An elderly relative has been diagnosed with high blood pressure and yet he exercises daily, has a good diet and doesn’t drink or smoke. He’s on tablets for it. Would you advise anything else for him to do to bring his blood pressure down?
BLOOD pressure refers to the pressure created by blood as it flows through arteries from the heart to the rest of the body. High pressure can occur due to pressure from blood or narrowing in the blood vessels.
If this high pressure goes on a while, the vessels through which blood flow can become weakened and damaged. In extreme high blood pressure there is a risk that a vessel may leak or burst. This can result in severe damage to the area of the body where the bleed occurs; this may cause a stroke in the brain or even death.
High blood pressure rarely gives any symptoms and often a person only becomes aware they have this condition when it is discovered during a routine check-up. In most cases there is no underlying cause. We call this essential hypertension.
High blood pressure does tend to run in families and the chance of developing it also goes up with age. You mention that your relative leads a relatively healthy lifestyle; this is important, as factors such as excess salt and alcohol intake, smoking, obesity and stress all increase the risk. Other illnesses such as kidney and heart disease or diabetes are contributing factors.
It is really important that your relative stays on his medication, as untreated high blood pressure seriously increases the risk of heart disease, stroke, heart failure, kidney disease, and dementia. Lifestyle change can make a difference and is essential in managing blood pressure but in most cases medication is also required.
Many blood pressure tablets today also act to protect heart function. Once started, blood pressure medication is usually required for life and should not be stopped unless advised to do so by a doctor.
It is really important to attend the doctor for regular check-ups to make sure that the blood pressure is reaching an acceptable level on the medication prescribed. In an otherwise healthy individual blood pressure should be below 140/90; if you have other cardiac disease, are diabetic or have other risk factors, lower goals may be set.
White coat hypertension is a term used to describe those whose blood pressure seems to rise when checked in a medical environment. 24-hour blood pressure monitors can be helpful in these people. This involves wearing a small device that checks blood pressure while out and about for 24 hours. It helps to decide whether blood pressure is elevated all the time or just on occasion.
Low blood pressure, although rarer, can occur. Although textbook blood pressure is set at 120/80, levels much lower can be quite normal, especially in pregnant women or in those who are very fit. In medical terms, blood pressure is considered low if a person is feeling unwell or suffering ill effects due to this.
It sounds like your relative most likely has essential hypertension. Age plays a role here but it is also important for him to reduce salt in his diet, and maintain his healthy lifestyle.
The issue of stress or mood disorders is often underestimated in the elderly and it is important to address any underlying stress issues as it can make blood pressure worse and be detrimental to health in general.
He is likely to require medication for life and taking this correctly is also essential.
The good news is that once blood pressure levels are controlled and maintained within normal levels, the risk of complications is reduced.