Ideal Blood Pressure for 85-Year-Olds: A Comprehensive Guide

What Should an 85-Year-Old’s Blood Pressure Be?

The American Heart Association and the American College of Cardiology use a set of guidelines jointly developed in 2017 to determine blood pressure categories. One blood pressure chart applies to all adults, regardless of age or sex.

This is different from the American College of Cardiology and the American Heart Association guidelines from 2011, where the normal blood pressure goal was a systolic blood pressure under 140–145mmHg in those over 80 years of age.

High blood pressure is more common with age due to changes in the heart and blood vessels that occur with aging. This means older adults are more likely to have higher BP than younger ones.

At the same time, the elderly are more likely to have isolated systolic hypertension – where only systolic blood pressure is in the high ranges.

Keep in mind that the blood pressure of older adults can be affected by external factors. For instance, other conditions like diabetes and sleep apnea and medication like NSAIDs can raise your blood pressure.

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Why Blood Pressure Matters at 85

It’s now clear that there is no separate blood pressure table for the elderly. But it is also clear that older people are more likely to have high blood pressure. Why is this?

At age 85, there are many changes in your cardiovascular system compared to a younger person. At 65, you are not only more likely to have high blood pressure, but your risk of cardiovascular disease also increases.

The major reason is that the arteries in your body get stiffer as you get older. This stiffness, especially in large arteries like the aorta, directly increases blood pressure.

To simplify why, it is because changes in your circulatory system cause part of the first pressure wave to be reflected backward. It arrives in time to “join” the next pressure wave, adding to it and increasing the systolic blood pressure.

The balance of blood pressure: high vs. low

High blood pressure (hypertension) is when the pressure of your blood in the vessels exceeds 130/80mmHg. Elevated blood pressure, over time, weakens and damages the vessels.

Hypertension typically doesn’t present with any symptoms, hence why it is called the “silent killer.”

Low blood pressure (hypotension) is when the pressure of your blood in the vessels is below 90/60mmHg. Lower blood pressure makes it harder for blood to feed all the parts of your body as effectively as it would with normal blood pressure.

You can tell low blood pressure by the symptoms it typically presents with:

• Dizziness
• Lightheadedness
• Fatigue
• Blurred vision
• Nausea and vomiting
• Confusion
• Fainting

Both high and low blood pressure are especially dangerous for older people. Cardiovascular diseases are already more common in older people, and so poorly controlled high blood pressure can further increase that risk.

Hypotension makes the heart work harder to properly supply the body with blood, and this can stress the heart to the point of damage or failure. Lightheadedness, dizziness, and fainting can also predispose to falls that can cause injury.

Risks of High Blood Pressure for People at 85

While hypertension and hypotension come with risks, it can be helpful to know the exact complications that can come with it and the mechanism that leads to these.

Most complications from hypertension are caused by the effect that high blood pressure has on your arteries. The constant high pressure damages the inner lining of these vessels, making them stiffer, weaker, and narrower. This damage to arteries throughout the body can cause:

• Stroke
• Heart failure
• Heart attack
• Changes in or loss of vision
• Aneurysm
• Chest pain (angina)
• Chronic kidney disease
• Vascular dementia

This pressure can also force the heart to pump harder, and over time, this leads to thickening (hypertrophy) of the heart’s left ventricle. This leads to an increased risk of cardiovascular disease such as:

• Cardiac arrest
• Heart failure
• Coronary artery disease
• Sudden cardiac death

The relationship between kidney function and a person’s blood pressure is an important one to pay attention to.

Optimal kidney function is important in maintaining healthy blood pressure. The kidneys remove excess fluid that may increase blood volume (and, in turn, BP) and are also responsible for balancing the sodium in the blood, which can also increase BP.

However, when kidney function is impaired, it can prevent them from doing their job right. The kidneys have several tiny arteries feeding them, and these can be narrowed and damaged by hypertension in the same way as other arteries in the body.

The impaired blood flow to the kidneys (which can also occur with persistent hypotension) can reduce kidney function gradually and eventually cause failure.

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Decoding Blood Pressure Readings

It’s important to know how to read blood pressure. There are two blood pressure numbers every time you do a reading. The first is your systolic blood pressure, and the second is your diastolic blood pressure, and they are represented by the unit “mmHg,” or millimeters of mercury.

Systolic blood pressure is the force exerted on the artery walls by your blood as the heart contracts. The diastolic pressure is the force when the heart is relaxed, which is why it is always the lower value.

