Blood pressure as we age: What is a healthy target?

Aug 24, 2023

Blood pressure as we age: What is a healthy target?

In this video, Drs. Anthony Levinson and Richard Sztramko will discuss high blood pressure and what healthy blood pressure targets are for older adults. You will meet Russell, who has taken their blood pressure at a local pharmacy and gotten a result of 140/95. Learn what their best next steps would be.

0:00 - Meet Russel
0:10 - What is blood pressure?
0:55 - How do you properly measure blood pressure at home?
2:13 - What time of day should you take your blood pressure?
3:11 - What kind of blood pressure monitor should I choose?
4:13 - Is there an ideal blood pressure target?
6:01 - Why is it important to measure your blood pressure at home?
8:03 - Why is it important to maintain an ideal blood pressure?
10:23 - Which people are at increased risk for developing high blood pressure?
11:07 - What are the main causes of high blood pressure?
13:03 - Back to Russel

Learn more at: https://www.mcmasteroptimalaging.org/…

This work is supported through the McMaster Institute for Research on Aging and funds provided by the Dean and Vice-President, Faculty of Health Sciences at McMaster University.

Disclaimer: These videos are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The videos may be used for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal ([email protected]).

Content

0.399 -> russell went to their local pharmacy to

2.8 -> check his blood pressure

4.72 -> the result was 140 over 95.

