An old man was brought to my clinic by his elder son, who reported that his father, around eighty years of age, often experienced dizziness and had suffered several falls. A review of his medical history revealed that he had been examined by a physician about six months earlier and was prescribed medication for high blood pressure. Since then, he had been experiencing episodes of dizziness and a general feeling of being run-down and lethargic. He did not revisit his physician, assuming these symptoms were a normal part of aging.
On examination, the rest of his physical assessment was normal, but his blood pressure was 110/60 mmHg which is relatively low for his age. Low blood pressure likely resulted in insufficient perfusion to his vital organs, causing dizziness and lethargy.
Dr. Munawar Aziz
This case reminded me of a teaching from decades ago: the definition of blood pressure as “an arbitrary figure of 140/90.” Although various figures have evolved over the years through various international studies, individual variations must always be considered.
As people age, maintaining adequate blood perfusion the process of delivering blood to tissues and organs becomes critical for preserving function and quality of life. In older adults, physiological changes such as arterial stiffening, reduced cardiac output, and decreased vascular compliance can compromise blood flow, especially to vital organs like the brain, heart, kidneys, and liver.
Reduced perfusion in the elderly is associated with several age-related conditions. For example, diminished cerebral blood flow can contribute to cognitive decline and increase the risk of dementia. Similarly, decreased renal perfusion may impair kidney function and exacerbate fluid and electrolyte imbalances. Ensuring sufficient blood supply is, therefore, essential for organ health and overall well-being in seniors.
Blood pressure plays a key role in maintaining adequate perfusion. The ideal blood pressure for older adults should be individualized but generally falls within the range of 140 mmHg systolic and 90 mmHg diastolic. Slightly higher pressures may be tolerated or even necessary in some cases to ensure adequate perfusion, particularly in individuals with atherosclerosis or other vascular conditions. However, excessively high blood pressure (above 140/90 mmHg) increases the risk of stroke, heart failure, and kidney damage.
A balanced approach to blood pressure management is essential, emphasizing regular monitoring, appropriate medication, and lifestyle modifications such as diet and exercise.
In conclusion, maintaining optimal blood pressure in old age is crucial for preserving adequate perfusion to vital organs. Treatment for high blood pressure is not a “one size fits all” approach, it must be tailored to the individual, taking into account age, weight, and the presence of comorbidities such as diabetes etc.
- Dr. Munawar Aziz
Abbottabad, Pakistan.
aziz.munawar@gmail.com
A very important topic discussed here . Though not very old , I suffer from diabetes and blood pressure issues and I can vouch how problematic it can be for people like me, with comorbidities, to maintain a balanced blood pressure. There are often fluctuations. It’s quite significant to maintain regular medical checks and contact with one’s physician .
Very right. Seniors need to be monitored regularly for any changes in blood pressure, diabetes, renal and pulmonary functions. Thank you for making us wiser on senior’s care.