Hypertension Care: What Causes Hypertension in the Elderly?

An estimated 30% of UK adults have high blood pressure, putting them at an increased risk of stroke, kidney disease and heart attack. There is a wide range of risk factors for hypertension, including obesity, diabetes, kidney problems and long term sleep deprivation. Older people aged 65+ are at increased risk of developing high blood pressure and may need to make lifestyle changes or take medication.

What is hypertension?

Hypertension, otherwise known as high blood pressure, can put extra strain on vital organs such as the heart and liver. When arteries become narrow, the pressure build-up of the blood against the artery walls can be high enough to damage them.

Most people with hypertension aren’t aware there’s a problem until they have their blood pressure taken.

Causes of hypertension in the elderly

Older people in particular are at risk of developing high blood pressure. However, blood pressure readings should be considered in the context of overall health. Everyone’s blood pressure reading is different, and what might cause complications for a 40-year-old may be less problematic for an older person.

The following are common causes of high blood pressure in older people:

• Kidney disease and long term kidney infections
• Diabetes
• Obesity

Some medications may also cause hypertension.

Understanding your blood pressure reading

The carer providing elderly care for your loved one should arrange for a blood pressure reading at least once a year. Readings can be done at a GP’s surgery, local pharmacy or during an NHS health check. Blood pressure readings can also be taken at home, which may be more suitable, especially for those receiving dementia care.

The blood pressure reading is shown as two figures:

• Systolic pressure when your heart beats
• Diastolic pressure when your heart rests between beats

The systolic pressure measurement is more critical for older people.

Colin and Dulcie’s story

Dulcie is 102-years-old and lives with her son Colin, his wife Mary, and her Carer Sarah. She has dementia and has had full-time live-in care for over two years.

We talk to the family about the challenges of finding the right care solution for a fiercely independent woman – and how the positive benefits of live-in care with Sarah has transformed all of their lives.

Preventing hypertension

If your loved one is showing signs of pre-hypertension, they can take steps to prevent high blood pressure developing by making some simple adjustments to their lifestyle.

Healthy diet and lifestyle

If your loved one is receiving live-in care, arrange a diet that is low in fat and salt and high in fruits and vegetables.

• Limit alcohol intake: ensure your loved one stays within the recommended levels of a maximum of 14 units a week – this may vary between men and women.
• Lose weight: losing just a few pounds can reduce the risks of hypertension.
• Get active: if your loved one is receiving home care, ask their carer to get them involved in regular exercise.
• Cut down on caffeine: reduce the intake of tea or coffee to 4 drinks a day.
• Stop smoking: arrange for loved ones receiving private care to get support to quit.

Making these changes quickly enough may prevent your loved one from needing blood pressure medication.

Medication for hypertension care

Medications for hypertension care fall into three main groups. Depending on your loved one’s blood pressure readings and other risk factors, their doctor may prescribe:

• Thiazide Diuretics: this type of medication focuses on good liver health by eliminating excess water, salt and sodium
• Beta-Blockers: this type of medication reduces the force of the heartbeat by making the heart beat more slowly. Beta-blockers are often used with diuretics to protect the liver and the circulatory system
• Inhibitors: Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin-2 receptor blockers (ARBs) work in similar ways to relax the blood vessels and reduce blood pressure

If your loved one experiences any side effects, they must talk to their doctor who can try a different course of treatment. Finding the right combination of drugs will differ according to the individual, their age and their risk factors.

The DASH diet

If your loved one is struggling to control their hypertension, the DASH diet may be beneficial. DASH stands for Dietary Approaches to Stop Hypertension and is a healthy eating plan designed and proven to reduce high blood pressure.

Low in fat, salt, sugary beverages and red meat, the DASH eating plan focuses on fresh fruits, vegetables and whole grains. It is rich in calcium, fibre and protein plus essential vitamins and minerals.

This diet also lowers levels of uric acid and is useful for the prevention of gout and heart disease.

Hypertension is a common problem, but with careful management, healthy eating and moderate exercise, your loved one can enjoy good health well into their later years.