8.72 -> what does this mean

11.2 -> as blood circulates through your body it

14.24 -> exerts pressure against the walls of

16.4 -> your arteries that pressure is what's

18.88 -> measured with a blood pressure device

21.76 -> blood pressure is measured by two

23.519 -> numbers

24.56 -> systolic or the top number or the first

27.92 -> number and diastolic the bottom or the

30.88 -> second number

32.48 -> systolic measures the pressure in your

34.719 -> arteries when your heart is pumping

37.76 -> diastolic measures the pressure in your

40.16 -> arteries when they're resting and

42.48 -> refilling

44.079 -> high blood pressure is something you

46.16 -> need to avoid in order to keep your

48.239 -> heart and arteries healthy and clear of

51.12 -> any cardiovascular disease

53.76 -> so let's start with the basics how do

56 -> you properly measure blood pressure at

57.92 -> home

58.879 -> great question anthony blood pressure is

61.28 -> always best measured at rest

63.68 -> it's important to take your blood

64.799 -> pressure following these easy

66.32 -> instructions

68.08 -> sit comfortably in a chair that offers

69.76 -> good back support much like the one that

71.84 -> i'm in now and uncross your legs

74.32 -> place the proper size blood pressure

75.84 -> cuff on one of your arms

77.759 -> the cuff should fit snugly around your

79.439 -> arm you should be able to fit two

81.119 -> fingers inside the cuff after it's been

83.119 -> placed on your arm

84.64 -> and the bottom of the cuff should be

86.159 -> three centimeters above your elbow

89.04 -> it's important to note that there are

91.2 -> several sizes of blood pressure cuffs so

93.52 -> if your arm is slightly larger

96.159 -> you can get a bigger cuff and if your

97.84 -> arm is smaller you can get smaller size

100 -> cuffs so if the blood pressure cuff does

102.24 -> not fit properly make sure you go see

104.479 -> your physician or another healthcare

106.399 -> provider to make sure that you're taking

108.479 -> your blood pressure with the right size

110.079 -> cup

111.28 -> put your arm on the armrest so that your

113.68 -> blood pressure cuff is at the same level

115.759 -> as your heart roughly around here

118.719 -> and relax for five minutes and do not

120.799 -> talk

121.759 -> if you have time take your blood

123.28 -> pressure three times over that five

125.28 -> minute period and discard the first

127.36 -> reading and average out the second and

129.2 -> third readings keep a log of your

131.28 -> readings for your doctor are there any

132.959 -> particular times of day or uh eating

136.56 -> drinking activities that you should

138.72 -> avoid before taking your blood pressure

141.44 -> it's good to take your blood pressure

142.959 -> actually at various times throughout the

145.28 -> day and the more readings you can take

148.319 -> and average the amount the more accurate

150.879 -> your blood pressure

152.319 -> readings will be overall

155.36 -> generally it's good to take your blood

156.72 -> pressure before meals

159.28 -> avoiding significant amounts of caffeine

163.04 -> or alcohol intake are also good as both

166 -> of those substances can increase your

167.92 -> blood pressure

169.2 -> avoiding vigorous activity or exercise

171.84 -> before taking your blood pressure is

173.36 -> also

174.56 -> advised it's good to have you in a low

176.8 -> stress environment as well so if you're

178.72 -> very

179.599 -> stressed

180.64 -> or anxious about something that can

182.72 -> artificially increase your blood

184.48 -> pressure

185.519 -> and so um taking it when you're more

187.84 -> relaxed is advised where would i

190.239 -> actually get a a machine or device to

193.28 -> measure my blood pressure the most

195.599 -> common place

196.8 -> that people get them would be a pharmacy

199.599 -> there's usual usually multiple brands

202.239 -> that are available and obviously

204.799 -> picking up a blood pressure cuff that is

207.599 -> health canada approved or fda approved

210.72 -> is important there are automated cuffs

213.36 -> now that can cycle on a regular basis um

216.879 -> and uh

218.239 -> help you average out your blood pressure

220.319 -> um in an easier fashion and then there

222.56 -> are more complex

224.64 -> apps now where

226.48 -> you can actually follow your blood

228 -> pressure on your smartphone or on

230 -> various other devices and log into a

231.92 -> portal so there's lots of different

234.319 -> options for people depending on how

236.64 -> high-tech or low-tech even writing your

239.68 -> blood pressure

241.28 -> readings down in a journal so that you

243.68 -> can take those to your doctor

245.76 -> is helpful as well so as long as you

248.08 -> have the right size cuff and you've got

250.239 -> a device there are many options for you

252.959 -> so is there an ideal blood pressure

255.519 -> there are ideal numbers to target for

257.84 -> blood pressure there are many different

260.479 -> organizations that publish cut offs on

263.199 -> what the numbers should be

264.88 -> but i find the simplest follower the

267.04 -> american college of cardiology and the

269.28 -> american heart association's

271.84 -> joint guidelines a normal blood pressure

274.56 -> is below

275.6 -> 120 systolic and 80 diastolic you're

279.12 -> classified as having elevated blood

281.04 -> pressure if your systolic is between 120

284.24 -> and 129 and your diastolic blood

286.8 -> pressure is less than 80.

289.199 -> high blood pressure or hypertension is

291.6 -> classified as stage 1 if your systolic

294.639 -> is 130 to 139

297.12 -> and your diastolic is 80 to 89 and stage

300.8 -> 2

301.919 -> if your systolic is greater than 140 and

304.16 -> your diastolic is greater than 90.

