February 28, 2014

High Blood Pressure in Elderly Men

By Diane Walker, RN, MS, CSA

According to the National Institutes of Health, one out of every three adults living in the United States has some form of cardiovascular disease. These numbers increase as we age so the elderly are impacted to a greater degree.  Heart disease, angina, and strokes — types of hypertensive heart disease — are the leading causes of death for males who are middle-aged and older. Much like the incidence of the diseases, the severity of these conditions worsen as the years progress. The primary cause of hypertensive heart disease is chronically elevated blood pressure.  According to the Framingham Study, hypertension accounts for about one quarter of heart failure cases. In the elderly population, as many as 68% of heart failure cases are attributed to hypertension.

High blood pressure is one of the most common cardiovascular problems that both men and women fail to address, but this condition is of particular importance to men.  Many younger males, especially those who are physically fit and active, have a tendency to avoid going to their doctor for regular physical check ups. Up until the age of 45, men have a higher rate of high blood pressure than women. From the age of 64 onward, women have a higher occurrence of hypertension.   The American Heart Association (AHA) noted that over 27,688 men died in 2009 alone as a result of high blood pressure. These deaths accounted for over 44.8% of all fatalities resulting from high blood pressure.


Risk Factors for High Blood Pressure in Elderly Men

There are two primary types of hypertension. Essential hypertension, a form that has no identifiable cause, accounts for 90% of cases of hypertension in adults. Secondary hypertension is caused by another medical condition that affect your kidneys, arteries, heart or endocrine system.

Secondary hypertension accounts for the remaining 10% of cases of chronically elevated blood pressure.  The risk factors for high blood pressure, however, are diverse and include genetics, race, family structure, obesity, aging, and the presence of other chronic diseases.

Having a personal family history of hypertension increases the likelihood that an individual develops hypertension The AHA also identifies that males of African American descent have a genetic predisposition to high blood pressure, as over 42% of men over the age of 20 in this cohort suffer from the health condition. This figure is slightly less for non-Hispanic whites (33%) and lesser still for Mexican Americans (30%).

A 2013 study from the National Institutes of Health concluded that genetics, combined with family structure and stability during a child’s formative years, also plays a role in high blood pressure. The study found African-American males as one of the most at-risk groups and revealed that those who grew up in two-parent homes for the first 12 years of their lives were less likely to have hypertension later in life than those raised in a single-parent household.

Scientific Director of the National Human Genome Research Institute, Dan Kastner, M.D., Ph.D, noted that “Family structure is among a slew of environmental influences that, along with our genes, help determine our health as adults. This study makes important observations about home life that may affect susceptibility to complex diseases later on in life.”

Despite the differences in frequency that hypertension affects people of different racial groups, it is important to remember that no one is immune from the disease. Other factors, such as additional health problems, including diabetes also play a role in high blood pressure. The CDC notes that 60% of all individuals with diabetes also have high blood pressure.

There are many risk factors that can greatly affect your loved one’s chances of developing dangerous hypertension levels.  Knowing what constitutes normal, elevated, and dangerous blood pressure levels is also important. The ideal systolic/diastolic blood pressure ratio is 120/80, with many individuals falling within a few points of each.

Hypertension is classified as any ratio over 140/85, with the worst readings being anything 160/100 and higher. 180/110 is considered life-threatening; if you or your loved one has a reading approaching these numbers, seek emergency medical care immediately.

What Causes High Blood Pressure in Elderly Men?

Genetic and family health history characteristics notwithstanding, listed below are the top contributing factors of hypertension in males and elderly men more specifically.

  •     Poor diet and a lack of exercise – Foods high in salt and bad cholesterol are a big no-no for our heart. They clog your arteries which in turn makes it more difficult for the blood to flow. High salt-intake has been estimated as a contributing factor in 20-40% of all cases of hypertension.
  •     An overworked and high-stress lifestyle – In today’s fast-paced society, staying relaxed is easier said than done. However, stress is one of the biggest causes of high blood pressure, so it pays to try to relax. Vigorous exercise, mental clarity (consider meditating daily) and getting adequate sleep can all help contribute to reducing your risk of high blood pressure.

According to the CDC, the best way to minimize your risk of developing life-threatening hypertension and achieve normal blood pressure levels (remember, 120/80 is the sweet spot) is to monitor your blood pressure or have your doctor take regular readings if you do not have a home monitoring device.

Your doctor may also be able to prescribe medication to help you treat your high blood pressure, as well as offer you guidance on lifestyle changes. A 2007 issue of Harvard Men’s Health Watch reported that one such drug being used to treat hypertension is Viagra, more commonly used to treat erectile dysfunction. The study cautions that men who use nitrates (prescription drugs typically used to treat angina and that include glyceryl trinitrate (GTN), isosorbide dinitrate, and isosorbide mononitrate) should avoid using ED medications. When used to treat hypertension, Viagra is often called “Reviato.” The function of these ED medications is to widen arteries to reduce blood pressure.

In men, the risk of hypertension leading to premature heart failure and other severe cardiovascular ailments is much higher, which is why regular monitoring and an appropriate treatment plan is essential for maintaining good health.