A
randomised controlled study published in Age
and Ageing ,
reveals a link between low blood pressure (BP) and higher mortality
rates in older patients.
The study was
conducted on adults >75 years of age (n=415,980). Associations
between baseline BP and mortality/cardiovascular outcomes at
follow-up of ≤10 years were stratified by frailty; non-frail
<85 years old, frail 75-84-year-olds, and all aged >85 years.
The risk of
cardiovascular outcomes increases with systolic blood pressure (SBP)
>150 mmHg.
SBPs above
130-139 mmHg were associated with lower mortality risk, particularly
in those with moderate-severe frailty or >85 years.
The lowest
mortality risk was at SBP >140-160 mmHg and diastolic blood
pressure (DBP) of 80-90 mmHg.
Higher
mortality was seen at follow-up in those with SPB <130 mmHg and
DBP <80 mmHg, irrespective of frailty.
Patients of 85
years and older who had raised blood pressure actually had reduced
mortality rates, compared to those with lower blood pressure.
International
guidelines are tightening blood pressure targets, which may not be
appropriate in frail older adults. Further work is required to
evaluate the safety of BP reduction in the frail elderly population.
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