2

High Blood 

Pressure

You can have high blood pressure, 

or hypertension, and still feel just fine. 

That’s because high blood pressure 

often does not cause signs of illness 

that you can see or feel. But, high 

blood pressure, sometimes called “the 

silent killer,” is very common in older 

people and a major health problem. 

If high blood pressure isn’t controlled 

with lifestyle changes and medicine, it 

can lead to stroke, heart disease, eye 

problems, kidney failure, and other 

health problems. High blood pressure 

can also cause shortness of breath 

during light physical activity or exercise. 

What Is Blood Pressure?

Blood pressure is the force of blood 

pushing against the walls of arteries. 

When the doctor measures your blood 

pressure, the results are given in two 

numbers. The first number, called 

systolic blood pressure, is the pressure 

caused by your heart pushing out blood. 

The second number, called diastolic 

blood pressure, is the pressure when your 

heart fills with blood. The safest range, 

often called normal blood pressure, is a 

systolic blood pressure of less than 120 

and a diastolic blood pressure of less 

than 80. This is stated as 120/80. 

Do You Have High Blood 

Pressure?

One reason to have regular visits to 

the doctor is to have your blood pressure 

checked. The doctor will say your blood 

pressure is high when it measures 140/90 

or higher at two or more checkups. He 

or she may ask you to check your blood 

pressure at home at different times of 

the day. If the pressure stays high, even 

when you are relaxed, the doctor may 

suggest exercise, changes in your diet, 

and medications. 

The term “prehypertension” describes 

people whose blood pressure is slightly 

higher than normal—for example, 

the first number (systolic) is between 

120 and 139, or the second number 

(diastolic) is between 80 and 89. 

Prehypertension can put you at risk for 

developing high blood pressure. Your 
3 4

doctor will probably want you to make 

changes in your day-to-day habits to try 

to lower your blood pressure.

What if Just the First

Number Is High?

For older people, the first number 

(systolic) often is 140 or greater, but the 

second number (diastolic) is less than 90.

This problem is called isolated systolic 

hypertension. It is the most common 

form of high blood pressure in older 

people and can lead to serious health 

problems. Isolated systolic hypertension 

is treated in the same way as regular 

high blood pressure but often requires 

more than one type of blood pressure 

medication. If your systolic pressure is 

140 or higher, ask your doctor how you 

can lower it.

What Do the Numbers Mean?

Systolic Diastolic

(first number) (second number)

Normal Blood Pressure Less than 120 Less than 80

Prehypertension Between 120-139 Between 80-89

High Blood Pressure 140 or more 90 or more

Isolated Systolic Hypertension 140 or more Less than 90

What if Your Blood Pressure

Is Low?

If your systolic blood pressure is 

less than 90, you may have low blood 

pressure. You may feel lightheaded, 

dizzy, or even faint. Low blood pressure, 

or hypotension, can be caused by not 

drinking enough liquids (dehydration), 

blood loss, or too much medication. 

Some Risks You Can’t Change

Anyone can get high blood pressure. 

But, some people have a greater chance 

of having it because of things they can’t 

change. These are:

F Age. The chance of having high blood 

pressure increases as you get older.

F Gender. Before age 55, men have a 

greater chance of having high blood 
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pressure. Women are more likely 

to have high blood pressure after 

menopause.

F Family history. High blood pressure 

tends to run in some families.

F Race. African-Americans are at 

increased risk for high blood pressure.

How Can I Control My Blood 

Pressure?

High blood pressure is very common 

in older people—over time most people 

find that aging causes changes to their 

heart. This is true even for people who 

have heart healthy habits. The good 

news is that blood pressure can be 

controlled in most people. 

There are many lifestyle changes 

you can make to lower your risk of 

high blood pressure, including:

F Keep a healthy weight. Being 

overweight adds to your risk of high 

blood pressure. Ask your doctor if you 

need to lose weight.

F Exercise every day. Moderate 

exercise can lower your risk of high 

blood pressure. Set some goals for 

yourself so that you can exercise safely 

and work your way up to exercising 

at least 30 minutes a day most days of 

the week. You should check with your 

doctor before starting an exercise plan 

if you have any health problems that 

are not being treated. You can find more 

information about exercise and physical 

activity from the National Institute on 

Aging at www.nia.nih.gov/Go4Life.

F Eat a healthy diet. A diet rich in 

fruits, vegetables, whole grains, and 

low-fat dairy products may help to lower 

blood pressure. Ask your doctor about 

following a healthy diet.

F Cut down on salt. Many Americans 

eat more salt (sodium) than they need. 

