time to connect with their medical provider and come up with a plan for treatment.
Low Systolic Blood Pressure
Having low blood pressure is usually something everyone strives for. But when your systolic blood pressure gets too low, it can cause dizziness and fainting, and in some cases, can even be life threatening. If youve recently had your blood pressure checked and your systolic number was low, you might be wondering what it means and what you can do about it.
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When To Contact A Medical Professional
If low blood pressure causes a person to pass out , seek treatment right away. Or call 911 or the local emergency number. If the person is not breathing or has no pulse, begin CPR.
- Black or maroon stools
Hypotension Blood pressure – low Postprandial hypotension Orthostatic hypotension Neurally mediated hypotension NMH
When Is Low Blood Pressure Too Low Hypotension And More
Some people naturally have low blood pressure, known as hypotension. However, when high blood pressure suddenly becomes low blood pressure, it could be cause for concern.
Low blood pressure, or hypotension, may be a sign of good health and of a decreased risk of heart disease. But not always. At times, continually low blood pressure or a sudden drop in blood pressure can lead to worrisome symptoms and even serious health problems.
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Does Normal Blood Pressure Change With Age
Just as our blood pressure readings change according to our posture, sleep time, and stress levels throughout the day, our blood pressure changes as we age. Despite the fluctuating or changing measurements, we should maintain a normal range. As we age, we can expect changes in our cardiovascular health, including our blood pressure and cholesterol levels. There are several factors that reflect our blood pressure levels over the years, including normal blood pressure for seniors.
Causes Of Low Diastolic Blood Pressure
There are three known causes of isolated diastolic hypotension:
- Alpha-blocker medications. These blood pressure medications work by causing your blood vessels to open up . Because they lower diastolic pressure more than systolic pressure, they may cause isolated diastolic hypotension. Common brand names include Minipress and Cardura.
- The aging process. As we age, we lose the elasticity of our arteries. For some older adults, arteries may become too stiff to spring back between heartbeats, causing diastolic blood pressure to be low.
- Too much salt in your diet. Dietary salt can decrease elasticity of your blood vessels. If you take in too much salt, you may increase your risk for low diastolic blood pressure.
There are several common causes of overall hypotension, which would include a low diastolic number.
- Overtreatment of high blood pressure. For some people, especially people over age 60, lowering systolic blood pressure below 120 may cause diastolic pressure to fall below 60.
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Who Is Affected By Low Blood Pressure
Low blood pressure can affect people of all ages, although it is more common in older people who are frail or bedridden. Pregnant women and older adults are more likely to have orthostatic hypotension. Children and young adults are most likely to experience neurally mediated hypotension, but they often outgrow it.
Hypotension commonly affects people who:
- Are taking certain medications that cause low blood pressure.
- Have hormonal imbalances or vitamin deficiencies.
- Also have heart problems or liver disease.
What Does High Blood Pressure Feel Like
High blood pressure often doesn’t have any symptoms, so you usually don’t feel it.
Hypertension is usually diagnosed by a health care professional during a routine checkup. The average person should get a blood pressure reading at least once a year. As a cardiologist, I think its important for everyone to know their numbers. That means knowing what your blood pressure is. And it also means knowing your blood sugar level, cholesterol and body mass index. When you know your numbers, you can work with your doctor to make a plan to reduce any risks.
Blood pressure is even more important to pay attention to, though, if you have a close relative with hypertension or other risk factors. And know that if your blood pressure is extremely high, you may have unusually severe headaches, chest pain, difficulty breathing or get easily worn out by workouts. If you have any of these symptoms, see your doctor right away.
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