Blood pressure and heart rate of the elderly

The article is professionally consulted by Master, Doctor Pham Van Hung - Department of Medical Examination & Internal Medicine - Vinmec International General Hospital Da Nang.

Aging is irreversible, progressive changes that change the structure and functioning of organ systems, notably the cardiovascular system. The necessary knowledge about blood pressure and heart rate of the elderly as well as supportive measures will help protect long-term health and prevent dangerous events.

Blood pressure is defined as the pressure of blood flowing in the arteries. Blood pressure is governed by the force of contraction of the heart muscle and the resistance on the vessel wall.
There are many different mechanisms that help keep blood pressure in balance; in which, the role of carotid sinuses and carotid corpuscles in the carotid artery is the most prominent. However, these two receptors become less sensitive as the body gradually ages. This may explain why elderly people often experience orthostatic hypotension, which is a sudden drop in blood pressure when changing positions from lying down or sitting to standing up. As a result, the patient will feel dizzy, lightheaded, and dizzy because the blood flow to the brain is reduced immediately. However, if the blood flow to the brain does not recover quickly, it will have serious consequences.
Besides, as we age, arteries will become thicker, stiffer and less flexible due to changes in the connective tissue of the blood vessel walls. This factor will make the blood pressure in the elderly will be higher and also make the heart work harder, leading to the thickening of the heart muscle fibers, thereby easily causing myocardial ischemia, infarction. heart muscle. Not only that, but the capillary walls also thicken, hindering the rate at which nutrients are exchanged with cells.
Thus, in healthy people but with advanced age, arterial blood pressure often increases but does not exceed the allowable limit. The normal blood pressure of the elderly increased by 29 mmHg systolic and 8.6 mmHg higher than in young adults. However, when the systolic blood pressure rises above 160 mmHg and the diastolic blood pressure is above 95 mmHg, the hypertension is no longer a normal phenomenon and requires early intervention.

The heart rate is controlled by the sinus node. Accordingly, the sinus node is responsible for controlling the rhythm and impulses will spread throughout the heart muscle through the conduction system, helping the four chambers work in harmony, working together as a whole.
However, as we age, aging causes fibrosis of the sinus node and conduction system; In addition, the structure of the heart is also changed, making the conduction pathway no longer intact, resulting in cardiac arrhythmias.
On the other hand, the circulatory system that feeds the heart for a long time has atheroma and hardening, which also affects the nutrition of the sinus node and the conduction system. As a result of this impairment, the heart rate slows down, the heart beats irregularly, or the conduction pathway becomes blocked. Moreover, other pacing foci were revealed, overwhelming the role of the rhythm master of the sinus node, causing the heart rate to beat too fast without control, easily leading to sudden death.

Due to the above physiological changes, the phenomenon of gradually increasing blood pressure in the elderly is inevitable. However, unlike young people, blood pressure control needs to be careful because the elderly have an additional risk of orthostatic hypotension. Increased blood pressure causes the heart muscle to increase its force of contraction, accompanied by atherosclerosis, which will cause patients to have angina pectoris, shortness of breath with exertion. Initially, these symptoms will be transient or subside after sitting down; In the long term, the pain will last longer, be more constant, and even with light exercise. On the other hand, if the coronary artery lumen is blocked by atherosclerotic plaque, myocardial infarction will occur, the patient will have very severe chest pain and the ability to contract the heart muscle will gradually decrease afterwards. If the infarction area is large, the myocardial necrosis area is large, the risk of heart failure or cardiac arrest is very high.
For heart rhythm abnormalities in the elderly, the most common is the sinus node insufficiency syndrome. The heart rate slows down or even stops for a significant amount of time before it starts again. Meanwhile, the patient will feel dizzy, lightheaded, dizzy, more severe may be lethargy, faint and lose consciousness, easy to fall causing an accident.
Besides, atrial fibrillation is also common with increasing age. Manifestations of this disorder are irregular heartbeats, resulting in increased thrombus formation in the heart chambers. If a certain stroke of the heart pumps blood with thrombus to the brain, it will block the blood vessels that perfuse the brain, causing a stroke, distortion of the mouth, weakness of the limbs.
In addition, when the arrhythmias are exposed due to the gradual deterioration of the cardiac structure, tachycardia will appear. The patient will feel palpitations, drop in blood pressure, and also have lightheadedness and dizziness due to decreased blood flow to the brain. In particular, the most frightening is ventricular fibrillation, a type of heart rhythm disorder that is deadly if not treated promptly.

Blood pressure and heart rate in the elderly are both more or less affected by age. This is a natural element that cannot be changed at all. However, there are still many other factors that come with it that can still be adjusted. Therefore, screening, treatment and prevention will partly help maintain stable health over the years.
Most specifically, the regular check of blood pressure; if blood pressure is high, need to take antihypertensive drugs; Avoid standing or sitting up suddenly while lying down to avoid orthostatic hypotension. In addition, it is necessary to have regular check-ups every 6 months to a year and screen for diabetes, dyslipidemia as well as other cardiovascular diseases in general. In case the patient has the above abnormal symptoms but does not find high blood pressure, the ECG measurement does not show any abnormality, it is recommended to monitor blood pressure as well as 24-hour continuous electrocardiogram. From there, the ability to detect the disease will be higher and make an early treatment plan.
In addition, diet plays a very important role. Encourage eating foods rich in fiber such as brown rice, green vegetables, ripe fruit. Should eat foods rich in omega 3 fatty acids such as salmon, mackerel... Do not eat fat, animal organs, processed products and contain a lot of salt such as canned fish, salted meat, pickles salt, braised dishes, rim, salt, sauces, savory dips. Quit smoking and limit alcoholic beverages such as beer and wine.
At the same time, the elderly still need regular exercise to help keep arteries elastic. In addition, a good night's sleep, avoiding anxiety and stress also contributes to lowering blood pressure, reducing the risk of cardiovascular disease and death in general.
In short, old age is not a disease, but it is a condition for more diseases to arise. With today's medical advances, cardiovascular events and blood pressure in the elderly are gradually controlled and prevented, helping to prolong life. Understanding the above issues, complying and periodically monitoring will help the elderly enjoy many more years of happy life.
As one of the key specialties of Vinmec International General Hospital, the Cardiology department includes experienced professors, doctors, specialists, and masters with great reputation in the field. medical treatment, surgery, interventional cardiac catheterization and application of advanced techniques in the diagnosis and treatment of cardiovascular diseases.