307.039 -> it's important to note that the reason

309.68 -> there are these different stages is that

312.24 -> as your blood pressure increases both

314.32 -> your systolic and diastolic your risk

317.12 -> for having adverse events such as a

319.28 -> stroke or heart attack increases so the

322.24 -> lower the stage or even normalizing your

325.199 -> blood pressure will provide benefit in

327.6 -> decreasing your risk for these poor

329.6 -> health outcomes you should note that if

332.08 -> there's a disparity in the category

333.919 -> between the systolic and diastolic

336.24 -> pressures the higher value determines

338.8 -> the stage

340 -> and other things to consider are that

342.56 -> if your

343.6 -> systolic blood pressure is classified as

345.84 -> being hypertensive

347.44 -> and your diastolic blood pressure is

349.84 -> within normal limits you can have

352 -> isolated systolic hypertension and the

355.759 -> reverse is true also you can have

357.52 -> isolated diastolic hypotension

360.56 -> so why is it important to measure the

362.88 -> blood pressure at home

364.8 -> and is it relatively accurate if i do

367.84 -> measure it at home

369.68 -> absolutely it's the most accurate when

371.919 -> you measure your blood pressure at home

374.16 -> the reason being when you go into a

376.16 -> doctor's office

378.479 -> you can have feelings of anxiety and

381.919 -> stress and so that can increase your

383.759 -> blood pressure so there's something

385.52 -> called white coat hypertension where

387.199 -> people will go into a doctor's office

389.36 -> and measure measure their blood pressure

391.44 -> and it's elevated but if you were to

393.28 -> measure it at home then it's actually

395.919 -> normal because their stress levels

398.24 -> that their body sees on a day-to-day

400.16 -> basis are lower so you wouldn't want to

402.639 -> go into your doctor's office get

404.24 -> diagnosed with high blood pressure you

406.4 -> started on medications that you don't

408.08 -> need and then when you go home your

409.52 -> blood pressure is actually low

411.599 -> and the reverse can be true also so when

414.56 -> people go into their doctor's office

416.72 -> their blood pressure may be normal

419.039 -> and when they go home their blood

420.8 -> pressure is elevated and that's called

423.039 -> masked hypertension

424.8 -> so for both of those reasons and for

427.039 -> having your stress levels be reflective

429.36 -> of what they are on a day-to-day basis

432.24 -> it's more accurate to measure your blood

434.479 -> pressure at home

436.4 -> the most accurate way to measure

438.72 -> someone's blood pressure is by using

441.12 -> ambulatory blood pressure monitoring

443.36 -> where people will wear a blood pressure

445.28 -> cuff over a 24 hour period or 48 hour

448.56 -> period and that blood pressure cuff will

450.72 -> cycle on a regular basis

452.72 -> and then you can be provided with

455.36 -> daytime average blood pressure readings

457.919 -> nighttime average blood pressure

459.36 -> readings and so there are slightly

461.039 -> different cutoffs that your physician

462.72 -> would interpret to diagnose hypertension

465.599 -> in that case so it's great to have these

468.72 -> different

469.759 -> non-office based blood pressure

471.36 -> management

473.12 -> blood pressure measuring solutions to

475.039 -> make sure that you're getting the most

476.56 -> accurate blood pressure

478.639 -> reading you possibly can so

480.96 -> why is it so important to maintain an

483.44 -> ideal blood pressure

485.919 -> well if you think about your heart as a

488.319 -> muscle

489.84 -> then you can see that your heart would

491.44 -> be working out against or pushing hard

494.72 -> against this higher pressure over

497.039 -> periods of time

498.479 -> and as that muscle

500.8 -> is getting worked out the size of it

502.96 -> increases and can actually impair

505.84 -> filling and the walls become stiff in

507.84 -> that muscle

509.039 -> the other thing is that the muscle can

511.68 -> become weak over time and so that can

513.519 -> result in heart failure

515.36 -> the other thing that the high blood

517.12 -> pressure

518.24 -> impacts is the blood vessels in your

520.64 -> body so when there's high pressure um

524.159 -> beating against your arteries on a

525.839 -> regular basis it causes atherosclerosis

528.88 -> which is the collection of cholesterol

531.68 -> and other kind of inflammatory

534.72 -> cells

535.68 -> and thickening of your arteries and when

537.839 -> that happens

539.68 -> strokes can happen

541.519 -> heart attacks can happen if those

543.519 -> plaques rupture and clots form

545.839 -> damage to your kidneys as they're trying

547.68 -> to filter your blood can happen and

550.32 -> people can have chronic kidney disease

