The short answer
- The target after 80 is different, and the GP sets itNICE gives a higher target for people aged 80 and over than for younger adults, and asks doctors to use their judgement for anyone who is frail or has several conditions. Agree the target with the GP.
- Home readings help when they are taken properlyA validated upper-arm monitor, the same times each day, two readings each time, and every number written down with a note of how they felt.
- Dizziness on standing is worth reportingBlood pressure that drops when someone stands up can cause light-headedness and falls. The GP can measure it lying and standing, and review the tablets.
- A carer helps with the routine around itPrompting tablets and writing them down, taking a reading at the agreed time if the GP has asked for one, and noticing dizziness or a change.
Carers on PrimeCarers charge £18 to £25 an hour, with our fee included, against £28 to £35 an hour at an agency. Nothing on this page replaces the advice of your relative's own GP, nurse or pharmacist.
High blood pressure is one of the long-term conditions covered in our health conditions section, and it can sit alongside others. Living with a long-term condition at home explains how the GP, the practice nurse, the pharmacist and a carer fit together. This page is about blood pressure in particular, for somebody in their seventies, eighties or older who lives at home.
What the numbers mean
What a blood pressure reading means, and why the target changes after 80
A reading is two numbers, such as 140/90. The first is the pressure when the heart beats and the second is the pressure between beats. The NHS says blood pressure is usually considered high at 140/90 or higher when a healthcare professional checks it, or 135/85 or higher when it is checked at home.
NICE targets for people already being treated for high blood pressure
| Checked at the surgery | Average of home readings | What NICE adds | |
|---|---|---|---|
| Aged under 80 | Below 140/90 | Below 135/85 | Different targets apply with some kidney conditions and type 1 diabetes. |
| Aged 80 and over | Below 150/90 | Below 145/85 | Use clinical judgement for people with frailty or several conditions. |
Aged under 80
- Checked at the surgery
- Below 140/90
- Average of home readings
- Below 135/85
- What NICE adds
- Different targets apply with some kidney conditions and type 1 diabetes.
Aged 80 and over
- Checked at the surgery
- Below 150/90
- Average of home readings
- Below 145/85
- What NICE adds
- Use clinical judgement for people with frailty or several conditions.
From NICE guideline NG136, recommendations 1.4.20 to 1.4.22. These are the general targets in the guideline, not your relative's own. Their target is the one agreed with their GP.
A home average of 140 can look worrying if you know only the figures for younger adults, but for somebody over 80 NICE sets the target higher, and it adds that people with frailty or several conditions need a doctor's judgement rather than a fixed number. A frail person on several medicines may have a target their GP has set for them alone, and that is the number that counts. Ask the GP what it is and write it at the top of the record sheet.
High blood pressure does not usually cause symptoms, which is why it is measured rather than felt. Left untreated it puts strain on the heart, the brain, the kidneys and the eyes, and the NHS lists heart attack, stroke, heart failure, kidney disease and vascular dementia among the risks. Lowering it even a little reduces them. For a gentle check on how much the family already knows, there is a short blood pressure quiz.
Checking at home
How to check blood pressure at home and keep a record the GP can use
A home monitor is useful when the GP or nurse has asked for readings, or wants to see how a new tablet is working. The value is in the pattern over days, so the method matters more than any single number. Here is the method the NHS, NICE and Blood Pressure UK describe, and a record sheet to copy.
Checking blood pressure at home, in six steps
The same method each time, so that this week’s readings can be compared with last week’s.
Step 1: Use a validated upper-arm monitor
Blood Pressure UK and the British Heart Foundation both recommend a monitor that goes round the upper arm and is listed as clinically validated by the British and Irish Hypertension Society. The cuff has to fit: too big reads low and too small reads high.
Have it recalibrated or replaced every two years.
Step 2: Check at the same times each day
Use the times the GP or nurse asked for, which the NHS says is usually morning and evening. Not straight after a large meal, a coffee, a cigarette or a walk, and not with a full bladder, because each of these can push a reading up for a while.
Same times, same arm, every day.
Step 3: Sit properly and settle first
An upright chair with a back, feet flat on the floor and legs uncrossed. The arm rests on a table at about the height of the heart, on a cushion if needed, with the sleeve rolled up or off.
An arm hanging down can read about 10 points high.
Step 4: Keep still and quiet, then take a second reading
Talking and moving during the reading both change it. Wait at least a minute and take a second reading, because Blood Pressure UK notes that the first one is often high.
Two readings each time, at least a minute apart.
Step 5: Write both numbers down exactly
Copy what the screen shows, with the date and time, and add anything that happened: dizziness on getting up, a missed or late tablet, a bad night. Pen and paper work as well as a monitor with a memory.
The notes column is the part the GP cannot get anywhere else.
Step 6: Take the sheet to the GP or nurse
One reading on its own does not tell you much. The GP or practice nurse looks at the pattern over the week and decides what it means. The NHS asks people who use a home monitor regularly to tell their GP practice.
Nobody changes a tablet because of one number.
