Definition of high blood pressure
What to do in case of hypertension?
For a better understanding of blood pressure The follow-up of a high blood pressure
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VIII - High blood pressure and special cases

8.1 - High blood pressure and sport
8.2 - High blood pressure and obesity
8.3 - High blood pressure and pregnancy
8.4 - High blood pressure and elderly
8.5 - High blood pressure and children
8.6 - High blood pressure and contraception
8.7 - Influence of hormones on high blood pressure (case of the post-menopausal woman)
8.8 - Influence of life style modification on blood pressure

8.4- High blood pressure and elderly

Blood pressure increases with age because the arteries become stiffer. Thus, high blood pressure is a very frequent pathology in the elderly, concerning 15 to 25% of the population. According to medical studies, people aged 60 and over are considered old.


The more the arteries become stiffer, the more the maximal blood pressure (the systolic one) increases compared to the minimal one (diastolic), which involves an increase in the difference (pulse pressure). For example, a blood pressure of 17/9 (170/90 mmHg), corresponds to a rise of the systolic blood pressure and of a normal diastolic blood pressure.

The difficulty in the elderly is represented by the extreme daily variation of the blood pressure, depending in particular on the body position. Indeed, these subjects often present a hypotension during the passage from the sitting or lying position to the standing position (defined by a fall of more than 20 millimetres of mercury between the 2 positions on the systolic blood pressure). This hypotension is characterized by giddiness and a great tiredness or fatigue, and impairs considerably the antihypertensive drug therapy.

8.4.1- What is the reference value?

Medical societies have fixed a maximum limit at 160/90 millimetres of mercury (16/9), value above which we speak about high blood pressure.

8.4.2- Is the high blood pressure in the elderly more complicated than the high blood pressure in the young subjects?

As previously described, the blood pressure in the elderly fluctuates more than in the young subject. The difficulty for the practitioner is to prescribe an antihypertensive drug for instance which will not lower the blood pressure too much in order to avoid the patient falling which could have dramatic consequences.

Because the elderly often had high blood pressure for some time, the cerebral, cardiac, vascular and renal damages are more frequent compared with younger subjects.

In fact, it is rather the duration of the high blood pressure which induces organ damage more than the age of the subject himself.

8.4.3- Is the antihypertensive drug effective?

In terms of the reduction of the blood pressure, the antihypertensive drug therapy is effective in general, but many practitioner have wondered if the antihypertensive drug could induce a reduction of the cardiovascular mortality in this case.

Medical studies have shown that a reduction of the blood pressure involves a reduction in the cardiovascular mortality, in a very significant way. The aim of the blood pressure value in this context is 140/90 millimetres of mercury. This decrease of the cardiovascular risk is proportional to the decrease of the arterial blood pressure.

8.4.4- How to treat?

It is very important to respect the life style modifications (sport, physical activity, absence of stress, sodium reduction, reduction of the consumption of coffee, tea...).

In the event of ineffectiveness of this treatment, an antihypertensive drug therapy can be prescribed. All the drugs can be given if they are well tolerated.

File last reviewed on : 18 dec 2011
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