High blood pressure associated with lower mortality on older adults
According to a recent investigation, high blood circulation pressure in persons aged over 85 may be associated with lowered mortality. The researchers also found that the chance of mortality was even lower for older adults with moderate or extreme frailty.
In 2017, several health organizations, like the American Heart Association (AHA) and American University of Cardiology, reduced their definitions of large blood pressure.
Previously, the thresholds were 140/90 millimeters of mercury (mm Hg) for people younger than 65 and 150/80 mm Hg for all those aged 65 and older.
But are these tighter rules truly ideal for older individuals, particularly for men and women with frailty?
As the authors of the new study explain, most data relating to hypertension and older adults usually do not necessarily signify frail older adults.
Simply because an insufficient number of the adults have participated in randomized clinical trials, because of comorbidities, limited life expectancy, problems with cognition, and factors associated with medication.
For these reasons, predicting cardiovascular or all-cause mortality from blood pressure among older adults is still challenging and uncertain.
To help address this matter, Jane Masoli - a National Institute for Health Exploration doctoral fellow and professional registrar in geriatric medicine at the University of Exeter, in britain - and colleagues completed a new study.
Masoli and the team set out to examine associations between mortality and blood circulation pressure in medical records of 415,980 older adults.
Hypertension linked with lower mortality
The researchers applied statistical tools, such as Cox proportional-hazards models, to check the association over a follow-up amount of at least a decade.
They stratified their analysis by frailty level, using an electric frailty index which includes classifications of fit (nonfrail) and mild, moderate, and serious frailty.
The analysis discovered that the chance of cardiovascular problems such as for example heart attacks increased when systolic blood circulation pressure was over 150 mm Hg.
However, systolic blood pressure above 130-139 mm Hg was associated with lower mortality risk, “specifically in moderate to extreme frailty or above 85 years.”
Specifically, when you compare systolic blood circulation pressure of 150-159 mm Hg (hypertension) with that in the number of 130-139 mm Hg, the researchers discovered that hypertension was connected with a 6% reduction in mortality risk among nonfrail older adults.
Among older persons with hypertension and average to serious frailty, the staff observed a 16% decrease in mortality risk through the study period.
“Hypertension was not associated with increased mortality in ages above 85 or perhaps at ages 75-84 with average/severe frailty, perhaps because of complexities of coexisting morbidities,” write the authors.
They conclude, “The priority given to aggressive [blood pressure] reduction in frail older persons requires further evaluation.”
“Internationally,” says Masoli, the study’s lead author, “guidelines are moving towards restricted blood circulation pressure targets, but our results indicate that this may well not be appropriate found in frail older adults.”
“We are looking for more research to see whether aggressive blood circulation pressure control is secure in older people, and then for which patient groups there may be benefit, so we are able to move towards more personalized blood circulation pressure management in older people.”
- Jane Masoli
She cautions, however, “We realize that treating blood pressure helps to prevent strokes and heart attacks, and we'd not advise anyone to end taking their medications unless guided by their doctor.”
Source: www.medicalnewstoday.com