It’s important to know what blood pressure range is normal. The list below lists the different BP categories with the appropriate systolic blood pressure and diastolic pressure cutoffs:

• Normal range: <120 and <80mmHg
• Elevated blood pressure (prehypertension): 120–129 and <80mmHg
• High blood pressure (hypertension stage I): 130–139 or 80–89mmHg
• High blood pressure (hypertension stage II): >140 or >90mmHg
• Hypertensive crisis: >180 and/or >120mmHg

Blood pressure monitors are essential for older adults, especially if you’re 85 or older. Using your blood pressure monitor at home is the quickest and easiest way to keep tabs on your blood pressure and keep it well controlled.

When buying a monitor to monitor your or a loved one’s blood pressure, look for a digital monitor with an easy-to-read display, a cuff that is worn on the upper arm, and a long battery life. The Cardi Health BP Monitor has all of these and also integrates easily with the app for easy logging of BP readings.

For accurate readings, the tips below can help:

• Rest for 5 minutes before the measurement.
• Wear the cuff on your bare skin and not too tight.
• Do not talk while measuring.
• Measure at least twice and discard a reading with more than a 10mmHg difference in the systolic reading.
• Measure at the same time every day.

Strategies to Maintain Healthy Blood Pressure

There are many lifestyle changes you can make to reduce blood pressure, and sometimes they can be enough to hit your blood pressure targets.

• Start on a heart-healthy diet. Following the recommendations of the DASH diet can help with lowering blood pressure. This means more fruits, vegetables, fiber, and low-fat dairy foods. Also, reduce the salt and saturated fat content in your diet. Foods like bananas, avocados, salmon, oats, and nuts, are rich in nutrients that can help control BP.
• Limit alcohol intake. If you drink alcohol, try to limit it or stop entirely. Alcohol is well-established to gradually increase your blood pressure.
• Reduce caffeine consumption. Caffeine causes an acute rise in your blood pressure. Aim to reduce your coffee, energy drink, and soft drink intake, at least before you measure your BP.
• Get more active. Regular exercise is one of the best lifestyle changes because it can help with hypertension and your overall health. At 85 years old, gentle exercises like walking or riding a stationary bike multiple times a week might be sufficient.
• Aim for losing weight. Blood pressure falls as your BMI goes down. Regular exercise and a good diet are lifestyle changes that can directly benefit hypertension and also help with weight loss.
• Manage your stress. You might not realize it, but when your daily life always ends with you stressed out, it can raise your BP. Your blood pressure falls if you can manage stress well. Stress management techniques like yoga and meditation can help.

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FAQ

Is there a separate blood pressure chart for elderly people?

No, the 2017 guidelines by the American Heart Association and the American College of Cardiology provide one blood pressure chart for all adults, regardless of age.

What are the risks of high blood pressure for someone aged 85?

High blood pressure in those over 85 can lead to complications such as stroke, heart failure, visual changes, and chronic renal disease due to the damage it causes to arteries.

How can one differentiate between hypertension and hypotension based on readings?

Hypertension, or high blood pressure, exceeds 130/80mmHg, while hypotension, or low blood pressure, is below 90/60mmHg. Both conditions come with specific symptoms and risks.

How can I ensure accurate blood pressure readings at home?

For accurate readings, rest for 5 minutes before measuring, wear the cuff on bare skin, remain silent during the process, and consistently measure at the same time daily using a reliable digital monitor.

What lifestyle changes can help maintain a healthy blood pressure?

Adopting a heart-healthy diet, limiting alcohol and caffeine, engaging in regular exercise, managing weight, and practicing stress-reducing techniques like meditation can help in maintaining healthy blood pressure.

Conclusion and Final Thoughts

As an 85-year-old with hypertension, there’s an increased risk of many cardiovascular health conditions. This is why regular monitoring of your or your loved one’s blood pressure is essential.

However, as much as you monitor your blood pressure at home, it is important to see your doctor regularly. Any complicating health conditions can be detected early and treated appropriately.

Managing hypertension in older adults is more meticulous than in younger people, so always make sure to follow your doctor’s advice and recommendations.

Written by

Robertas Pranevicius, MD

Robertas Pranevicius is a medical advisor at Cardi Health who earned his Master’s degree and cardiology residency from the Lithuanian University of Health Sciences. He specializes in interventional cardiology and performs both diagnostic and therapeutic invasive procedures. In recent years, he has focused on structural heart disease treatment, such as transcatheter aortic valve implantation (TAVI).