Based on annual physical assessments, an older adult female's blood pressure readings have changed from 120/82 to 155/86 mm Hg over the past two years. The practical nurse (PN) should recognize which factors in the client's history are likely to be associated with this finding? (Select all that apply.)

A. History of diabetes mellitus: Diabetes contributes to vascular damage and decreased arterial elasticity, which can elevate blood pressure over time. Poor glucose control increases atherosclerotic risk, making hypertension more likely in older adults. B. Hyperlipidemia: Elevated lipid levels promote plaque formation within arterial walls, reducing vessel flexibility and increasing systemic vascular resistance. This process contributes to the gradual development of hypertension. C. Leads an aerobics class: Regular aerobic exercise typically improves cardiovascular health by lowering blood pressure and enhancing vessel elasticity. This lifestyle factor would more likely protect against hypertension rather than cause it. D. Increase in age: Aging naturally causes vascular stiffening and decreased arterial compliance, leading to higher systolic blood pressure. This physiological change is a major risk factor for developing hypertension in older adults. E. Body mass index of 22: A BMI within the normal range (18.5–24.9) indicates a healthy weight, which generally supports normal blood pressure. Obesity, not a normal BMI, is a key contributor to hypertension.