Understanding Blood Pressure Charts For The Elderly

Learn how to understand and interpret elderly blood pressure charts

Blood pressure is an important metric that needs to be regularly monitored in older adults to identify potential health issues before they develop. Here, we are looking at blood pressure charts, why understanding them is so important, how to interpret one, what the normal blood pressure ranges are, factors that affect blood pressure in older people, how to measure and manage this at home, and how caregivers can support older people with blood pressure issues. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about blood pressure charts, we can help. 

What are normal blood pressure ranges for older adults, and how can readings be interpreted? 

As we age, our blood pressure tends to change in response to various health issues and the general effects of getting older. Different organisations might suggest slightly different numbers when they share their ideal blood pressure ranges, but according to the NHS, low blood pressure is considered to show a systolic reading of 89 mmHg or lower, and a diastolic reading of 59 mmHg or lower, which would be written as 89/59 mmHg. The range for normal blood pressure is considered to start from 90/60 mmHg, and go up to 120/80 mmHg, and these ranges apply whether you are measuring blood pressure at home or at a pharmacy, GP surgery or clinic.High blood pressure is considered to be anywhere from 135/85 mmHg or higher if your blood pressure reading was done at home. Or, if it was taken in a pharmacy, GP surgery or clinic, this could be anywhere from 140/90 mmHg or higher. If you have high blood pressure, this is usually categorised as one of 3 stages, as suggested by the British Heart Foundation:

1. Stage one is blood pressure that sits between 140/90 mmHg and 160/100 mmHg if measured in a pharmacy, GP surgery or clinic, or 135/85 mmHg to 150/95 mmHg if measured at home.
2. Stage two is blood pressure that sits between 160/100 mmHg and 180/120 mmHg if measured in a pharmacy, GP surgery or clinic, or over 150/95 mmHg if measured at home.
3. Stage three is blood pressure that sits over 180/120 mmHg if measured in a pharmacy, GP surgery or clinic, which is known as “severe hypertension” and will require an urgent GP assessment to find out the cause and start the required treatment as soon as possible. 

Older adults are more susceptible to developing high blood pressure due to isolated systolic hypertension, which causes the systolic reading to be 130 or higher, and the diastolic reading to be less than 80. This happens due to age-related stiffening of the arteries, which can cause serious health issues if not addressed. These readings could also cause shortness of breath during gentle physical movement, feeling faint or lightheaded when standing up too fast, or falls. Keep in mind that the above ranges are all merely guidelines for managing blood pressure, and each person’s target for what they might consider healthy may vary from others based on their specific health conditions and what their doctor has recommended.If you are unsure whether or not your readings are in the normal, low or high range, the NHS provides an online blood pressure reading service to help you find out.

How can blood pressure be accurately monitored at home? 

It is important to collect up-to-date, accurate data when measuring an older adult’s blood pressure at home. For an accurate reading of a person’s blood pressure, this usually involves a caregiver or medical professional checking their heart rate to ensure the readings are properly understood, and to give medical professionals a clearer picture of what is going on in the body. Doctors or carers will be looking out for an elevated systolic blood pressure reading, as this could sometimes indicate that the heart is having to work harder to pump blood around the body, causing additional cardiovascular stress. This number will naturally be higher in older adults as blood vessels become less elastic with age, but it is important to ensure this stays as close to the normal range as possible. Before you use a home blood pressure monitor on an older person, try to make sure they avoid anything that could temporarily raise their blood pressure, such as eating, drinking caffeinated drinks, exercising or smoking. Remind them to use the toilet before taking their reading, and have them wear clothing that makes it easy to apply the blood pressure cuff as it should be placed directly on the skin for the most accurate reading. Also, let them rest for a few minutes before taking their reading to allow their blood pressure to normalise. The left arm being used for readings is recommended for most people, unless they have something preventing this, such as a port for dialysis, lymphedema in the left arm or have had previous breast surgery on that side. As you take the reading, make sure their arm is resting at the same level as their heart, and their hand is relaxed and not tensed. The cuff should be snug but not too tight or loose and should be the correct size for the arm. All cuffs will have minimum and maximum measurements on to assist but each blood pressure monitor may be slightly different so be sure to read the instructions. Usually they will ask you to place the cuff around their arm just above the elbow to take the reading, and inflate as directed. It is best to take two or three readings around one or two minutes apart, and work out the average. Write down the readings so you can start to track any changes over time. Remember to always use the same arm, take readings at a similar time each day, record readings exactly (don’t round up or down), and always take their blood pressure according to their doctor’s recommendations – not too often or too infrequently. 

What factors affect blood pressure in older adults? 

