In a new study, researchers found that taking blood pressure medication as prescribed helped even the frailest elderly people (65 and older) live longer, and the healthiest older people had the biggest survival boost.
The research was conducted by a team at the University of Milano-Bicocca in Milan, Italy.
Previous research has shown that high blood pressure medication was protective in general among older people.
In this study, the team focused on whether it is also protective in frail patients with many other medical conditions who are usually excluded from randomized trials.
They reviewed data on almost 1.3 million people aged 65 and older (average age 76) in the Lombardy region of northern Italy who had 3 or more high blood pressure medication prescriptions in 2011-2012.
Examining the public health care database, the researchers calculated the percentage of time over the next seven years (or until death) that each person continued to receive the medications.
They compared roughly 255,000 people who died during the 7-year follow-up with age-, gender-, and health-status-matched controls who survived and divided them into four groups of health status: good, medium, poor or very poor.
The probability of death over 7-years was 16% for people rated in good health at the beginning of the study. Mortality probability increased progressively to 64% for those rated in very poor health.
The team found compared with people with very low adherence to blood pressure medications (dispensed pills covered less than 25% of the time period), people with high adherence to blood pressure medications (more than 75% of the time period covered) were:
44% less likely to die if they started in good health; and
33% less likely to die if they started in very poor health.
A similar pattern was seen with cardiovascular deaths. The greatest survival benefit was among the people who started in good health, and the most modest survival benefit was in those who started in very poor health.
The findings suggest that even in very frail people, high blood pressure treatment reduces the risk of death; however, the benefits may be smaller in this group.
No matter what a person’s initial health status, survival benefits were greatest in those who received blood pressure medication to cover more than 75% of the follow-up period, highlighting the importance of consistent use of blood pressure medications.
The lead author of the study is Giuseppe Mancia, M.D.
The study is published in Hypertension.
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