What Happens to Blood Pressure as We Age

African American doctor checking senior man's blood pressure
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How does your blood pressure change with aging? Age is a known risk factor for high blood pressure. In general, blood pressure rises as people get older. In fact, up to 80 percent of people over 65 have measurable high blood pressure. There are typical changes to blood pressure as you age as well as greater risks of hypertension and a need to treat hypertension differently in an older person.​

Basics of Blood Pressure: Systolic and Diastolic

Your blood pressure is read in two numbers, systolic over diastolic, and measure in millimeters of mercury. A typical number is 120/80 mm Hg or "120 over 80."

  • Systolic blood pressure is the higher number and it represents the pressure at the maximum part of your heartbeat when the heart chambers contract to push blood through your blood vessels.
  • Diastolic blood pressure is the lower number, which is the pressure in your blood vessels between heartbeats, at the point where the chambers are refilling with blood.
  • The safest range of blood pressure is less than 120 systolic and less than 80 diastolic.
  • High blood pressure (hypertension) is defined as 140/90 or higher at two or more checkups.
  • Low systolic blood pressure of less than 90 is low blood pressure or hypotension.

Both systolic and diastolic blood pressure are important when it comes to diagnosing and monitoring high blood pressure. But they change in different ways as you age.

Systolic Pressure Up, Diastolic Pressure Down With Age

Specifically, the systolic blood pressure rises with age, while the diastolic blood pressure tends to fall. This is true for people with high blood pressure and those with no history of high blood pressure. For people with pre-existing high blood pressure, this age-related blood pressure increase happens even if the blood pressure is well controlled with medicine.

In almost 60 percent of cases, people diagnosed with high blood pressure after age 65 have "isolated systolic hypertension." This type of high blood pressure means that only the systolic blood pressure is elevated to over 140 mm Hg while the diastolic blood pressure remains under 90 mm Hg.

Hypotension With Age

If your systolic blood pressure is under 90 mm Hg, you may feel lightheaded or even faint. This can be caused by becoming dehydrated if you don't drink enough liquids. You may also get hypotension with blood loss or due to too much of some medications.

Orthostatic hypotension is also common as you age. This is a drop in blood pressure when you rise after having by lying down or sitting. It can result in dizziness, fainting, and falls.

Why Blood Pressure Changes With Age

The reasons why blood pressure increases with age are still poorly understood but are a topic of intense research. Some known contributors include:

  • Age-related changes in hormone profiles
  • A tendency for older people to oversalt their food because of decreased taste bud sensitivity
  • Changes that happen in the walls of arteries and other blood vessels
  • Decreased efficiency of the heart

While a certain amount of blood pressure increase is unavoidable as we age, blood pressure health can still be maintained by following the same lifestyle recommendations as younger people.

Treating High Blood Pressure in Older Individuals

If you are being treated for high blood pressure, your doctor may need to adjust your treatment with advancing age. This is especially a concern for keeping your diastolic pressure high enough to prevent low blood pressure that could lead to a fall. Be sure to discuss all of your symptoms with your doctor and get regular checkups.

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