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High Blood Pressure Affects Your Walking Speed And Your Independence

According to research published in the Journal of the American Geriatrics Society, the negative effects on high blood pressure extend even beyond its heart disease risk. Researchers from the University of Pittsburgh and the University of Washington in Seattle studied 2,733 older adults for over 18 years and discovered that people with high blood pressure were more likely to experience a slowing of their walking speed over a long period of time. This side effect is important because the ability to walk at an acceptable speed is vital to the independence of older adults.

Researchers and physicians were already aware that older adults with high blood pressure are less likely to function well and more likely to become physically disabled than people with normal blood pressure levels. But that knowledge was based on studies lasted up to five years at the most. The researchers who conducted this study investigated whether the link between poorer function and high blood pressure persisted over a longer period of time.

The Need For Speed

Gait speed, or the speed at which you walk, is an important factor in the health and, in turn, the independence of older adults. It is a marker and a predictor of how well you function, take care of yourself and participate in vital social activities. According to the researchers, limitations such as slow gait speed increase your risk for hospitalization and even death. Also of concern, having a slower walking speed seems to predict the development of dementia and disability.

In this study, researchers found that gait speed was significantly slower in people with high blood pressure than it was in people with normal blood pressure. They also learned that, over time, the slowing of gait speed happened faster in people with high blood pressure than in people with normal blood pressure.

Adults in their early 70s who live independently usually have a gait speed of about one meter or about 3 feet per second. The gait speed of older adults who need help with their daily activities is only about half that rate; in other words, it takes them about twice as long to walk three feet.

Though no one knows why having high blood pressure might slow your walking speed, the researchers in suggested a theory that might explain the connection—a condition called white matter hyperintensities (WMH) might be the link. WMHs, which show up as bright white spots in the brain on brain scans, are areas of inflammation in the brain. The researchers found that people with high blood pressure tend to have more WMHs than other people and that having greater numbers of WMHs is linked to slower gait and impaired mobility.

What You Can Do

First, know your blood pressure numbers. Be sure to have your blood pressure checked regularly. If you’ve been diagnosed with high blood pressure, get it under control through doctor-recommended lifestyle changes, like a no- or low-sodium diet, and medication if needed. If you’ve been prescribed medication, take it as directed. Remember than high blood pressure does not have any symptoms—“feeling fine” doesn’t mean you don’t have high blood pressure or that it’s gone away. Stopping treatment puts you at risk for a variety of other heart conditions.

Next, ask your doctor to periodically evaluate your gait speed for your physical and mental well-being. "I think physicians should add gait speed to their routine exams for older adults," said lead author Caterina Rosano, MD, MPH, associate professor of epidemiology in the department of epidemiology at the University of Pittsburgh’s Center for Aging and Population Research. "Our research team has repeatedly shown that slowing gait is associated with underlying brain abnormalities."

By keeping your blood pressure under control as early in life as you can, you could help protect against gait slowing and stay functional and independent far into the future.

About the study. The full report, titled "High Blood Pressure Accelerates Gait Slowing in Well-Functioning Older Adults Over 18 Years of Follow-Up," was authored by Dr. Rosano, William T. Longstreth, Jr., MD, Robert Boudreau, PhD, Christopher A. Taylor, PhD, Yan Du, MS, Lewis H. Kuller, MD, DrPH and Anne B. Newman, MD. It was funded with grants from the National Heart, Lung and Blood Institute with additional contributions from the National Institute of Neurological Disorders and Stroke.