[KoK! Health] Winter Cold Intensifies... How to Manage Hypertension in Elderly During Winter

As winter sets in and the cold intensifies, patients with hypertension who usually have cardiovascular or cerebrovascular diseases or are aged 65 and older need to be cautious as blood pressure tends to rise with the cold. In observance of the first week of December as 'Hypertension Week' every year, we explored winter health management methods for elderly hypertensive patients with Professor Son Il-seok from the Department of Cardiovascular Medicine at Gangdong Kyung Hee University Hospital.

On the 28th, after the rain, the temperature dropped significantly, and at Gwanghwamun Intersection in Jongno-gu, Seoul, citizens wearing scarves and thick clothing hurried along. Photo by Jo Yongjun jun21@

According to the 2023 Hypertension Fact Sheet by the Korean Society of Hypertension, it is estimated that there are 12.3 million hypertensive patients in South Korea. Among them, the prevalence of hypertension in elderly people aged 70 and above exceeds 60%, and even when expanding the range to those in their 60s, about half are estimated to have hypertension. Hypertension itself has no symptoms but causes various complications. Representative complications include heart failure, arteriosclerosis, chronic kidney disease, and vision impairment due to retinal hemorrhage.

Especially in winter, as the weather gets colder, blood vessels constrict and blood pressure tends to rise, so hypertensive patients need to be more careful. According to the Disease Interest Statistics from the Health Insurance Review and Assessment Service, the number of patients treated for hypertension was highest in December in both 2021 and 2022. Professor Son Il-seok from the Department of Cardiovascular Medicine at Gangdong Kyung Hee University Hospital explained, "As the temperature drops, blood pressure changes significantly. Conversely, in summer, blood vessels dilate and dehydration caused by heat lowers blood pressure. If hypertension medication is reduced during this time, blood pressure may rise again when it gets cold, making control difficult."

If blood pressure is higher than 160/100 mmHg, appropriate management should be discussed with a specialist. It is recommended that systolic blood pressure in elderly patients be controlled below 140 mmHg. Treatment requires medication with antihypertensive drugs, but removing risk factors in daily life is most important. The advice is to improve lifestyle habits rather than relying solely on the effects of hypertension medication.

Managing hypertension in daily life starts with recording 'home blood pressure.' Blood pressure measured in the clinic can differ from that at home. To verify this, blood pressure should be measured and recorded in the morning and before bedtime regardless of symptoms, especially 1 to 2 weeks before a medical appointment. Afterwards, it is advisable to consult with the primary care physician about blood pressure fluctuations.

Staying indoors just because it is cold is not good either. Blood pressure may rise further, weight may increase causing blood sugar levels to rise, and muscle strength may decrease, increasing the risk of falls and fractures. Therefore, it is good to engage in light walking, strolling, or equipment exercise during warmer times of the day. However, elderly people who enjoy exercising early in the morning should move their exercise time to after breakfast or in the afternoon. When rain or snow makes road conditions poor, indoor exercise is recommended to prevent falls.

Controlling 'salt' intake is important for managing hypertension. When sodium levels in the blood increase, blood volume expands and vascular pressure rises. Hypertension treatment guidelines recommend limiting daily salt intake to less than 6 grams. Professor Son advised, "Research shows that drinking one less cup (200 ml) of soup per meal can reduce daily salt intake by half. If reducing salt makes food too bland to eat, it is good to start by avoiding soup."