Hypertension, or high blood pressure, is a common ailment among the over 65s, with about half said to suffer from it. But if left untreated it can lead to an increased risk of heart attacks, strokes or kidney damage. Dan Parton reports.

In this article:

  • What is hypertension?
  • Symptoms of hypertension
  • Causes of hypertension
  • Treatment
  • Healthy blood pressure

What is hypertension?

Simply, hypertension is when the pressure of the flow of blood puts too much strain on the arteries and heart.

It is more common in older people when the arterial system becomes less elastic over time.

If left untreated, hypertension can contribute to developing cardiovascular disease – including heart attacks and strokes – where it can damage the arteries and put a strain on the heart. Hypertension can also lead to kidney damage.

Symptoms of hypertension

Hypertension can cause headaches, dizziness and vision problems, but in most cases does not have any outward symptoms. So it can go unnoticed until it causes something more serious like a heart attack.

This is why it is important to have regular blood pressure checks – every 3 to 5 years – which can pick up any problems before it becomes serious. For older people, yearly checks are advisable.

One high blood pressure reading is not a sign that someone has hypertension. Blood pressure varies throughout the day and can be influenced by stress, exercise and such like.

If a reading is found to be high, a doctor or nurse will often want to monitor the reading and take several more before deciding on any further action.

Causes of hypertension

In 90% of cases the cause of hypertension remains a mystery. This is known as ‘essential hypertension’.

Nevertheless, there are recognised factors that can contribute to hypertension:

  • Being overweight
  • Eating a lot of salt
  • Low daily intake of fresh fruit and vegetables
  • Not taking enough exercise
  • Drinking a lot of coffee or alcohol
  • Smoking
  • Having a history of high blood pressure in your family
  • Being of African or Caribbean descent

Other medical causes can include: kidney disease, diseases in the arteries supplying the kidneys, type 1 and 2 diabetes, hormone problems or an underactive thyroid.

Unfortunately your chances of having hypertension increase as you age.


In some cases, especially where blood pressure is not significantly high, simple changes in lifestyle can reduce and regulate hypertension. For example, for people who are overweight shedding pounds can make a big difference; blood pressure can fall by up to 2.5/1.5 mmHg for each excess kilo lost.

As part of this, eating a healthy diet can play an important part in reducing blood pressure. Eating five portions of fruit and vegetables per day, cutting down on fatty food, eating lean meat and lowering salt intake can all be beneficial.

Along with this, taking regular exercise can help. Anything from a brisk walk to swimming, dancing or playing sports, undertaken several times a week for 30 minutes can significantly reduce blood pressure.

Cutting out smoking and drinking only in moderation can also help to bring blood pressure down.

But where lifestyle changes do not have the desired effect or if the patient has diabetes or heart disease, drug treatment can be used to lower pressure.

Several drugs can be used to control hypertension. These include:

  • Beta blockers: these block the effects of adrenaline, which relaxes the heart so it beats more slowly and thus reduces pressure
  • Alpha-blockers: these cause blood vessels to relax and widen. They can be combined with beta-blockers to create a greater effect
  • ACE inhibitors: These stop the angiotensin II hormone being produced, which makes the blood vessels narrow. As a result, vessels expand, improving blood flow
  • Angiotensin-II receptor antagonists: Instead of stopping production of angiotensin II, as ACE inhibitors do, these block its action allowing blood vessels to expand
  • Calcium-channel blockers: These reduce muscle tension in the arteries, so they expand. In addition, they slightly relax the heart so it beats more slowly
  • Diuretics: These help the body get rid of excess salt and fluids via the kidneys. In some cases they can also relax blood vessels, which reduces the strain on circulation

Generally, any drugs will need to be taken for life. But in some cases where blood pressure has been controlled for more than three years, medication may be stopped under guidance from your GP. Blood pressure will still need to be monitored, however.

If hypertension is treated well, it lessens the chance of complications and should not reduce life expectancy.

Healthy blood pressure

Blood pressure measures how strongly blood presses against the walls of your arteries as it’s pumped round your body by the heart. Arteries are blood vessels which transport blood away from the heart (whereas veins transport blood back to the heart). Arteries are normally comparitively large in size.

Blood pressure is measured in millimetres of mercury and recorded as two figures, for example 130/80. The first number is systolic pressure; the pressure in the arteries when the heart contracts. The second number is the diastolic pressure; the pressure in the arteries when the heart rests between each beat.

Normal blood pressure is below 130/80 mmHg. People with a systolic blood pressure consistently above 140mmHg and/or a diastolic pressure of more than 90mmHg need treatment to lower their blood pressure. Those with blood pressure between 140-159 mmHg should seek treatment via their GP as heart attacks, strokes or kidney disease become more likely at these levels.

These days you can buy a self-test kit to monitor your own blood pressure at most chemists.