Life after 60: What causes high blood pressure?

Life after 60: What causes high blood pressure?

As we age, our bodies go through natural changes that can make maintaining a healthy blood pressure more challenging. Understanding what drives high blood pressure (hypertension) after 60 can help you take informed steps to protect your heart and blood vessels.

What is blood pressure?

Blood pressure measures the force of blood pushing against artery walls as your heart pumps. It’s recorded as two numbers:

• Systolic (top number): pressure when the heart contracts
• Diastolic (bottom number): pressure when the heart relaxes

Normal blood pressure is below 120/80 mm Hg. Hypertension generally starts at 130/80 mm Hg or higher.

Why does blood pressure often rise after 60?

Several age-related changes in blood vessels and heart function contribute to higher blood pressure in later life:

1. Arterial stiffening

   • With age, large arteries (like the aorta) lose elasticity and become stiffer.
   • Stiffer vessels can’t expand as easily when the heart pumps, so systolic pressure rises.
   • Franklin et al. (1997) showed that systolic hypertension becomes more common in older adults due to this stiffening.

2. Endothelial dysfunction

   • The endothelium is the inner lining of blood vessels, producing substances (like nitric oxide) that help vessels relax.
   • Seals et al. (2011) found that aging reduces endothelial function, decreasing nitric oxide availability and impairing vessel relaxation.
   • This leads to higher resistance in small arteries and arterioles, raising diastolic pressure and overall workload on the heart.

3. Changes in blood volume and kidney function

   • Kidneys regulate blood volume and salts; reduced kidney function with age can lead to salt and water retention.
   • Excess fluid in circulation increases blood volume, pushing up pressure on vessel walls.

4. Overactive hormonal systems

   • The renin-angiotensin-aldosterone system (RAAS) helps control blood volume and vessel constriction.
   • Aging and some genetic factors can cause RAAS to be overactive, narrowing vessels and retaining sodium.

Common risk factors in later life

Besides the natural aging process, several lifestyle and health factors further elevate hypertension risk after 60:

• Sedentary lifestyle
– Lack of regular physical activity weakens cardiovascular fitness and promotes weight gain.
– Exercise helps keep vessels flexible, supports healthy weight, and lowers blood pressure.

• Unhealthy diet
– High salt intake leads to fluid retention and increased blood pressure.
– Diets rich in saturated fats, processed foods, and sugar can worsen artery health.

• Overweight and obesity
– Extra body weight increases the workload on the heart and blood vessels.
– Fat tissue, especially around the abdomen, produces hormones that can raise blood pressure.

• Chronic stress
– Prolonged stress raises levels of “fight or flight” hormones (adrenaline, cortisol), causing temporary spikes in blood pressure.
– Over time, this can contribute to sustained hypertension.

• Excessive alcohol and tobacco use
– Heavy drinking can raise blood pressure and damage heart muscle.
– Smoking damages vessel walls, reduces elasticity, and promotes plaque buildup.

• Sleep apnea
– Interrupted breathing during sleep triggers sudden blood pressure surges.
– Over time, this can lead to persistent hypertension.

• Family history and genetics
– A family history of hypertension increases your risk, especially when combined with other factors.
– Certain genetic variants affect how your body regulates salt, fluid, and vessel tone.

• Other health conditions
– Diabetes, high cholesterol, and chronic kidney disease often coexist with hypertension, each worsening the other.

Recognizing symptoms and taking action

High blood pressure is often called the “silent killer” because it may cause no obvious symptoms until serious damage occurs. However, some people notice:

• Headaches, especially in the morning
• Dizziness or lightheadedness
• Blurred vision
• Nosebleeds

These signs aren’t specific to hypertension, so relying on symptoms alone can be misleading. Regular checks are crucial:

• Aim for a blood pressure reading at least once a year if it’s normal.
• Check every 3–6 months if you have prehypertension (120–129/80 mm Hg) or other risk factors.
• If you’re on medication, follow your doctor’s recommended schedule.

If you’re unsure about certain symptoms or want a quick online evaluation, try a free, online symptom check for high blood pressure before your next appointment:
symptom check

How to manage and lower blood pressure after 60

Even if age-related changes make hypertension more likely, there’s a lot you can do to keep blood pressure in check:

1. Adopt a heart-healthy diet

   • Follow the DASH diet (Dietary Approaches to Stop Hypertension):
     • Plenty of fruits, vegetables, whole grains
     • Low-fat dairy products, lean proteins (fish, poultry, beans)
     • Nuts, seeds, and healthy oils (olive, canola)
     • Limit salt to 1,500–2,300 mg per day

2. Get regular physical activity

   • Aim for at least 150 minutes per week of moderate-intensity exercise (walking, swimming, cycling).
   • Include muscle-strengthening activities on 2 or more days weekly.
   • Even short, frequent walks can improve vessel flexibility and lower stress.

3. Maintain a healthy weight

   • Losing just 5–10% of body weight can have a significant impact on blood pressure.
   • Combine diet changes with exercise for sustainable results.

4. Limit alcohol and quit smoking

   • Keep alcohol to no more than 1 drink per day for women and 2 for men.
   • Seek support programs, nicotine replacement, or medications to help quit smoking.

5. Manage stress

   • Practice relaxation techniques: deep breathing, meditation, yoga, or tai chi.
   • Stay socially connected—friends, family, community groups can provide emotional support.
   • Hobbies and leisure activities help distract from daily worries.

6. Monitor your blood pressure at home

   • Use a validated home blood pressure monitor.
   • Follow instructions carefully—sit quietly for 5 minutes, keep arm at heart level, avoid caffeine or exercise 30 minutes before.
   • Record readings and share them with your doctor.

7. Take medications as prescribed

   • Many people over 60 need medication to reach target blood pressure.
   • Classes include ACE inhibitors, ARBs, calcium-channel blockers, diuretics, and beta-blockers.
   • Report side effects promptly—your doctor may adjust doses or switch drugs.

When to seek medical attention

High blood pressure can quietly damage your heart, kidneys, brain, and eyes over time. Seek immediate care if you experience:

• Severe chest pain or shortness of breath
• Sudden weakness or numbness on one side of the body
• Slurred speech or difficulty understanding speech
• Severe headache with vision changes
• Sudden confusion or fainting

Any of these could signal a life-threatening condition (heart attack, stroke, hypertensive crisis). Always speak to a doctor about concerning symptoms or readings.

Final thoughts

While aging makes high blood pressure more likely, understanding the causes and taking proactive steps can help you stay healthy and independent well into your golden years. Regular check-ups, a balanced lifestyle, and working closely with your health care team are key.

If you ever feel uncertain about new symptoms or sudden changes in your well-being, don’t hesitate to do a quick symptom check and then speak to a doctor—especially for anything that could be life threatening or serious. Protecting your heart health is an investment in a vibrant, active life after 60.