Taking blood pressure
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Adults over 80 should stick to medications that keep their blood pressure under control, a study published on Monday in the Journal of the American College of Cardiology finds.
Keeping systolic blood pressure under 130 lowers the risk of heart-related death by about 26% among people 80 or older, according to the researchers.
“Blood pressure above 145 was linked to a higher risk of heart-related death,” Yuan Lu, an assistant professor of cardiology at Yale School of Medicine, said in a podcast about the study.
In 2017, the leading heart health groups revised blood pressure guidelines, setting 130 systolic as the new number at which people would be diagnosed with hypertension, or high blood pressure. Systolic blood pressure is the pressure inside blood vessels during a heartbeat. Previously, the threshold was 140 for people under the age of 65 and 150 for people 65 and older.
However, “the evidence regarding optimal blood pressure targets for adults aged greater than 80 years remains limited and inconsistent across various guidelines,” researchers said in their new paper.
That’s because major blood pressure studies have either excluded people 80 and older, or have not been able to perform sufficient follow-up, researchers said in background notes.
Lu’s team wanted to know if blood pressure should be lowered aggressively, or if people should take a moderate approach.
“Some studies suggest that lowering blood pressure too much might actually be harmful in older adults,” Lu noted.
The researchers assessed medical records for nearly 1,593 participants who were aged 80 and older and prescribed blood pressure medications between 1988 and 2014. The team tracked their deaths through 2019. In total, 46% of deaths among older adults were from heart disease, the data revealed.
When blood pressure was maintained below 130, it effectively lowered participants’ risk of heart-related death, results show.
“We must know that treatment decisions should still be personalized for frail individuals and those with multiple health conditions,” Lu added. “A slightly higher blood pressure target may be safer.”