Almost half of men and 61 percent of women age seventy-five or older take blood pressure medications. The rationale is that high blood pressure is bad for the brain and increases the risk of stroke and dementia. While higher blood pressure is related to higher rates of stroke, high blood pressure may actually protect against dementia.

In a new study from the University of California-Irvine, researchers found that high blood pressure is associated with healthy brain aging. Participants who reported they had high blood pressure in the years before the study began were 42 percent less likely to develop dementia during the period of the study.

The researchers stated, “In this first-of-its-kind study, we find that hypertension is not a risk factor for dementia in people age 90 or over, but is actually associated with reduced dementia risk.”

Apparently, the body increases blood pressure as we age to ensure adequate blood flow to the brain. In the elderly, the walls of the arteries become thicker and the heart gets weaker, resulting in less blood flow to the brain and other organs. Increased blood pressure is a way to overcome these limitations.

Doctors prescribe several different types of drugs to lower blood pressure. ACE inhibitors contain a compound originally isolated from the venom of the Brazilian pit viper, which prevents an enzyme in your body from producing angiotensin II, a substance that narrows your blood vessels and releases hormones that can raise your blood pressure. They have many side effects including trouble breathing, dizziness or lightheadedness, irregular heartbeat, hives, fainting, dry cough, headache and swelling of the face, lips, tongue or throat (see illustrations below).

Calcium channel blockers prevent calcium from entering cells of the heart and blood vessel walls, relaxing and widening blood vessels, resulting in lower blood pressure. Side effects include lightheadedness, low blood pressure, slower heart rate, drowsiness, constipation, increased appetite, GERD, bleeding gums and sexual dysfunction. While ACE inhibitors can cause swelling in the tongue and face, calcium channel blockers can cause swelling of the feet, ankles and legs.

Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. When you take beta blockers, your heart beats more slowly and with less force, thereby reducing blood pressure. The list of beta blocker side effects is long: congestive heart failure, fatigue, dizziness, depression, slower heartbeat, cold extremities, pins and needles, shortness of breath, drowsiness, lethargy, insomnia, headaches, poor memory, nausea, diarrhea, constipation, colitis, wheezing, bronchospasm, Raynaud’s syndrome, cramps and muscle fatigue, lowered libido and impotence, poor posture and hypoglycemia.

Finally, diuretics act by increasing the excretion of sodium by the kidneys into the urine. When the kidneys excrete sodium, they excrete water from the blood along with it. That decreases the amount of fluid flowing through the blood vessels, which reduces pressure on the walls of the arteries. Diuretics also have side effects, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains, cramps, confusion, seizures, muscle weakness, low urine production, racing heart, digestive problems, gout, increased uric acid—and death due to sodium deficiency.

The point is that all types of blood pressure medication can cause serious side effects. Seniors should be wary of taking them, especially as blood pressure, like cholesterol levels, goes up naturally and gradually with age.

What is normal blood pressure for seniors? For many years, the guideline number was 140/90. Then under new guidelines, researchers defined 120/70 as “borderline hypertension.” One twenty over seventy is a healthy blood pressure for people who are young and fit, but not necessarily for seniors. In fact, the old formula, “age plus one hundred over ninety,” probably serves seniors the best.

Anything in excess of this may warrant a blood pressure drug, but not before making changes in the diet. Elimination of processed food, including refined sweeteners and industrial seed oils, and incorporation of unrefined salt, cod liver oil and healthy animal fats will often bring blood pressure down. Epsom salts baths to provide magnesium and moderate outdoor exercise may also help.

And please note: if you want to go off blood pressure medication, don’t do it suddenly. Discontinue slowly. Cold turkey withdrawal can lead to very high blood pressure, heart attack and even sudden death.

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A key role of sodium is the maintenance of blood pressure. Adequate body sodium content is necessary for maintenance of blood volume and renal perfusion, and these variables are strongly defended by the body. When our salt consumption is too low, defense mechanisms include salt hunger to increase sodium intake and reduction of urine and sweat to reduce sodium losses. When salt intake is too high, salt receptors in the tongue “flip” from positive to negative, which tends to decrease intake of salty foods.

Salt Intake in the U.S.