Known as the “silent killer” due to its lack of expressed symptoms, hypertension is one of the primary preventable causes of premature cardiovascular disease and mortality in the world. The elderly are particularly effected by this disease. More than 25% of all adults worldwide have hypertension and more than 50% of adults 60 years of age and older are hypertensive. Clinical management of hypertension takes up a significant part of the primary care clinical workload.
Hypertension is essentially high blood pressure. With age, a variety of blood pressure changes occur that can increase an older adult’s vulnerability to hypertension. Age-related changes in hormones (i.e., aldosterone) related to blood pressure, arterial wall stiffening, and decreased heart and kidney functioning occurs. Seniors are likely to increase their salt intake by over-salting their food due to decreased taste bud sensitivity.
In terms of the prevalence of hypertension, over 65 million adults in the United States experience increasing blood pressure with age. Specifically, many adults experience increasing isolated systolic blood pressure with age, with an estimated 60% new onset of isolated systolic hypertension after the age of 65. There are gender differences with hypertension—male onset of elevated blood pressure occurs between the ages of 35 and 55 and tend to be diastolic, while female onset of elevated blood pressure occurs post-menopause due to the changes in estrogen and progesterone interaction.
Major age-related changes in the heart and blood vessels occur as a person ages. In the heart, muscle cells begin to degenerate, heart valves thicken and stiffen, fibrous tissue and fat deposits accumulate, and the heart muscle becomes slightly enlarged due to thickening walls in which ventricle chambers hold less blood. For blood vessels, the aorta becomes thicker, stiffer, and less flexible, resulting in a rise of blood pressure due to the heart having to pump harder. Baroreceptors become less sensitive and the capillary walls become thicker, causing a slower exchange of oxygen. The lumen (the space inside the blood vessel wall) can narrow and cause normal blood volume that passes through it to increase blood pressure.
High blood pressure is over 140 systolic and 90 diastolic. The force on the arteries due to increased blood flow causes damage and the force of the heart pumping can lead to strain. A study published in the Journal of the American Medical Association (JAMA) found that cardiovascular mortality risk becomes greater with the rise of blood pressure. Approximately 1 million adult participants’ blood pressure and mortality risk were analyzed. In adults between the ages of 40 and 69 years of age, every 20/10-mm Hg rise in blood pressure doubled the risk of mortality from stroke, ischemic heart disease, and various additional vascular causes. The study’s finding was the same for both men and women.
Many studies have also found that obesity is a significant contributor to high blood pressure. In both men and women, a rise in blood pressure was correlated with a rise in body mass index (BMI).
Through the ongoing cycle of maintaining a healthy lifestyle, regularly measuring blood pressure, undergoing treatment with drugs if necessary, and modifying drug treatment if side effects develop, an older adult’s blood pressure can be controlled. Elderly patients in nursing homes and assisted living facilities must be monitored carefully and be provided with the best quality care to prevent adverse cardiac events from occurring and maintain quality of life. If you or a loved one has suffered from neglect or abuse due to ill treatment from a nursing home or assisted living facility, such as one in Firebaugh or Huron, California, contact us today. We will do all that we can to obtain a just solution for the pain you unrightfully experienced.