You can have high blood pressure, or hypertension, and still feel just fine. That’s because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called “the silent killer,” is very common in older people and a major health problem. If high blood pressure isn’t controlled with lifestyle changes and medicine, it can lead to stroke , heart disease , eye problems, kidney failure, and other health problems. High blood pressure can also cause shortness of breath during light physical activity or exercise.
Blood pressure is the force of blood pushing against the walls of arteries. When the doctor measures your blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by your heart pushing out blood. The second number, called diastolic blood pressure, is the pressure when your heart fills with blood. The safest range, often called normal blood pressure, is a systolic blood pressure of less than 120 and a diastolic blood pressure of less than 80. This is stated as 120/80.
One reason to have regular visits to the doctor  is to have your blood pressure checked. The doctor will say your blood pressure is high when it measures 140/90 or higher at two or more checkups. He or she may ask you to check your blood pressure at home at different times of the day. If the pressure stays high, even when you are relaxed, the doctor may suggest exercise , changes in your diet, and medications.
The term “prehypertension” describes people whose blood pressure is slightly higher than normal—for example, the first number (systolic) is between 120 and 139, or the second number (diastolic) is between 80 and 89. Prehypertension can put you at risk for developing high blood pressure. Your doctor will probably want you to make changes in your day-to-day habits to try to lower your blood pressure.
|Normal Blood Pressure||Less than 120||Less than 80|
|Prehypertension||Between 120–139||Between 80–89|
|High Blood Pressure||140 or more||90 or more|
|Isolated Systolic Hypertension||140 or more||Less than 90|
For older people, the first number (systolic) often is 140 or greater, but the second number (diastolic) is less than 90. This problem is called isolated systolic hypertension. It is the most common form of high blood pressure in older people and can lead to serious health problems. Isolated systolic hypertension is treated in the same way as regular high blood pressure but often requires more than one type of blood pressure medication. If your systolic pressure is 140 or higher, ask your doctor how you can lower it.
If your systolic blood pressure is less than 90, you may have low blood pressure. You may feel lightheaded, dizzy, or even faint. Low blood pressure, or hypotension, can be caused by not drinking enough liquids (dehydration), blood loss, or too much medication.
Anyone can get high blood pressure. But, some people have a greater chance of having it because of things they can’t change. These are:
High blood pressure is very common in older people—over time most people find that aging causes changes to their heart. This is true even for people who have heart healthy habits. The good news is that blood pressure can be controlled in most people.
There are many lifestyle changes you can make to lower your risk of high blood pressure, including:
If these lifestyle changes don’t lower your blood pressure enough to a safe level, your doctor will also prescribe medicine. You may try several kinds or combinations of medicines before finding a plan that works best for you. Medicine  can control your blood pressure, but it can’t cure it. You will likely need to take medicine for the rest of your life. Plan with your doctor how to manage your blood pressure.
High blood pressure is serious because it can lead to major health problems. Make a point of learning what blood pressure should be. And, remember:
If your doctor asks you to take your blood pressure at home, keep in mind:
Here are some helpful resources:
National Heart, Lung, and Blood Institute
Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
National Library of Medicine
Search for: “high blood pressure”
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
For more information on health and aging, contact:
National Institute on Aging
P.O. Box 8057
Gaithersburg, MD 20898-8057
Sign up for regular email alerts  about new publications and find other information from the NIA .
Visit www.nihseniorhealth.gov , a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health and wellness information for older adults. Special features make it simple to use. For example, you can click on a button to make the type larger.
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services