Blood pressure is one of the most important measurements of your overall health. It shows how strongly your blood pushes against the walls of your arteries each time your heart beats and when it rests between beats.
Healthy blood pressure helps deliver oxygen and nutrients to every part of your body. However, when blood pressure stays too high for many years, it can slowly damage your heart, brain, kidneys, and blood vessels without causing obvious symptoms. That is why high blood pressure is often called the “silent killer.”
Heart disease and stroke remain two of the leading causes of death worldwide, and high blood pressure is one of their biggest risk factors. On the other hand, blood pressure that becomes too low can also cause problems, especially in older adults.
It may lead to dizziness, fainting, poor balance, and falls that can result in serious injuries such as broken bones. Finding the right blood pressure target is therefore a careful balancing act.
For many years, doctors generally recommended keeping the top blood pressure number, known as systolic blood pressure, below 140 millimeters of mercury (mmHg) for most older adults.
Systolic blood pressure measures the pressure in your arteries when your heart pumps blood. The bottom number, called diastolic blood pressure, measures the pressure when the heart relaxes between beats.
Over the past decade, researchers have learned more about how blood pressure affects long-term health. One of the most influential studies was the Systolic Blood Pressure Intervention Trial, better known as the SPRINT study. This large clinical trial included thousands of adults who were at high risk of heart disease but did not have diabetes.
The researchers divided participants into two treatment groups. One group aimed to lower systolic blood pressure to below 120 mmHg, while the other group aimed for below 140 mmHg.
After following the participants for several years, the scientists found that people in the lower-target group had fewer heart attacks, fewer strokes, fewer cases of heart failure, and fewer deaths related to cardiovascular disease.
At first, these findings suggested that everyone should aim for a blood pressure below 120 mmHg. However, doctors soon realized that the answer is more complicated, especially for older adults.
As people age, their bodies often become more sensitive to blood pressure medicines. Lowering blood pressure too much can reduce blood flow to important organs. Some older adults may experience dizziness when standing up, fainting, falls, or kidney problems. These side effects can sometimes outweigh the benefits of extremely low blood pressure.
Because of this, many experts now recommend a more personalized approach. For many adults over the age of 60, a systolic blood pressure below 130 mmHg, but generally not below 120 mmHg, appears to provide a good balance between reducing the risk of heart disease and avoiding unwanted side effects.
This target may help protect the heart and brain while lowering the chance of dizziness and falls.
However, there is no single blood pressure goal that is right for everyone. People with diabetes, chronic kidney disease, heart failure, or other medical conditions may need different treatment targets.
A person’s overall health, medications, physical fitness, and how they feel during treatment should all be considered. This is why blood pressure goals should always be discussed with a healthcare professional rather than chosen using a single number.
Healthy lifestyle habits remain the foundation of blood pressure control at any age. Eating plenty of fruits, vegetables, whole grains, and low-fat dairy products, reducing salt intake, exercising regularly, maintaining a healthy weight, limiting alcohol, avoiding smoking, getting enough sleep, and managing stress can all help lower blood pressure naturally.
When lifestyle changes are not enough, medications can safely reduce blood pressure and lower the risk of serious complications.
The most important message is that managing blood pressure is not about reaching the lowest possible number. Instead, it is about finding the safest and most effective range for each individual.
Regular blood pressure checks, routine medical visits, and open conversations with your healthcare provider can help ensure that your treatment plan matches your personal health needs and supports a long, active, and healthy life.
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The findings discussed are based on the Systolic Blood Pressure Intervention Trial (SPRINT).
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