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For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
In people aged under 50 years, more men than women have hypertension, [10] and in ages above 50 years the prevalence of hypertension is the same in men and women. [10] In ages above 65 years, more women than men have hypertension. [ 7 ]
There is an ongoing medical debate over what is the optimal level of blood pressure to target when using drugs to lower blood pressure with hypertension, particularly in older people. [ 13 ] Blood pressure fluctuates from minute to minute and normally shows a circadian rhythm over a 24-hour period, [ 14 ] with highest readings in the early ...
Automated blood pressure measurements over 15 to 20 minutes in a quiet part of the office or clinic can reduce (but not eliminate) incorrect blood pressure measures. [8] People with white coat hypertension do not exhibit the signs indicative of trepidation and their increased blood pressure is often not accompanied by tachycardia. [9]
For hypertensive men, alcoholic drinks should be reduced to 14 units per week. For hypertensive women, alcoholic drinks should be reduced to 8 units per week. (1 unit corresponds to 1/8 liter of wine or 1/4 liter of beer). [7] In addition to lifestyle changes, medication can also be used to reduce systolic hypertension to safe levels. [8] [9]
Although severe hypertension is more common in the elderly, it may occur in children (though very rarely), likely due to metabolic or hormonal dysfunction. In 2014, a systematic review identified women as having slightly higher increased risks of developing hypertensive crises than do men. [5]
Essential hypertension (also called primary hypertension, or idiopathic hypertension) is a form of hypertension without an identifiable physiologic cause. [1] [2] It is the most common type affecting 85% of those with high blood pressure. [3] [4] The remaining 15% is accounted for by various causes of secondary hypertension. [3]