Borderline Pressure May Be Better Than Low for Very Old

Patients over 80 with treated hypertension who have lower blood pressure have shorter survival

TUESDAY, March 13 (HealthDay News) -- Patients with treated hypertension who are aged 80 and older have better five-year survival if they still have relatively high blood pressure than patients with treated hypertension who achieve a lower blood pressure, researchers report in the March issue of the Journal of the American Geriatrics Society. The finding suggests physicians should exercise caution when prescribing antihypertension medication in this age group.

Daniel J. Oates, M.D., of Boston Medical Center, and colleagues conducted a study of 4,071 hypertension patients aged 80 and above recruited from 10 Veterans Affairs sites. Patients were followed-up for five years.

By the end of the follow-up period, those with a systolic blood pressure of up to 139 mm Hg and a diastolic blood pressure of 89 mm Hg had greater odds of survival than those with lower blood pressure. Up to a systolic blood pressure of 139 mm Hg, the hazard ratio was 0.82 for every 10-point increase in systolic blood pressure, and was 0.85 for a diastolic blood pressure of up to 89 mm Hg. The association was only detected among patients undergoing treatment for hypertension and not for those with uncontrolled hypertension.

"This suggests that clinicians should use caution in their approach to blood pressure lowering in this age group," the authors conclude. "The results do not contradict current guidelines, with their emphasis on lowering blood pressure to a target of 140/90, but they suggest that further reductions in blood pressure in very old men with treated hypertension may be harmful."

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