As a primary care physician specializing in senior health care, I’m no stranger to a common malady in older adults: hypertension, more commonly referred to as high blood pressure.

Hypertension affects nearly one in three adults in the United States, some 70 million people. Left untreated, it can cause serious complications, including a higher chance of stroke or heart attack, trouble with memory and understanding, vision loss and metabolic syndrome, which affects the body’s metabolism.

Hypertension is often called the “silent killer” because people don’t normally associate these symptoms with high blood pressure, unless it is dangerously high. Extremely high blood pressure can cause headaches, dizziness, fatigue, and ringing in the ears.

Blood pressure is typically recorded as two numbers, written as a ratio. The first systolic number is the measurement of the pressure of the blood against the vessels when the heart beats. The second diastolic number is the pressure against the vessels when the heart relaxes between beats.

Normal blood pressure measures lower than or equal to 120/80. Hypertension occurs at a blood pressure of 140/90 and higher.

Changes in the arteries over the years are often associated with high blood pressure, such as a buildup of fatty deposits inside the arteries (atherosclerosis) and thickening of the artery walls. When that happens, the arterial blood vessels are constricted and this increases the resistance to blood flow, resulting in hypertension.

Think of it like squeezing a water hose. The heart must work harder to pump blood through the narrowed arteries. This puts strain on both the blood vessels and the heart.

It’s extremely important for older adults to see a primary care doctor on a regular basis for a checkup, which must include a blood pressure check, especially if you are at risk. Risk factors for hypertension include:

• Family history of high blood pressure
• Being overweight or obese
• Diets high in salt
• Smoking
• Diabetes

Also control what you can. Start with small steps, like giving up soda, which surprisingly has high sodium content in addition to being high in sugar. Try adding a short walk to the everyday routine.

You should always talk to their doctor before making changes to their diet or exercise routine. Healthy lifestyle choices, however, are the first line of defense against hypertension. Ideally, you should follow a healthy diet, get enough exercise, quit smoking, limit alcohol consumption and reduce stress.

If those steps are followed and blood pressure is still too high, medications can be prescribed to help control hypertension. It’s common for patients with hypertension to require two or more medications to keep blood pressure at a safe level.

I believe that a close relationship with your doctor is the key to controlling hypertension. A primary care physician with a focus on preventive care will diligently track blood pressure and will be on the lookout for complications that can arise.