Doctors face a particular challenge in treating older men and women for high blood pressure because they have more health problems than younger adults and because they're more likely to suffer from medication side effects.
See also: Six foods to fight high blood pressure.
On April 25, an expert panel convened by the American College of Cardiology (ACC) and the American Heart Association (AHA) offered a number of concrete recommendations for treatment of people over 65.
"We have very good data to show that treatment is beneficial at least up to the age of 80," says cardiologist Jerome Fleg, M.D., of the National Heart, Lung and Blood Institute, and co-chair of the ACC-AHA writing committee. "After that the data are sparser although they still suggest a benefit."
Here are some key recommendations to doctors from the consensus document, plus suggestions of steps you can take to lower your blood pressure.
Base a diagnosis of hypertension on three blood pressure measurements taken on at least two office visits.
What you can do: "If your blood pressure was high when you had it taken at a health fair or at a pharmacy, don't just assume it was a bad day and forget about it," says cardiologist Richard Stein, M.D., of New York University School of Medicine, who was not involved with writing the document. "Follow up with a visit to your doctor."
- Set a systolic/diastolic target of less than 140/90 mm Hg in people 65 to 79 years old. For those 80 and over, aim for a systolic number between 140 and 145 mm Hg.
What you can do: If your numbers are in the red zone for high blood pressure, "allow your doctor to start treatment and don't kid yourself by saying you're fine," says Stein. "Medications that control blood pressure reduce the risk of a heart attack by almost 40 percent and the risk of a stroke by more than 30 percent."
- To avoid side effects, start with a single medication at the lowest dose and increase it gradually. If the response is inadequate, determine possible reasons the drug isn't working and add a second drug if necessary.