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Hypertension/blood pressure and age

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Question
Hello,
first of all thank you for being here online for all of us.
My name is Klaas and I would like to know ,does the normal range of the blood pressure varies by age?
I am reading so many  confusing opinions on the web,I really don't know what to believe anymore.
What I knew was that the normal range is max 120/80,no matter the age,and anything above 120/80 until 130/90 is pre-hypertension.Anything above is hypertension.
I hope that I will get an answer from you.Thanks in advance.Klaas

Answer
Good morning, klaas,

First of all, the natural history for blood pressure, is to slowly rise as one ages. The rate of rise varies from person to person and likely has a significant genetic component.

Back in the 1930's the Metropolitan life Insurance Company noticed that, if they insured individuals with blood pressures above 140/90, they lost money. If the BPs were less than 140/90, they made money. Those with BPs above 140/90 had a much higher incidence of heart attack, heart failure, stroke and kidney failure.  They died like flies!

In the 1960's and early 70's, the Veteran's Administration conducted a very large treatment trial which slowed that treating the elevated blood pressures to levels less than 140/90, brought the death risk back towards normal.  Therefore, we treat.

The normal blood pressure, then, became defined as 140/90.  A higher pressure does not, necessarily, constitute a "disease", but may possibly define a population of people that die earlier than the others. Treatment reverses that risk.

Population studies, since then, have shown that the slow rise is BP that I mentioned above, is especially striking for those with BPs in the 120/80 to 130/89 range.  These patients invariably developed sustained hypertension. So striking was this association that many began to advocate treating them as well.  There is, however, no PROOF that doing so significantly alters outcome, but life style modifications, such as, weight loss, a low salt diet and aerobic exercise can either slow or prevent the ultimate development of sustained hypertension.

So, to answer your question, the "NORMAL" blood pressure does NOT vary by age.  Since the pressures slowly increase with age and when one reaches the threshold of 120/80 one can be pretty sure that will rise to 140/90 in the future. This patient is said to have "pre-hypertension" and he is a member of the group that caused Met Life to lose money.

Patients with pre-hypertension should be treated with life style modifications. Patients with sustained hypertension (pressures 140/90 and higher) are treated first with life style modifications then antihypertensive medications.

I hope I have not further confused the issue for you.  If so, please feel free to follow up.

Thanks for the question.

sincerely,

Dr Falkinburg  

Hypertension

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Newell R. Falkinburg, M.D. FACP

Expertise

Any question regarding hypertension or clinical nephrology

Experience

35 years of experience in the field of nephrology & hypertension. Emeritus Professor of clinical Medicine at a major medical school and director of Nephrology & Hypertension at a university affiliated medical center.

Education/Credentials
M.D. Board certified internal medicine Board certified Nephrology & hypertension

Awards and Honors
Fellow, American College of Physicians

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