How To Control Blood Pressure in Elderly People？

Basic knowledge of blood pressure: Understanding your blood pressure
Blood pressure is the pressure exerted on the walls of blood vessels by the flow of blood, divided into systolic pressure (high pressure) and diastolic pressure (low pressure). In China, the standard for hypertension is systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90mmHg, while the standard in the United States is ≥ 130/80mmHg.

The importance of blood pressure control in the elderly
As people age, the elasticity of their blood vessels gradually decreases, making blood pressure control particularly important. A prospective cohort study of 1181 elderly individuals with an average age of 71.9 years showed that when systolic blood pressure was controlled below 130mmHg, there was no significant difference in the incidence of cardiovascular target organ damage and major adverse cardiovascular events between elderly individuals with diastolic blood pressure between 70-79mmHg and 80-89mmHg.
Systolic blood pressure or diastolic blood pressure: which is more critical?
The main harm of hypertension is to damage the intima of arteries, induce and accelerate atherosclerosis, thereby causing myocardial infarction, cerebral infarction, damage the heart and kidney, accelerate vascular stiffness and cause cerebral hemorrhage. Among these two types of blood pressure, an increase in systolic blood pressure causes much greater harm to the human body than an increase in diastolic blood pressure. Elevated diastolic blood pressure may indicate adequate arterial elasticity, which is more common in middle-aged and young individuals with hypertension. However, hypertension in the elderly is often characterized by a simple increase in systolic blood pressure, while diastolic blood pressure remains unchanged or slightly lower.

Blood pressure control targets for the elderly
In recent years, research has not confirmed a direct relationship between diastolic blood pressure and cardiovascular events, and most elderly people have good tolerance to low diastolic blood pressure. Therefore, for elderly people over 65 years old, if they can tolerate and have no ischemic symptoms such as dizziness during the process of lowering blood pressure, it is recommended to control the systolic blood pressure below 130mmHg, while the diastolic blood pressure can be appropriately ignored.
Differences in blood pressure control between middle-aged and elderly people
For middle-aged and young people, it is necessary to actively control the increase in diastolic blood pressure, which can not only delay the increase in systolic blood pressure, but also prevent the occurrence of cardiovascular and cerebrovascular diseases in the elderly. The commonly used drugs for controlling diastolic blood pressure include sartans and lorvos. When choosing medication, it should be determined based on resting heart rate: when the heart rate is less than 80 beats per minute, consider using sartan drugs, and when it is greater than 80 beats per minute, consider using lorvos drugs.

Summary and Reminder
When controlling blood pressure in elderly people, the main focus should be on achieving systolic blood pressure, and it is recommended to keep it below 130mmHg. Slightly higher or lower diastolic blood pressure does not significantly increase cardiovascular risk. When using any medication, it should be done under the guidance of a doctor and consult a doctor or pharmacist if in doubt.
Through scientific and rational blood pressure management, elderly people can effectively reduce health risks and enjoy a healthier and higher quality of life. Remember, blood pressure control is a long-term battle that requires our persistent attention and management.