When you think of high blood pressure, do you recall the cartoons where someone gets redder and redder, then eventually explodes? In reality, high blood pressure (also called hypertension) is often called “the silent killer.” Despite presenting you with no symptoms, hypertension can lead to a heart attack, stroke or other life-threatening problem.
Your blood pressure often rises as you grow older. This post will tell you what you need to know about blood pressure at midlife.
High blood pressure is common
According to the Centers for Disease Control (CDC), 1 in 3 US adults has high blood pressure. Another third has pre-hypertension, meaning elevated blood pressure that is not yet in the high blood pressure range.
Only about half (54%) of people with high blood pressure have it under control. High blood pressure is a primary or contributing cause to over 1100 deaths per day in the US.
One in five people with high blood pressure even doesn’t know they have it. Hypertension gives you no warning signs like fatigue, shortness of breath, and so on.
Here’s another warning about blood pressure at midlife. At age 45, more men than women have hypertension. By age 65 the situation reverses, and more women than men have high blood pressure.
Diabetes, another common midlife health problem, puts you at higher risk for hypertension. About 60% of people with diabetes also have high blood pressure.
There’s a genetic component to hypertension as well. If you have a close family member with high blood pressure, you’re at higher risk for it yourself.
What do your blood pressure numbers mean?
Your blood pressure measurement has two parts. The first number is the systolic reading, or how much pressure your blood exerts against your artery walls as your heart beats. The second number, or diastolic reading, is the pressure your blood exerts against your artery walls while your heart rests between beats.
Blood pressure is measured in mm Hg, or millimeters of mercury. This started because the first accurate blood pressure gauges used mercury. It’s still the standard unit of blood pressure measurement in medicine today.
Don’t confuse your blood pressure with your pulse, another reading the nurse will record at the same time she takes your blood pressure. Pulse measures how many times your heart beats per minute.
What’s normal blood pressure?
Normal blood pressure typically measures 120/80. Refer to the American Heart Association chart above to assess where your blood pressure reading falls on a continuum from normal to “hypertensive crisis.”
While practitioners usually consider low blood pressure to be good, extremely low pressure may be dangerous. For example, if low blood pressure causes you to become dizzy whenever you stand up, you’re at increased risk for balance issues and falls. Consult with your doctor about what your blood pressure numbers mean for you at midlife.
Why does blood pressure at midlife matter?
As you get older, your artery walls usually grow stiffer and may contain plaque. High blood pressure can further damage the blood vessels, constricting arteries around the heart, brain, eyes, kidneys and sex organs. An infographic from the American Heart Association highlights the possible consequences of hypertension.
Blood pressure at midlife matters because aging already puts you at greater risk of cardiovascular disease. But hypertension can lead to ischemia, a condition where blood flow (and oxygen) are restricted or reduced in part of the body.
Hypertension and dementia
Studies following large groups of people for 15-40 years have demonstrated a link between high blood pressure in midlife (ages 40-65) and vascular dementia. Vascular dementia is the second most common type of dementia after Alzheimer’s. It results from constricted blood flow to the brain.
A recent randomized clinical trial showed promising results regarding the blood pressure/dementia link. Researchers found that aggressive blood pressure control (targeting systolic pressure below 120) resulted in fewer new cases of cognitive decline among the study population. These findings suggest you may be able to reduce your risk of dementia by controlling your blood pressure.
Interestingly, however, somewhat elevated blood pressure in elderly adults (ages 80s/90s) can help reduce their risk of dementia. The thinking behind this is that elderly adults need greater blood pressure to continue pumping enough blood and oxygen to the brain, heart and other organs.
Do you know your blood pressure?
The medical assistant will usually measure your blood pressure and pulse whenever you visit your doctor’s office. But don’t panic if your blood pressure reading is high at there. White coat hypertension, or high blood pressure at the doctor’s, is a real phenomenon.
Depending on whether you just walked up a flight of stairs to get the doctor’s office or whether you are feeling stressed about being there, your pressure reading may be elevated. Additionally, the nurse may take your blood pressure the instant you enter the exam room, giving you little time to sit down and catch your breath.
Home blood pressure monitors
If your doctor thinks your blood pressure is high, buy a home blood pressure monitor and start measuring it yourself at different times throughout your day. Keep notes you can share with your doctor later.
The goal is to find your personal blood pressure averages and trends. Your numbers will likely go up and down over the course of a day. Make sure you’re measuring consistently from one time to the next. It’s a good idea to take your home monitor into the doctor’s office and compare the reading it gives you there to what the doctor’s machine says.
Dr. Leslie Kernisan’s blog, Better Health While Aging, has a post on how home blood pressure monitors help older adults. Another article discusses how to choose a home blood pressure monitoring device.
One device she recommends (and that I also like) is the Omron 10 Series.* It’s affordable and connects to your smartphone via Bluetooth. This makes it particularly easy to note patterns and share results with your medical team.
Natural ways to lower your blood pressure
Especially if your blood pressure is only somewhat elevated, there are a number of ways you may be able to reduce it without a prescription. For example, the Mayo Clinic lists 10 ways to control high blood pressure without drugs:
- Lose extra pounds and watch your waistline
- Exercise regularly
- Eat a healthy diet
- Reduce sodium in your diet
- Limit the amount of alcohol you drink
- Quit smoking
- Cut back on caffeine
- Reduce your stress
- Monitor your blood pressure at home and see your doctor regularly
- Get support from friends, family or a support group who can encourage you to take care of yourself
These practices are good for everyone who wants to live a healthier life. They’ll help you reduce your overall risk of cardiovascular disease, diabetes, depression, and so on.
In addition to the Mayo Clinic’s list, Medical News Today specifies some foods that may help you lower your blood pressure. It gives you the suggestions listed above, but it also directs you to eat foods rich in calcium and/or potassium, berries, and dark chocolate. I don’t think this means you get to eat raspberry and dark chocolate gelato (my favorite gelato combo). But any excuse to have chocolate is a good one!
Medication to lower your blood pressure
In addition to recommending changes in your diet, etc., your physician may prescribe medication to help you lower your blood pressure at midlife. The American Heart Association’s website lists different classes of drugs prescribed for this condition:
- ACE inhibitors
- Angiotensin II receptor blockers
- Calcium channel blockers
- Alpha blockers
- Alpha-2 Receptor Agonists
- Combined alpha and beta-blockers
- Central agonists
- Peripheral adrenergic inhibitors
On the website, you can click on a drug class name to see more detail. It will give you the brand and generic names for various drugs in the category. It will also tell you how they work to lower your blood pressure and list their common side effects.
Work with your doctor to determine the right course of treatment for you. And make sure to tell him or her about all the other prescriptions and over-the-counter medications you’re taking. Doing so will help you avoid drug interactions.
For more suggestions about how to make the most of your time with your physician, check out this post: Improve how to talk with your doctor. It shows you ways you can help your doctor to help you.
Now you know
High blood pressure at midlife is common. Two out of three adults have pressure readings in the elevated or high ranges. As you age, your blood pressure may increase and your artery walls become stiffer. It can get harder for your heart to pump your blood around your body. This puts you at risk for a cardiac event, stroke, vision or other problem.
Don’t be one of the 20% of people who have hypertension and don’t know it. Ask your doctor about it and consider monitoring it at home. In this case, knowledge isn’t only power. Knowledge is life.
So live well. Don’t wait for your blood pressure to go up before improving your lifestyle. You can start eating better, exercising and doing other things recommended to begin to lower your blood pressure today. You’ll feel better and reduce your risk of all kinds of diseases.
One last thing. As you make choices to live healthier, don’t forget to eat your berries and dark chocolate!