Low blood pressure linked to high mortality in older people
International blood pressure guidelines may need to be reviewed, according to UK researchers who have found a link between low blood pressure and higher mortality among older people.
A large-scale study led by the University of Exeter analysed medical records of nearly 416,000 older adults in England.
“We need more research to ascertain whether aggressive blood pressure control is safe in older adults”
Jane Masoli
The research, funded by the National Institute for Health Research and published in the journal Age and Ageing, comes after some countries changed blood pressure guidelines to encourage clinicians to take steps to reduce blood pressure to improve patients’ health.
However, previous studies have not considered the impact on frail older adults, who are often not included in trials.
The team found people aged 75 or over with low blood pressure – below 130/80 – had increased mortality rates compared with those who had normal blood pressure.
This was especially pronounced in “frail” individuals who had a 62% increased risk of death during the 10-year follow-up.
While high blood pressure did increase the risk of cardiovascular events, such as heart attacks, it was not linked to higher death rates in frail adults over 75, the study found.
Meanwhile, older people aged 85 and over who had raised blood pressure actually had reduced mortality rates compared with those with lower blood pressure – regardless of whether they were frail or not.
The researchers said UK blood pressure guidelines were within safe parameters for all. However, they said their findings raised questions about current international guidance.
“Internationally, guidelines are moving towards tight blood pressure targets, but our findings indicate that this may not be appropriate in frail older adults,” explained study lead and geriatrician Jane Masoli.
“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 personalised blood pressure management in older adults,” she added.
She stressed that treating high blood pressure had been shown to prevent strokes and heart attacks.
“We would not advise anyone to stop taking their medications unless guided by their doctor,” she added.
The paper is entitled ‘Blood pressure in frail older adults: associations with cardiovascular outcomes and all-cause mortality’.
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