How Age Affects Blood Pressure

Blood Pressure tends to increase with age

Does Blood Pressure Increase With Age?

Blood pressure tends to increase as we age, which can increase the risk of developing cardiovascular diseases such as heart attack, stroke, and heart failure. 

As we age, it is common for blood pressure levels to rise gradually. According to the American Heart Association, approximately two-thirds of adults over the age of 60 have high blood pressure. While there is no set amount by which blood pressure will rise as we age, on average, systolic blood pressure (the top number) tends to increase by about 1-2 mmHg per year, while diastolic blood pressure (the bottom number) may remain stable or even decrease slightly.

However, it's important to note that not everyone will experience a significant increase in blood pressure as they age. Lifestyle factors, such as diet, exercise, and stress management, can play a significant role in managing blood pressure levels. In addition, some people may be genetically predisposed to high blood pressure, regardless of their lifestyle habits or age. 

How Age Affects Blood Pressure

Stiffening of Arteries: As we age, our arteries become stiffer and less elastic, which can make it harder for them to expand and contract in response to changes in blood flow. This results in a rise in systolic blood pressure, which is the pressure in the arteries when the heart beats. In contrast, diastolic blood pressure may remain stable or even decrease slightly with age, in absence of other blood pressure issues.

Besides the increase in large artery stiffness and peripheral vascular resistance, there are several other pathophysiological factors that contribute to an increase in blood pressure with aging. These factors include:

  • Decreased Baroreceptor Sensitivity: Baroreceptors are specialized pressure sensors located in the walls of the blood vessels and the heart that help to regulate blood pressure. With aging, the sensitivity of these receptors decreases, which can impair the body's ability to respond to changes in blood pressure and maintain normal blood pressure levels.

  • Increased Responsiveness to Sympathetic Nervous System Stimuli: The sympathetic nervous system is a part of the nervous system that helps to regulate many bodily functions, including blood pressure. With aging, the sympathetic nervous system becomes more sensitive, leading to an increase in blood pressure.

  • Altered Renal and Sodium Metabolism: The kidneys play a crucial role in regulating blood pressure by controlling the balance of salt and water in the body. With aging, the kidneys may become less efficient at regulating this balance, leading to an increase in blood pressure.

  • Altered Renin-Aldosterone Relationship: Renin and aldosterone are hormones that regulate blood pressure by controlling the balance of salt and water in the body. With aging, the renin-aldosterone relationship may become altered, leading to an increase in blood pressure.

These pathophysiological factors contribute to an increase in blood pressure with aging, and they can interact with each other to further amplify the effect.

Increased Plaque Buildup: Plaque buildup is a gradual process that occurs when substances such as cholesterol, fat, calcium, and other cellular waste products accumulate inside the walls of arteries. This buildup is known as atherosclerosis and can cause the walls of the arteries to thicken and harden over time, making it difficult for blood to flow through them.

When plaque builds up in the walls of arteries, the passageway for blood flow becomes narrower, which can increase blood pressure. This happens because the heart has to work harder to pump blood through the narrower arteries, causing the blood pressure to rise.

A diet high in saturated and trans fats can contribute to plaque buildup by increasing the levels of bad cholesterol in the blood. This bad cholesterol, known as LDL cholesterol, can contribute to the formation of plaque in the arteries. Smoking can also damage the walls of the arteries, making it easier for plaque to build up.

High blood sugar levels and high blood pressure can also contribute to plaque buildup. High blood sugar levels can damage the lining of the arteries, making it easier for plaque to adhere to the walls. High blood pressure can cause the walls of the arteries to become damaged, leading to the formation of plaque.

Changes in Hormones: Hormonal changes that occur with age, such as a decrease in estrogen levels in women, can contribute to an increase in blood pressure. Women tend to have lower blood pressure than men until they reach menopause, at which point their blood pressure levels tend to rise to levels similar to those of men.

Lifestyle Factors: As we age, we may become less physically active and gain weight, both of which can increase blood pressure. Additionally, our dietary habits may change, which can also contribute to an increase in blood pressure. Eating a diet that is high in salt, for example, can increase blood pressure in some people.

Average age to start blood pressure medications?

There isn't a specific average age to start blood pressure medications, as the need for treatment depends on an individual's blood pressure levels, overall health, and the presence of other risk factors. It is true that hypertension is more common among older adults, primarily due to the natural aging process that can lead to the hardening and narrowing of arteries. As a result, older people may be more likely to require blood pressure medications compared to younger individuals.

he American College of Cardiology and American Heart Association (ACC/AHA) classify blood pressure levels as follows:

Normal: systolic blood pressure (SBP) < 120 mm Hg and diastolic blood pressure (DBP) < 80 mm Hg

Elevated: SBP 120-129 mm Hg and DBP < 80 mm Hg

Stage 1 hypertension: SBP 130-139 mm Hg or DBP 80-89 mm Hg

Stage 2 hypertension: SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg

Generally, healthcare providers may consider prescribing blood pressure medications if a patient has:

Stage 1 hypertension with a calculated 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 10% or higher, or if they have clinical ASCVD or diabetes.

Stage 2 hypertension, regardless of their 10-year ASCVD risk.

For younger individuals, lifestyle modifications are typically the first line of defense against elevated blood pressure or stage 1 hypertension.

For older individuals, blood pressure medications may be prescribed more frequently due to the higher prevalence of hypertension in this age group. Nonetheless, lifestyle changes are still essential and can complement the effects of medication, contributing to