High blood pressure in people older than 85 years of age can be associated with decreased longevity, according to a recent study. The researchers also found that for older adults with mild or extreme fragility the risk of mortality was still lower.
A number of health organizations, including the American Heart Association (AHA) and the American Cardiology Institute, lowered their definitions of high blood pressure in 2017.
For those younger than 65 and 150/80 mm Hg, the limits for those aged 65 and above were 140/90 millimeters of mercury (mm Hg).
But are these tighter guidelines really helpful for older people, especially adults with vulnerability?
As suggested by the authors of the new study, many hypertension data and older adults are not inherently fragile older adults.
Because of comorbidities, shortened life span, cognitive impairment and drug causes, an inadequate proportion of these individuals engaged in randomized clinical trials.
It is therefore also difficult and unreliable to estimate cardiovascular or all-cause blood pressure mortality in older adults.
A recent study was carried out by Jane Masoli— a PhD and specialist registrar of geriatric pharmaceutical products at Exeter University in the UK, the National Institute for Health Research and fellow members. To help address this issue.
Masoli and the team set out to examine associations between mortality and blood pressure in the health records of 415,980 older adults.
They recently published their results in the journal Age and Ageing.
Hypertension linked with lower mortality
For a follow-up period of at least 10 years, researchers used statistical methods, such as the Cox proportional risk model, to determine the relationship.
They stratified their study to a degree of fragility by an electronic index of fitness (non-frail), mild, moderate, and severen fragility.
The analysis found that the risk of heart attacks was higher when the blood pressure was above 150 mm Hg.
In comparisons with that of 130-139 mm Hg in the range 130–139 mm Hg, researchers found that hypertension was linked to 6 percent decreases in mortality risk in non-frail ol as well as with a decreasing risk of mortality in the period from the systolic blood pressure above 130–139 mm Hg.
In particular when comparing systolician blood pressure of 150–159 mm Hg (hypertension), to that of 130–139 mm Hg, scientists found that hypertension was associated with a 6 percent reduction in mortality risk for nonfrail older people. Hg was linked to lower mortality risk, “particularly with moderate to severe frailty or above 85 years.”
The team reported a 16% reduction in mortality risk during the study period among the elderly with hypertension and moderate to severe frailties.
“The increased mortality at ages above 85 and 75-84 with mild / s extreme frailty was not associated with hypertension, possibly due to the complexities of co-existing morbidities,” the authors write.
They conclude, “The priority given to aggressive [blood pressure] reduction in frail older people requires further evaluation.”
“Internationally,” says Masoli, the principal author of the study “the recommendations work towards strict blood pressure targets, but our findings indicate that these may not be sufficient for vulnerable older adults.”
“We need more research to ascertain whether aggressive blood pressure control is safe in older adults, and then for which patient groups there may be benefit, so we can move towards more personalized blood pressure management in older adults.”
– Jane Masoli
She warns, however: “We are aware that blood pressure treatment helps prevent heart attacks and strokes and would not recommend that anyone stop taking medications except under the guidance of their doctor.”