There are several factors that can affect blood pressure in older people, and these include:

• Age – Blood pressure readings tend to change as we age, and this is natural as blood vessels tend to become stiffer over time, which can raise blood pressure. Despite this, blood pressure should still be in the normal ranges for older adults as described above, so you cannot chalk every potential health issue up to age. 
• Weight – People who have excess weight on their body or who suffer from obesity may notice their blood pressure increases due to the added strain on their heart.
• Diet – Those with a diet high in salt or with poor nutritional value may have elevated blood pressure. Certain foods can help to lower cholesterol that is linked to heart disease and hypertension, so eating a healthy diet can make a difference. 
• Physical Activity – A lack of physical exercise could contribute to higher blood pressure. Exercise is known to help lower blood pressure and is regularly recommended for the prevention and treatment of hypertension. 
• Medications – Certain medications can negatively impact blood pressure levels in older adults, such as certain pain medications, antidepressants, herbal supplements, stimulants and more. If you are taking any of these, you should be checked by your doctor regularly to ensure your blood pressure does not become too high, or you can discuss alternative medications with them that may not impact blood pressure.  
• Chronic Conditions – Those with chronic health conditions may find their blood pressure is affected as a result, such as chronic kidney disease, metabolic syndrome, obesity, sleep apnea, thyroid problems and more. These conditions are known to cause a rise in blood pressure, so if you are living with any of these conditions, you should check in regularly with your doctor to ensure your blood pressure is within a healthy range. 
• Stress – Stress can be responsible for a number of health conditions, and chronic stress is thought to lead to the formation of unhealthy habits that can increase your risk of high blood pressure, such as smoking, eating foods high in fat or sugar, overconsuming alcohol, not exercising enough, and more. 

How can older adults manage blood pressure? 

Older adults can manage theirblood pressurewith several effective strategies and lifestyle changes that can be done at home, either alone or with the help of a caregiver. For example:

• Eating a balanced diet – By paying more attention to food, you can balance your blood pressure. Add more fruits, vegetables, whole grains and lean proteins to your diet, and try to reduce salt and processed foods where possible. 
• Getting regular exercise – The British Heart Foundation recommends building up to at least 150 minutes of moderate aerobic activity per week to improve overall health and manage blood pressure. You can learn more in our guide to fitness and exercise for older adults.
• Maintaining a healthy weight – It is important to maintain a healthy weight in order to reduce the strain on your heart, as a lower BMI means it does not need to work as hard to pump blood around the body.  
• Limiting alcohol consumption – Research finds that drinking more than three drinks in one sitting can temporarily raise blood pressure, so consuming alcohol in moderation or avoiding it altogether can help you to keep blood pressure levels balanced.
• Quitting smoking – Smoking has been found to temporarily raise blood pressure, so if you are worried about high blood pressure or you have been warned that you have this already, it can be helpful to speak to your doctor about stopping smoking to improve your cardiovascular health.
• Staying hydrated – Hydration may not seem like an important factor in blood pressure management, but it is crucial to drink plenty of water in order to support your overall health, as well as improve blood circulation in the body. Blood consists of 90% water, so when you don’t drink enough, the body responds by narrowing blood vessels which can cause blood pressure to rise. You can learn more in our article: Symptoms Of Dehydration In Older People
• Improving sleep – It is believed that blood pressure decreases by 10-20% during sleep, so getting adequate sleep at night could help to lower your blood pressure. If you are struggling with sleep, speak to your doctor to find out if something else could be causing your sleep issues, such as sleep apnea. You can learn more in our guide to healthy sleep and insomnia in older adults.
• Regularly monitoring blood pressure – Scheduling regular blood pressure checks into your week (or however often your doctor recommends them) is extremely important in order to track any significant changes and adjust the treatments as necessary. If you are a caregiver, you should liaise with your older loved one’s doctor to keep them informed of any changes. 

As well as adopting the above habits, your doctor may recommend and prescribe blood pressure medications that can help to lower this for you, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium-channel blockers, ‘water’ tablets (thiazide diuretics), beta blockers or alpha blockers. Adherence to these medications as directed by a doctor is extremely important, in order to bring blood pressure to a safe level. It may be necessary to try out several types of medications, or a combination of different medications to find what works best. 

How can caregivers support older people in managing their blood pressure? 

Caregivers can support older people who need to manage their blood pressure at home by providing regular blood pressure monitoring and helping them maintain a healthy lifestyle. This could include things like:

• Assisting with meal planning to ensure they are eating a diet low in sodium 
• Encouraging and facilitating regular physical activity in a safe way 
• Monitoring blood pressure medication adherence and providing reminders if necessary (you may find more helpful information on this in our guide to easier medication management for older adults using blister packs)
• Offering emotional support and stress management techniques, such as mindfulness or relaxation exercises
• Keeping track of blood pressure readings
• Facilitating regular check-ups with healthcare providers

You can learn more about how to provide excellent care for those who require blood pressure monitoring in our article: Monitoring & Vital Signs Ranges For Older AdultsIf you or a loved one requires blood pressure monitoring and could use the help of a home care professional, you can reach out to your local Home Instead office to learn more. We offer vital signs monitoring at home, which includes blood pressure checks for older adults. Medical teams will need to be in contact to delegate these checks before they are carried out. Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.