553.04 -> and peripheral vascular disease as well

555.2 -> as eye problems so there's a whole host

558.64 -> of bad outcomes with respect to

562.16 -> high blood pressure if it's not managed

564.24 -> at a lower level

566.32 -> over time i guess this is

568.56 -> often why people talk about hypertension

571.519 -> being kind of a silent disease because

574.48 -> when you just have elevated blood

576.08 -> pressure you may not notice any signs or

578.8 -> symptoms unless it's extreme

581.36 -> but even if it's elevated and you're not

583.519 -> experiencing anything it may be causing

586.48 -> some of damage to your blood vessels and

589.36 -> to some of those other organs that

591.44 -> eventually do result in serious health

594.08 -> conditions

595.6 -> absolutely and the problems are manifest

598.72 -> usually over longer periods of time so

602 -> um it's really challenging to motivate

604.399 -> some people as well because they don't

606.079 -> feel like something's wrong and unless

607.92 -> they understand the risks to you know

610 -> their heart or let's say their brain and

612.32 -> the risk of developing dementia

614.959 -> it's hard for them to alter their

616.399 -> lifestyle because there doesn't seem to

618.56 -> be any immediate threat to them so are

621.44 -> there any people who might be at

623.6 -> increased risk for developing high blood

625.76 -> pressure

627.12 -> absolutely so the risk of blood pressure

629.6 -> increases

631.12 -> as you age so if you're older than age

634 -> 65 about 50 of people have high blood

636.72 -> pressure

637.6 -> if you have relatives that have high

639.6 -> blood pressure because it's thought to

641.68 -> have a significant genetic component

644.56 -> that if you are uh black or of african

647.36 -> descent of south asian descent or first

649.92 -> nations heritage um where high blood

652.399 -> pressure is more common and if you are a

654.88 -> male or female past menopause's men are

657.68 -> more likely to develop high blood

659.519 -> pressure in women but the risk for women

662.72 -> increases after menopause

665.6 -> what are some of the main causes of high

667.92 -> blood pressure

669.2 -> there are two main causes or types of

671.68 -> high blood pressure so there's primary

674.079 -> which is also known as essential it is

676.64 -> usually the common age-related one that

678.88 -> we see

680.079 -> in this case there's no easily

682.079 -> identifiable

683.44 -> cause for the high blood pressure and we

685.519 -> don't understand

687.12 -> the pathophysiology in general so

689.44 -> there's some genetic or environmental

691.519 -> exposures which over the course of

693.44 -> someone's life result in them having

695.279 -> high blood pressure

696.8 -> there are a number of lifestyle factors

698.56 -> that can increase the risk of having

700.32 -> having essential hypertension

702.48 -> including having too much salt in your

704.48 -> diet drinking alcohol excessively

707.68 -> being overweight

709.519 -> getting insufficient exercise or being

712.48 -> sedentary and experiencing unmanageable

715.6 -> stress those are the primary causes

719.04 -> or primary cause or essential

720.959 -> hypertension

722.399 -> what are some of the other potential

724 -> causes so the other causes are known as

727.04 -> secondary when there is an identifiable

730.16 -> cause

732 -> for

732.72 -> high blood pressure

734.24 -> some of these include

735.92 -> chronic kidney disease so you're not

738 -> able to get rid of

740.48 -> some of the sodium that's circulating in

742 -> your blood

743.279 -> hormone disorders such as thyroid

745.279 -> problems or adrenal gland

747.76 -> problems

749.12 -> some drugs such as the oral

750.8 -> contraceptive pill or non-steroidal

753.8 -> anti-inflammatory drugs these include

756.16 -> things like advil and sleep out you know

759.6 -> there's a really exhaustive list of

762.079 -> these secondary problems um and there

765.36 -> are

766.079 -> reasons why your

767.44 -> doctor might suspect you have a

768.959 -> secondary cause and if that's the case

772.079 -> uh generally you'll you'll have to

774.399 -> undergo

775.519 -> different sets of tests

777.279 -> to come up with a firm diagnosis

780.32 -> russell went to the local pharmacy and

782.8 -> used the machine to check their blood

784.88 -> pressure the result was 140 over 95

789.68 -> after two weeks of taking their blood

791.6 -> pressure at home with similar readings

794.079 -> they decided to make an appointment with

795.92 -> their family physician to discuss the

798 -> next steps

799.6 -> their doctor diagnosed them with

801.519 -> hypertension and suggested that they

803.839 -> first attempt to make some lifestyle

806 -> changes before they consider the need

808.399 -> for medications

818.8 -> you

Source: https://www.youtube.com/watch?v=b802r8I8LuE