In a recent study about nearly 7,500 Americans age 65 or older, researchers found that elevated blood pressure is not related to high mortality risk in people with weak grip strength.
Previous research showed that the relationship between high blood pressure and the risk of death is largely dependent on elders’ frailty status like walking speed.
The current finding is important because it suggests that treating high blood pressure in older patients should not follow a one-size-fits-all approach.
When an older person is still functioning at a high level physically, high blood pressure indicates mortality risk.
However, when the person is not physically robust, high blood pressure is not a marker for mortality risk.
This means if people are very frail, they typically don’t respond well to anti-hypertensive therapy and they are not benefiting from having low blood pressure.
Most people’s diastolic blood pressure goes down with age. Systolic blood pressure, though, tends to rise, and high blood pressure — hypertension — can put extra strain on the heart and arteries, causing a greater risk of heart attack and stroke.
But as the research suggests, an elderly patient’s level of physical function should be considered in determining whether anti-hypertensive therapy is beneficial.
Grip strength, easily measured by an inexpensive device known as a dynamometer, is a common way to gauge functionality in the elderly. Another often-used measuring stick is walking speed.
The study showed that elevated systolic blood pressure (150 or greater) and diastolic blood pressure (90 or greater) correlated with a substantially higher likelihood of dying for those with normal grip strength, which is 26 kilograms or more for men and 16 kilograms or more for women.
The team also explained how high blood pressure might actually help in some cases.
As people age, blood vessels lose elasticity and become stiff. Higher blood pressure could be a compensatory mechanism to overcome this loss of vascular elasticity and keep fresh blood pumping to the brain and heart.
Everyone ages differently. With fast walkers, high blood pressure may be more indicative of underlying disease and not just a symptom of the aging process
In addition to the connection with weak grip strength, the team found there was a “very clear” inverse association between high blood pressure and mortality among those who weren’t physically able to finish the gait-speed test in the latest study.
This means among those who couldn’t walk a little over 8 feet, high blood pressure was linked to less mortality risk.
The study is published in the Journal of the American Geriatrics Society.
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