Most of the salt comes from processed 

food (for example, soup and baked 

goods). A low-salt diet might help lower 

your blood pressure. Talk with your 

doctor about eating less salt. 

F Drink less alcohol. Drinking alcohol 

can affect your blood pressure. Most 

men should not have more than two 

drinks a day; most women should not 

have more than one drink a day.

F Don’t smoke. Smoking increases 

your risk for high blood pressure, 

heart disease, stroke, and other health 

problems. If you smoke, quit.

F Get a good night’s sleep. Tell your 

doctor if you’ve been told you snore 

or sound like you stop breathing for 

moments when you sleep. This may be 

a sign of a problem called sleep apnea. 

Treating sleep apnea and getting a 

good night’s sleep can help to lower 

blood pressure.
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If these lifestyle changes don’t lower 

your blood pressure enough to a safe 

level, your doctor will also prescribe 

medicine. You may try several kinds 

or combinations of medicines before 

finding a plan that works best for 

you. Medicine can control your blood 

pressure, but it can’t cure it. You will 

likely need to take medicine for the rest 

of your life. Plan with your doctor how 

to manage your blood pressure.

High Blood Pressure Facts

High blood pressure is serious because 

it can lead to major health problems. 

Make a point of learning what blood 

pressure should be. And, remember:

F High blood pressure may not make 

you feel sick, but it is serious. See a 

doctor to treat it.

F You can lower your blood pressure 

by changing your day-to-day habits and 

by taking medicine, if needed.

F If you take high blood pressure 

medicine, making some lifestyle changes 

may help lower the dose you need.

F If you take blood pressure medicine 

and your blood pressure is 120 or less, 

that’s good. It means medicine and 

lifestyle changes are working. If another 

doctor asks if you have high blood 

pressure, the answer is, “Yes, but it is 

being treated.”

F Tell your doctor about all the drugs 

you take. Don’t forget to mention overthe-counter drugs, vitamins, and dietary 

supplements. They may affect your blood 

pressure. They also can change how well 

your blood pressure medicine works.

F Blood pressure pills should be taken 

at the same time each day. For example, 

take your medicine in the morning 

with breakfast or in the evening after 

brushing your teeth. If you miss a dose, 

do not double the dose the next day.

F Don’t take more of your blood 

pressure medicine than your doctor 

prescribes. Do not stop taking your high 

blood pressure medicine unless your 

doctor tells you to stop. Don’t skip a day 

or take half a pill. Remember to refill 

your medicine before you run out of pills.

F Before having surgery, ask your 

doctor if you should take your blood 

pressure medicine on that day.

F Get up slowly from a seated or lying 

position and stand for a bit. This lets 

your blood pressure adjust before walking 

to prevent dizziness, fainting, or a fall. 

If your doctor asks you to take your 

blood pressure at home, keep in mind:

F There are many blood pressure 

home monitors for sale. Ask your 

doctor, nurse, or pharmacist to see 

which monitor you need and to show 

you how to use it. Have your monitor 
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checked at the doctor’s office to make 

sure it works correctly.

F Avoid smoking, exercise, and 

caffeine 30 minutes before taking 

your blood pressure.

F Make sure you are sitting with 

your feet on the floor and your back 

is against something.

F Relax quietly for 5 minutes before 

checking your blood pressure.

F Keep a list of your blood pressure 

numbers to share with your doctor, 

physician’s assistant, or nurse. 

For More Information About 

High Blood Pressure

Here are some helpful resources:

National Heart, Lung, and 

Blood Institute

Health Information Center

1-301-592-8573 

nhlbiinfo@nhlbi.nih.gov (email)

www.nhlbi.nih.gov

National Library of Medicine

MedlinePlus

Search for: “high blood pressure”

www.medlineplus.gov

American Heart Association

1-800-242-8721 (toll-free)

inquiries@heart.org (email)

www.heart.org NIH...Turning Discovery Into Health®

March 2015

For more information on health and 

aging, contact:

National Institute on Aging

Information Center

P.O. Box 8057

Gaithersburg, MD 20898-8057

1-800-222-2225 (toll-free)

1-800-222-4225 (TTY/toll-free)

niaic@nia.nih.gov (email)

www.nia.nih.gov

www.nia.nih.gov/espanol

To sign up for regular email alerts about 

new publications and other information 

from the NIA, go to www.nia.nih.gov/health.

Visit www.nihseniorhealth.gov, a seniorfriendly website from the National 

Institute on Aging and the National 

Library of Medicine. This website has 

health and wellness information for older 

adults. Special features make it simple 

to use. For example, you can click on a 

button to make the type larger.

National Institute

on Aging