What Happens to Your Blood Pressure As You Age

Blood pressure may change with age, potentially increasing cardiovascular disease risk, but there are things you can do to treat and prevent this. Your healthcare provider will also help you monitor your blood pressure regularly and adjust your treatment as needed.​

How Blood Pressure May Change With Age

Systolic and diastolic blood pressure may change differently as people age in the following ways:

• Both high systolic pressure (top number) and high diastolic pressure (bottom number) may occur.

• Low blood pressure overall may also occur, depending on various factors.

• Systolic blood pressure may rise while diastolic blood pressure falls even without a prior history of hypertension. This change may lead to isolated systolic hypertension (systolic above 129, diastolic below 90).

People with pre-existing hypertension can still show these changes even when blood pressure is well-controlled with medication.

Why Blood Pressure Changes With Age

Blood pressure changes with age may be partly due to the following:

• Medications, such as some antidepressants, can lower sodium levels and BP

• Carotid artery narrowing (carotid stenosis) can lower BP

• Kidney conditions can impact blood pressure regulation

• Stiff arteries or heart valve problems can raise systolic (top number) pressure

• Loss of blood vessel elasticity generally increases BP

• Weakened baroreceptors reduce the body's ability to regulate BP when moving

These changes may affect how the heart and circulatory system manage pressure as the body ages, so monitoring and managing blood pressure are essential.

Risks of Blood Pressure Changes in Older Adults

High systolic blood pressure may increase the risk of the following in older adults:

• Stroke

• Heart disease

• Dementia

• Kidney disease

Low blood pressure in older adults can be common and associated with the following risks:

• Fainting and potential fall injuries (severe)

• Cognitive impairment

• Other cardiovascular events, such as stroke

• Increased mortality

• Reduced quality of life

• Impact on independence

• Increased health costs

Orthostatic hypotension (low blood pressure and dizziness when standing) is characterized by:

• A drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing

• Increased prevalence with age (adults 65 and older)

• Increased risk of falls or injury

Managing Blood Pressure as You Age

If you're undergoing treatment for high blood pressure, your healthcare provider may adjust your treatment over time to balance the following:

• Reducing heart disease risk

• Preventing orthostatic hypotension

• Other conditions you may have

• Other medications you may take

• Your preferences

Some blood pressure elevation may be unavoidable for some people. However, you can minimize your risk by following nutrition and lifestyle recommendations, such as:

• Eat a low-fat, lower salt diet, with enough fiber and whole foods

• Include potassium-rich foods in your diet

• Avoid processed foods

• Drink enough water

• Reduce or eliminate alcohol and tobacco products

• Maintain a healthy weight and muscle mass

• Get at least 150 minutes per week of moderate-intensity aerobic activity such as a brisk walk (ex., 30 minutes a day/5 days a week or around 22 minutes per day)

• Engage in activities that reduce your stress and bring you joy

• Spend quality time with loved ones (including pets)

• Listen to calming music to reduce tension

• Try to spend time outdoors, such as gardening

• Try deep breathing or meditation programs

• Get enough high-quality sleep

• Avoid excess screen time

• Keep your routine check-ups

• Monitor your blood pressure regularly

• Regularly take your daily medications as prescribed

Registered dietitian nutritionists can help you with your diet and lifestyle changes. Ask your healthcare provider for a referral.

Target BP Guidelines: Age 65 and Up

Adults 65–80: Aim for BP under 130/80 mm Hg if heart disease is stable.

Over 80: Avoid going below 130/65 mm Hg, as too-low BP may raise cardiovascular risk.

How to Monitor Your Blood Pressure

Blood pressure is measured using a cuff called a sphygmomanometer. You can measure it in the following places:

• At home

• In your healthcare provider's office

• At pharmacies

• At mobile health clinics

Understanding Your Blood Pressure Reading

Your reading includes two numbers, typically written as systolic over diastolic (e.g., 120/80 mm Hg):

• Systolic (top number): pressure when your heart beats.

• Diastolic (bottom number): pressure when your heart rests between beats.

What Do the Numbers Mean?

High blood pressure (hypertension):

• Systolic 130 mm Hg or higher, or

• Diastolic 80 mm Hg or higher

• (Previously defined as 140/90 or higher)

Low blood pressure (hypotension):

• Below 90/60 mm Hg

Why It Matters

Knowing your numbers can help prevent heart disease, stroke, and kidney problems. Regular checks help you stay informed and empowered.

Key Takeaways

• ACC/AHA guidelines recommend a blood pressure target of under 130/80 for adults 65 to 80 with stable heart disease, and not below 130/65 for adults over 80.

• Some blood pressure elevation may be unavoidable for some people, but following lifestyle changes can help.

• Speak with your healthcare provider or registered dietitian nutritionist for any questions.