Blood pressure is one of the four vital signs, along with pulse rate, respiratory rate and temperature. Blood pressure monitoring is particularly important for seniors, due to an increased risk for both high and low blood pressure. The normal blood pressure range is the same for adults of all ages -- even seniors. However, blood pressure tends to increase with age and more than 67 percent of people aged 60 or older have high blood pressure, according to a 2017 report from the American Heart Association.
Normal Range: High Blood Pressure
Blood pressure includes two measurements, systolic and diastolic pressure. Systolic pressure reflects the pressure in the arteries when the heart contracts, and diastolic pressure reflects arterial pressure between heart contractions. Blood pressure is reported as systolic pressure/diastolic pressure in millimeters of mercury (mmHg). With respect to high blood pressure, the normal range for adults is less than 120/80 mmHg. High blood pressure, or hypertension, and prehypertension are defined as follows:
-- Prehypertension: systolic pressure of 120 to 139 mmHg, or diastolic pressure of 80 to 89 mmHg
-- Hypertension: systolic pressure of 140 mmHg or higher, or diastolic pressure of 90 mmHg or higher
Most seniors with high blood pressure have isolated systolic hypertension (ISH), meaning only the systolic pressure is too high. While this might seem like a good thing at first blush, it is not. Elevated systolic pressure is more closely associated with increased risk for cardiovascular complications than elevated diastolic pressure.
Normal Range: Low Blood Pressure
Cutoff values for low blood pressure, or hypotension, are not as well defined as for high blood pressure. Nonetheless, the lower limit of normal blood pressure is generally considered to be 90/60 mmHg. However, seniors are more likely than younger adults to develop symptoms of low blood pressure -- such as dizziness, fainting, loss of balance and confusion -- at the lower end of this range. In fact, researchers who conducted a large study involving more than 902,000 adults seen in the emergency department concluded that a systolic pressure of 90 mmHg often represents hypotension in adults aged 65 or older, as reported in the July 2011 issue of the "Archives of Surgery." The authors further noted that the optimal systolic pressure -- that associated with the lowest risk of death -- among seniors in the study was 117 mmHg.
Risks Associated with Abnormal Blood Pressure
Both hypertension and hypotension pose serious health risks. People with hypertension, especially seniors, have a significantly increased risk for other serious conditions, including a heart attack, heart failure, stroke and kidney disease. Hypotension is also associated with an increased risk for heart failure as well as heart rhythm abnormalities, and an overall increased risk of death, as reported in August 2014 issue of the "Journal of Hypertension." Orthostatic hypotension -- a drop in blood pressure that occurs when rising to a sitting or standing position -- might also increase the risk for falls, although the evidence to date on this possible association is inconclusive.
Next Steps and Precautions
The U.S. Preventive Services Task Force and several other professional medical organizations recommend blood pressure screening at least once per year after age 40. If you have high blood pressure, see your doctor as often as recommended. Treatment may include changes in diet, exercise and antihypertensive medications to lower your blood pressure.
If you're having trouble with dizziness or fainting, let your doctor know so you can be checked for orthostatic hypotension. This problem can often be treated with medication adjustments and simple steps to prevent dizziness, such as sitting on the edge of the bed for several minutes before standing.
Reviewed and revised by: Tina M. St. John, M.D.