What a week on the record sheet looks like
Blood pressure record
- Name
- blank
- Arm used
- Left
- Times asked for
- Morning and evening
Example entries, to show how a line is filled in. These are not targets.
When a GP uses a week of home readings to confirm high blood pressure, NICE says the first day is set aside and the rest are averaged. That is why a week of steady readings at the same times is worth more than a single worrying number.
Sources: NICE guideline NG136 (recommendations 1.1.3, 1.1.4 and 1.2.7), NHS guidance on measuring blood pressure at home, Blood Pressure UK home testing guidelines, and the British Heart Foundation. Checked October 2026.
A few practical points sit around the steps. Blood Pressure UK says that people with an irregular heartbeat, such as atrial fibrillation, should have their blood pressure checked by their doctor, because digital monitors can struggle to read it accurately, so ask the GP before relying on a home monitor in that case. Wrist monitors are a fallback for somebody who cannot use an upper-arm cuff, not a first choice. If your relative's arm is large or very thin, measure it and buy the right cuff size, which may be sold separately.
Free blood pressure checks are available at many pharmacies for people aged 40 and over, and the GP practice may lend a monitor. If your relative already has a monitor, tell the practice, and take the sheet to every appointment, including the yearly review that NICE says everyone with high blood pressure should be offered to go over their readings, lifestyle, symptoms and medicines.
Dizziness and falls
Low blood pressure on standing, and why it matters for falls
Some people's blood pressure drops when they stand up or change position. They feel light-headed or dizzy, their vision blurs, or they feel weak, and they may faint or fall. The NHS calls this postural hypotension. It says some people develop low blood pressure as they get older, and that some medicines can cause it, including several blood pressure tablets.
What the NHS suggests
- Getting up slowly from a chair, and holding on to something stable
- Getting out of bed in stages: lying to sitting on the edge, a pause, then standing
- Small, frequent meals, and sitting still for a while after eating
- Drinking more water, unless the GP has asked them to limit fluids, in which case ask the GP
- Telling the GP if dizziness or fainting keeps happening
What the NHS suggests avoiding
- Standing up quickly, or bending down and straightening up suddenly
- Sitting or standing still for long periods
- Too much alcohol
- Getting up and moving about straight after a large meal
- Carrying on walking through the dizziness instead of sitting down
This matters because dizziness is one of the ways a fall begins. NICE's falls guideline lists a lying and standing blood pressure test as part of a full falls assessment, and names low blood pressure and certain medicines among the risks that can be changed. Its hypertension guideline is more specific. For anyone with symptoms such as falls or dizziness on standing, the GP or nurse measures blood pressure lying down, then again after at least a minute of standing. A fall of 20 points or more in the first number, or 10 or more in the second, counts as a significant drop, and the guideline says to look for the cause, including reviewing the medicines. NICE also asks for this check in everyone with high blood pressure who is aged 80 and over, or has type 2 diabetes, which is worth knowing if your relative has both conditions.
You do not need to measure this yourself. What helps the GP is a description: when the dizziness happens, whether it is on getting out of bed or after a meal, how long it lasts, and whether it started after a new tablet or a change of dose. Write it in the notes column of the record sheet. If your relative has already fallen, mobility and falls care covers what to do and the help available at home.
The medicines
Side effects people notice, and asking for a medicines review
The NHS says most blood pressure medicines are tablets taken once a day, and many people need more than one. Each kind has its own common side effects, listed in the leaflet in the box and on the NHS medicines pages. These are the ones that can show at home.
Dizziness or light-headedness
Several kinds of blood pressure tablet
A dry cough that will not clear
ACE inhibitors such as ramipril
Swollen ankles, feet or legs
Amlodipine, and some others
Needing the toilet more often
Water tablets, called diuretics
None of this is a reason to stop a tablet. The NHS medicines pages say to keep taking the medicine unless a doctor or pharmacist advises otherwise, and to speak to them about any side effect that bothers your relative or does not go away. A community pharmacist can answer questions about side effects without an appointment at the GP.
Every person with high blood pressure should have a yearly review under NICE NG136. For an older person on several medicines, ask the practice for a structured medication review, an appointment where a GP or pharmacist goes through every medicine to check it is still helping and is not causing harm. NICE's falls guideline recommends one for people at risk of falling, to find medicines that make falls more likely. Several conditions and many medicines explains how to prepare for that review and what to bring.
Salt, activity and alcohol
Salt, activity and alcohol: the changes that help alongside the tablets
NICE asks doctors to give lifestyle advice to everyone with high blood pressure, and to keep giving it, because it can lower blood pressure on its own and helps the tablets work. These are the figures the NHS gives, and what they mean in an older person's ordinary week.
6g
of salt a day at most for adults, about one level teaspoon. The NHS says around three quarters of the salt we eat is already in bread, cereals, meat products and ready meals.
150 minutes
of moderate activity a week is the NHS aim for adults aged 65 and over, built up gently, with some activity every day, even light activity.
2 days
a week of activities that improve strength, balance and flexibility, which the NHS says help people who have fallen or are worried about falling.
