CALee Acupuncture

Age-Related Hypertension — Part 1

When blood pressure returns to normal, has the person truly become healthy?

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Approximately 70% of individuals over the age of 65 are diagnosed with hypertension.
Blood pressure is classified as hypertensive when systolic pressure exceeds 140 mmHg or diastolic pressure exceeds 90 mmHg.

In older adults, a specific pattern known as isolated systolic hypertension is especially common—where only the systolic value is elevated. This pattern is closely associated with structural changes in blood vessels that occur with aging (Franklin et al., 2001).

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Why Does Aging Raise Blood Pressure?

As aging progresses, the composition of the arterial wall changes.
Elastin decreases, and collagen increases.

As a result, the elasticity of blood vessels declines.
Even when the heart pumps with the same force, the pressure is no longer absorbed effectively—it is transmitted directly through the arterial system.

This phenomenon is known as arterial stiffness, a central pathophysiological feature of age-related hypertension (Lakatta & Levy, 2003).

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At the same time, the function of the vascular endothelium also changes.

• The production of nitric oxide (NO), which promotes vasodilation, decreases

• The activity of Endothelin-1, associated with vasoconstriction, relatively increases

This shift leads to increased peripheral vascular resistance (Taddei et al., 2001).

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The autonomic nervous system also undergoes changes.

• Sympathetic nervous system activity increases

• Baroreflex sensitivity, which detects and regulates blood pressure fluctuations, declines

This results in greater variability in blood pressure (Monahan, 2007).

In elderly patients, symptoms such as dizziness, headache, tinnitus, and sleep disturbances often appear together. These may reflect combined changes in autonomic regulation and cerebral blood flow dynamics (Iadecola, 2013).

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What Modern Medicine Does

The approach of modern medicine is clear:

It lowers elevated numbers.

Calcium channel blockers, ACE inhibitors, diuretics—
although their mechanisms differ, their goal is the same:

to maintain blood pressure below a certain threshold.

This approach is undeniably effective.

Decades of clinical research consistently show that lowering blood pressure reduces the risk of stroke and cardiovascular events (Lewington et al., 2002).

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But This Question Is Rarely Asked

A patient takes antihypertensive medication.
The blood pressure decreases to 130 mmHg.

However—

• Arterial stiffness continues to progress

• Autonomic regulation remains altered

• Endothelial dysfunction persists

• Symptoms such as dizziness or sleep disturbance often do not fully resolve

So we return to the question:

When the numbers return to normal,
has the person truly become healthy?

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This is not a rejection of modern medicine.

If modern medicine measures blood pressure as a number,
then perhaps the underlying changes in the body that led to that elevation
require a different way of being observed.

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What Comes Next

In the next article,
we will explore how Classical Medicine approaches this same question—
and what it sees differently.

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References

Franklin SS, et al. (2001). Hemodynamic patterns of age-related changes in blood pressure. Circulation.

Lakatta EG, Levy D. (2003). Arterial and cardiac aging. Circulation.

Taddei S, et al. (2001). Age-related reduction of NO availability and endothelial dysfunction. Hypertension.

Monahan KD. (2007). Effect of aging on baroreflex function in humans. American Journal of Physiology.

Iadecola C. (2013). The pathobiology of vascular dementia. Neuron.

Lewington S, et al. (2002). Age-specific relevance of usual blood pressure to vascular mortality. Lancet.