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How Low Should Blood Pressure Be In Older Adults
Previous large studies, including the HYVET trial and the more recent SPRINT trial, have shown that treatment of high blood pressure in older adults remains important, and may reduce the risk of heart attack, heart failure, stroke, and cardiovascular death. Black adults made up 31% of the SPRINT trial study population therefore, study results could be used to make recommendations for this population, which is at increased risk for high blood pressure. However, many groups of older people were excluded, including nursing home residents, those with dementia, diabetes, and other conditions common in more frail older adults.
The most recent guidelines from the American College of Cardiology and the American Heart Association , published in 2017, define optimal blood pressure as less than 120/80 for most people, including older adults age 65 or above. They recommend a target of 130/80 for blood pressure that is treated with medication. The 2018 guidelines from the European Society of Cardiology and the European Society of Hypertension recommend a more relaxed goal of less than 140/90.
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Alternative Blood Pressure Medications
Now that weve covered older medications for treating high blood pressure, it may be helpful to know which medications are recommended first-choice based on research and medical guidelines.
The most recent guidelines for high blood pressure from the American College of Cardiology and the American Heart Association were published in 2017. These guidelines help healthcare providers choose the best medications for treating high blood pressure.
In many cases, the best blood pressure medication will depend on your other health conditions. In general, there are four types of medications that are first-choice for lowering blood pressure. Always check with your healthcare provider to help choose which medication is best for you.
1) Thiazide diuretics: help the kidneys remove extra water and salt from the body, which lowers blood pressure.
2) ACE inhibitors: block an enzyme that causes our blood vessels to constrict. By blocking this enzyme, our vessels remain relaxed and blood can flow more easily to the heart.
Does High Blood Pressure Lead To Weight Gain
Some high blood pressure medications can, in fact, lead to weight gain. Common offenders include older beta-blockers such as propranolol and atenolol . There could be several reasons for this — including the fact that the medications can make patients feel tired and thus less likely to exercise.
- Minoxidil tablets — used only when other antihypertensive medications have failed — can also cause weight gain.
- Weight gain is also listed as a common side effect of doxazosin . Diuretics are more likely to cause weight loss.
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Why Blood Pressure Drugs Are Dangerous For Seniors
When you go in for a checkup, one of the first things they do istake your blood pressure. If your numbers are over 130/80, chances are youllbe prescribed a hypertension drug.
But if you are older, taking the medication could send you to anearly grave.
That may sound alarmist. But its exactly what scientists found ina major new study of 415,980 people.
It showed that in people over 75, high blood pressure is linked toa longer lifespan. Normal blood pressure which mostdoctors want you to havewas actually associated with earlier death.
The researchers foundthis effect held especially true for frail seniors. With low blood pressure, theyhad a 62% higher risk of death over 10 years.
The study comes fromBritains University of Exeter. It was led by doctoral candidate Jane Masoli.She said that, even though blood pressure guidelines keep moving to lower normalreadings, our findings indicate this may not be appropriate in frail olderadults.
An earlier study backs up this idea. It found that high bloodpressure helps older people stay mentally sharp.
The research waspublished in the journal Alzheimers andDementia. Scientists followed 559 people over 90 for close to three years.None of the subjects had dementia when the study began.
The researchers collectedthe subjects blood pressure history from earlier years and checked them fordementia every six months. The studydefined high blood pressure as 140/90 or higher.
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Make Lifestyle Changes First
Even if you don’t have high blood pressure, it’s important to take steps to keep it under control because it tends to get higher with age. That’s especially important if you’re a black American or have a family history of the condition, since both sharply increase the risk of developing it. And a healthy diet and lifestyle are essential if you already have high-normal readings. For people with high blood pressure, lifestyle measures can sometimes reduce or even eliminate the need for drugs. For example, research has found that the DASH diet can be as effective as medication for some people with mild hypertension. This relatively low-sodium diet relies on fruit, vegetables, and low-fat dairy products. The potassium in those foods, and possibly the calcium, too, appear to help control blood pressure. For people with normal blood pressure and no heart disease or stroke risk factors, the suggested 2,400 mg daily sodium limit, achievable by adopting the DASH diet alone, might help ward off the upward creep of blood pressure that can occur with age. Other steps include losing excess weight, exercising regularly, and drinking alcohol only in moderation, as shown in the table below.
| Aim for a body mass index under 25. | 2.5 to 10 mmHg for about every 11 pounds |
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What Other Drugs Interact With Amlodipine
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
Severe Interactions of amlodipine include:
- dantrolene
Serious Interactions of amlodipine include:
- diltiazem
Amlodipine moderate interactions with at leas 92 different drugs.
Amlodipine moderate interactions with at leas 100 different drugs.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.
Do I Have High Blood Pressure
Anyone can have high blood pressure. Some medical conditions, such as metabolic syndrome, kidney disease, and thyroid problems, can cause high blood pressure. Some people have a greater chance of having it because of things they can’t change. These are:
- Age. The chance of having high blood pressure increases as you get older, especially isolated systolic hypertension.
- Gender. Before age 55, men have a greater chance of having high blood pressure. Women are more likely to have high blood pressure after menopause.
- Family history. High blood pressure tends to run in some families.
- Race. African Americans are at increased risk for high blood pressure.
High blood pressure often has no signs or symptoms, but routine checks of your blood pressure will help detect increasing levels. If your blood pressure reading is high at two or more check-ups, the doctor may also ask you to measure your blood pressure at home.
There are important considerations for older adults in deciding whether to start treatment for high blood pressure if it is above 130/80, including other health conditions and overall fitness. Your doctor may work with you to find a blood pressure target that is best for your well-being and may suggest exercise, changes in your diet, and medications.
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