14 units
of alcohol a week is the most the NHS advises with high blood pressure. Its advice on low blood pressure on standing also says not to drink too much.
NHS: high blood pressure, salt in your diet, and physical activity guidelines for older adults. Checked October 2026.
Salt is where a carer who cooks can make the most difference. The NHS suggests tasting food before adding salt, using herbs, black pepper, garlic or lemon juice instead, keeping salt off the table, and choosing foods with green or amber labels on the front of the pack. It also notes that some dissolvable tablets, such as soluble painkillers, can be high in salt, and says to speak to the GP before changing any medicine. One warning is easy to miss. NICE says salt substitutes made with potassium chloride should not be used by older people, people with diabetes or kidney disease, or people taking some blood pressure medicines such as ACE inhibitors, so do not swap the salt cellar for a low-sodium substitute without asking the GP or pharmacist.
Activity does not have to mean exercise classes. The NHS counts getting up to make a cup of tea, moving round the house and walking slowly as light activity, and breaking up long spells of sitting is part of the guidance. For someone who gets dizzy on standing, the slow start to each walk matters as much as the walk itself. The NHS also suggests not having too much caffeine, so a strong coffee straight before a reading is best avoided. If your relative has had a stroke, these same changes are part of preventing a second stroke.
How a carer helps
How a carer helps with tablets, readings and noticing changes
A carer does not treat blood pressure. What a carer can do is keep the routine around it steady, so the tablets are taken, the readings are kept, and a change is noticed and passed on. Here is what that can look like on an ordinary morning visit.
- Getting up
Standing up slowly, with someone there
Sitting on the edge of the bed for a moment before standing, a steadying hand, and a chair close by in case they feel light-headed. The NHS advice for dizziness on standing is to get up slowly and hold on to something stable.
- If asked
A reading at the agreed time, written down
If the GP or nurse has asked for home readings, the carer can take them with the home monitor at the agreed times and copy both numbers on to the sheet. The GP decides what the readings mean.
- Tablets
Prompted, watched and recorded
A reminder, the blister pack or dosette box opened if asked, a glass of water, and a note of what was taken and when. A missed or refused dose goes on the sheet and is passed to the family.
- Breakfast
Breakfast with less salt
Food cooked from fresh where possible, the salt cellar off the table, and something to drink.
- Any day
Noticing dizziness, a cough or swollen ankles
A carer who sees your relative several times a week can spot a change you might miss, and tell you or ring the GP practice, as you have agreed in advance.
What a carer may and may not do with medicines is set out in can a private carer give medication. In short, prompting and helping with prescribed tablets and writing down what was taken is ordinary care work, agreed with the family in advance. Deciding what a reading means, and anything to do with changing a dose, stays with the GP. If the GP wants home readings, write down the range they want reported, so a carer knows when a number should be passed on.
PrimeCarers is an introductory service. You choose the carer, meet them first, and agree the visits and routine with them directly, and you can keep the same person. Every carer on PrimeCarers has had their identity and right to work checked and an enhanced DBS check (or PVG in Scotland, Access NI in Northern Ireland) issued within the last 2 years, and has been interviewed online. Carers are insured while they work. There is no way to search for carers by experience of a particular condition, and what a carer says about their experience is their own account on their profile, so ask them about it when you meet. If your relative needs someone to call in each morning to help with tablets and a steady start to the day, you can search for carers near you and compare their rates.
Questions
Questions families ask about blood pressure in later life
NICE guideline NG136 gives a target below 150/90 at the surgery, or an average below 145/85 from home readings, for people aged 80 and over who are being treated for high blood pressure. It asks doctors to use clinical judgement for people with frailty or several conditions, so your relative's own target is the one agreed with their GP. Ask what it is and write it at the top of the record sheet.
Blood Pressure UK and the British Heart Foundation recommend an upper-arm monitor listed as clinically validated by the British and Irish Hypertension Society, with a cuff that fits the arm. Wrist monitors are for people who cannot use an upper-arm cuff. Blood Pressure UK says to recalibrate or replace a monitor every two years. If your relative has an irregular heartbeat, ask the GP before relying on a home monitor.
As often as the GP or nurse asks. The NHS says this is usually morning and evening, with two readings each time at least a minute apart. When home readings are used to confirm high blood pressure, NICE asks for at least four days and ideally seven, and the first day is set aside.
One common cause is postural hypotension, a drop in blood pressure on standing. The NHS says it can come with age and with some medicines, including blood pressure tablets, and that getting up slowly, drinking enough and eating smaller meals can help. Tell the GP if it keeps happening. They can measure her blood pressure lying and standing and look at her medicines. Never stop a tablet without asking.
A carer can take a reading with a home monitor and write it down, if that has been agreed and the GP has said what range should be reported. The carer does not decide what the reading means or change any medicine. That stays with the GP, nurse or pharmacist.
They can contribute. Several blood pressure medicines list dizziness among their common side effects, especially on standing, and NICE's falls guideline names certain medicines and low blood pressure among the risks that can be changed. That is why a structured medication review is worth asking for after a fall or a near miss. The answer is a review with the GP, not stopping the tablets.