Hypertension: General blood pressure guidelines no longer apply with increasing age

Hypertension: General blood pressure guidelines no longer apply with increasing age

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New insights into blood pressure in old age

So far, doctors have believed that it is healthier for older people to lower their blood pressure below 140/90 mmHg. Researchers have now found that this assumption does not apply to all hypertension patients. On the contrary: the risk of death increases for people who are older than 80 or who have already had a stroke or a heart attack.

According to the European guidelines, blood pressure in people over 65 years of age should be set below 140/90 mmHg in order to protect them from cardiovascular diseases. These target values ​​also apply to people over the age of 80, but they have to consider individual factors such as comorbidities.

In an observational study, Charité researchers have now been able to show that lowering blood pressure to below 140/90 mmHg - and especially below 130/90 mmHg - does not always have a protective effect. The analysis is based on epidemiological data from more than 1,600 women and men who were at least 70 years old at the start of the study in 2009 and who were receiving antihypertensive treatment.

The researchers found that those over 80 years of age who had blood pressure below 140/90 mmHg were 40 percent more likely to die than those who had blood pressure above 140/90 mmHg. The research group made a similar observation among the participants in the study who had previously suffered a stroke or heart attack: those who had blood pressure below 140/90 mmHg increased the risk of death by as much as 61 percent compared to those whose blood pressure remained above this limit despite drug treatment.
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The scientists therefore conclude that the treatment of increased blood pressure in these patient groups should be individually adjusted. One should get away from applying the recommendations of the professional associations to all patient groups.

The epidemiological data were collected as part of the “Berlin Initiative Study,” in which the study participants were interviewed every two years about their illnesses and medication, measured blood pressure and kidney function and analyzed blood and urine. After six years, the scientists used statistical methods to investigate the extent to which the blood pressure measured at the start was related to death. Factors such as gender, body mass index, smoking status, alcohol consumption, diabetes and the number of antihypertensive agents were also taken into account.
You can find the study here.

Author and source information

Video: Guidelines for Hypertension Treatment. UPMC (May 2022).