Low blood pressure may strongly harm health in older people

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In a recent study at the University of Exeter, researchers found a link between low blood pressure and higher mortality rates in older people.

The study was conducted after some countries have changed blood pressure guidelines to encourage clinicians to take measures to reduce blood pressure in a bid to improve health outcomes.

They analyzed 415,980 electronic medical records of older adults in England.

They found that people aged 75 or over with low blood pressure (below 130 / 80) had increased mortality rates in the follow-up, compared to those with normal blood pressure.

This was especially pronounced in ‘frail’ people, who had a 62% increased risk of death during the ten-year follow-up.

The study is published in Age and Ageing. One author is Jane Masoli, a geriatrician, and NIHR Doctoral Research Fellow.

Although high blood pressure increased the risk of cardiovascular incidents, such as heart attacks, it was not linked to higher mortality in frail adults over 75.

Older people aged 85 and over who had raised blood pressure actually had reduced mortality rates, compared to those with lower blood pressure, regardless of whether they were frail or not.

The team says internationally, guidelines are moving towards tight blood pressure targets, but our findings indicate that this may not be appropriate in frail older adults.

Scientists need more research to ascertain whether aggressive blood pressure control is safe in older adults, and then for which patient groups there may be a benefit, so they can move towards more personalized blood pressure management in older adults.

The researchers also say that treating blood pressure helps to prevent strokes and heart attacks and they would not advise anyone to stop taking their medications unless guided by their doctor.

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