Blood pressure chart by age: what really applies

You are looking for a chart that tells you which blood pressure is normal at your age. You will find plenty of them – with figures such as 140/90 for sixty-year-olds and 150/90 for seventy-year-olds.

These charts have no basis in the current guidelines. Neither the German National Disease Management Guideline (Nationale VersorgungsLeitlinie) nor the European guidelines include age-dependent thresholds.

At first that sounds unsatisfying. But the real answer is more useful than any age chart – because it explains what actually matters in older age.

The threshold applies regardless of year of birth

High blood pressure starts at 140/90 mmHg in the doctor's surgery and at 135/85 mmHg for self-measurement at home – at 35 just as at 75. The full classification is set out in Blood pressure chart: what your numbers mean.

The reason is simple: the risk associated with raised blood pressure does not disappear with age. It actually increases. Setting a higher threshold for older people would mean leaving untreated precisely those people who benefit most from treatment.

Why blood pressure still rises with age

The observation behind the circulating charts cannot be disputed: average blood pressure does rise over the years. There is a concrete reason for this.

A young aorta works like an air chamber. It expands with each heartbeat, absorbs part of the pressure peak and releases it again during the pause. As the large vessels become stiffer over the years, this buffer is lost – the pressure peak comes through in full, and the upper reading rises.

That is why isolated systolic hypertension is the most common form in older age: upper reading above 140, lower reading normal or even low. We explain what lies behind it in Blood pressure 160 over 80.

Common is not the same as healthy

This is where the age charts go wrong. They confuse average with standard.

The fact that many seventy-year-olds have a blood pressure of 150 describes the current state of affairs. It says nothing about whether this state is desirable. Tooth decay is also common in certain age groups, and nobody would derive an age-appropriate normal value from that.

Statistically, rising blood pressure in older age is to be expected. Medically, it remains a treatable risk factor.

What is in fact adjusted individually

And here comes the part that the age charts get wrong, but which has a kernel of truth: in very old age, the treatment target is individualised – not the definition.

The difference is crucial:

• Definition: From what point is it called high blood pressure? – Unchanged at 140/90 in the doctor's surgery, at any age.
• Treatment target: What value is treatment aiming for? – That depends on age, frailty, other conditions and tolerability.

In very old or frail people, the target is deliberately set less strictly. The reason is not negligence, but a weighing of risks: pressure that is lowered too far brings its own risks – dizziness when standing up, falls, fractures. In this age group a fall can have more serious consequences than a slightly elevated blood pressure.

Which target makes sense for you is decided by your doctor based on your situation – not by a chart on the internet.

Are there separate values for women?

No. The thresholds are the same for both sexes. People search particularly often for a chart for women over 60 – there is no separate classification for that either.

What is true: before the menopause, women have slightly lower readings on average than men. After that this evens out, and in older age groups the relationship is in some cases even reversed. This is a statistical difference – the classification remains the same for everyone. For the lower end of the scale, see Blood pressure of 100 over 70 in women.

What really matters in older age

Instead of looking for an age chart, three other questions are worth asking:

1. How large is the gap between the readings? Beyond the age of 60, a pulse pressure persistently above 60 mmHg is considered an indication of stiffened vessels. This number does not appear on any display, yet it is meaningful – more in Pulse pressure: what the gap between your blood pressure readings reveals.

2. How does the pressure change when you stand up? In older age it is more common for blood pressure to drop when changing position. This is a fall risk in its own right and is missed when measuring only while seated. If you tend to get dizzy when standing up, also measure after one to three minutes standing – and take these readings with you to your doctor.

3. How stable are the readings over the week? A single measurement does not classify anyone. What counts is the average over seven days with two measurements each morning and evening. Why individual readings vary so much is explained in Why your blood pressure is different every time you measure.

A technical note for older arms

With stiff vessels, cuff measurement can in rare cases overestimate the pressure. That makes an upper-arm monitor validated to DIN EN ISO 81060-2 and the right cuff size all the more important – see Which blood pressure monitor is the most accurate? and the most common sources of error in Measuring blood pressure correctly.

When you should seek medical advice

• If your weekly average at home is at or above 135/85 mmHg – regardless of age
• If you experience dizziness or vision going dark when standing up
• After a fall or near-fall
• If the gap between the upper and lower reading is persistently above 60 mmHg
• If you have headaches, visual disturbances, shortness of breath or a racing heart

In case of sudden severe headache, chest pain, speech or visual disturbances or one-sided paralysis: call the emergency services on 112 immediately. Never change existing medication on your own – not even because a chart on the internet labels your readings as age-appropriate.

A chart tells you whether a reading is typical. It does not tell you what your circulation was doing at the moment you felt something – that is what the BPER blood pressure event recorder records, beat by beat.