A new study has found that keeping systolic blood pressure below 130 can significantly reduce the risk of dying from heart disease or stroke in people aged 80 and older.
The findings, published in the Journal of the American College of Cardiology, show a 26% drop in heart-related deaths among older adults who maintained lower blood pressure levels.
The research offers new insight into how aggressively blood pressure should be treated in seniors.
For years, there has been uncertainty about the ideal blood pressure targets for people over 80. That’s largely because many past studies either excluded the oldest adults or didn’t track them long enough to gather reliable data.
This new study, led by Dr. Yuan Lu, assistant professor of cardiology at Yale School of Medicine, helps fill that gap. “We found that people with blood pressure below 130 have a lower risk of dying from heart disease and stroke,”
Dr. Lu said in a podcast discussing the research. On the other hand, she noted, systolic blood pressure above 145 was linked to a higher risk of death from heart-related causes.
What Is Systolic Blood Pressure?
Systolic blood pressure is the top number in a blood pressure reading. It measures the pressure in your arteries when your heart beats. A normal reading is usually below 120. In 2017, U.S. health experts lowered the threshold for high blood pressure to 130. Before that, the cutoff was 140 for younger adults and 150 for seniors over 65.
But even with the updated guidelines, some experts have remained unsure whether people in their 80s or beyond should aim for the same target, or whether lowering blood pressure too much might cause harm. Older adults are more likely to be frail or have other health conditions that make aggressive treatment risky.
To learn more, researchers looked at the medical records of nearly 1,600 adults aged 80 and older who were taking blood pressure medications. The data came from patients tracked between 1988 and 2014, with death records followed through 2019.
Nearly half of the deaths in this group—46%—were caused by heart disease. But those who kept their systolic blood pressure under 130 were much less likely to die from heart-related issues than those with higher readings.
The researchers concluded that aiming for a lower blood pressure goal could be beneficial, even in very old adults. “Our study suggests that treating high blood pressure aggressively in adults 80 and above may be beneficial,” said Dr. Lu. “A systolic blood pressure below 130 is associated with lower cardiovascular risk.”
Despite the encouraging findings, Dr. Lu cautioned that treatment plans must still be tailored to each individual.
Frail seniors or those with multiple chronic health issues might not tolerate aggressive blood pressure lowering. In those cases, a slightly higher target may be safer and more appropriate.
This study adds to a growing body of evidence suggesting that “lower is better” when it comes to blood pressure—even for people in their 80s. It challenges the older belief that high blood pressure is a normal part of aging or that aggressive treatment in the very old is unnecessary or dangerous.
However, it also highlights the importance of individualized care. While some 80-year-olds are active and healthy, others may be frail or managing multiple conditions. For these individuals, sharply lowering blood pressure could cause dizziness, falls, or other complications.
In summary, for many older adults, maintaining systolic blood pressure below 130 appears to lower the risk of heart disease and stroke. But decisions about treatment should be made carefully, balancing the benefits of lower blood pressure with the risks and overall health status of the person.
This study provides a useful benchmark for doctors and patients when discussing treatment goals—and another reminder that it’s never too late to take care of your heart.
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The research findings can be found in Journal of the American College of Cardiology.
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