Elderly people benefit from taking medications to keep their blood pressure low, same as younger folks, a new study says.
Systolic blood pressure kept under 130 reduces the risk of heart-related death by about 26% among people 80 or older, researchers reported in the Journal of the American College of Cardiology.
“We found that people with blood pressure below 130 have a lower risk of dying from heart disease and stroke,” senior researcher Yuan Lu, an assistant professor of cardiology at Yale School of Medicine, said in an ACC podcast on the study. “Blood pressure above 145 was linked to a higher risk of heart-related death.”
America’s leading heart health groups tightened blood pressure guidelines in 2017, setting 130 systolic as the new number at which anyone could be diagnosed as having high blood pressure. Systolic blood pressure is the pressure inside blood vessels during a heartbeat.
Prior to that, the threshold was 140 for people younger than 65 and 150 for seniors 65 and older.
However, “the evidence regarding optimal blood pressure targets for adults aged greater than 80 years remains limited and inconsistent across various guidelines,” researchers said in their new paper.
That’s because major blood pressure studies have either excluded people 80 and older, or have not been able to perform sufficient follow-up, researchers said in background notes.
“The key question is, should blood pressure be lowered aggressively, or is more moderate approach safer?” Lu said. “Some studies suggest that lowering blood pressure too much might actually be harmful in older adults.”
It’s an important question, given that heart disease affects more than 85% of people fortunate enough to reach their 80s, researchers noted.
For this study, researchers evaluated medical records for nearly 1,600 people 80 and older prescribed blood pressure medications between 1988 and 2014, and tracked deaths through 2019.
Heart disease accounted for nearly half (46%) of deaths that occurred among these seniors, researchers said.
But keeping systolic blood pressure below 130 effectively lowered their risk of heart-related death, results show.
“Our study suggests that treating high blood pressure aggressively in adults 80 and above may be beneficial, as a systolic blood pressure below 130 is associated with lower cardiovascular risk,” Lu said.
“However, we must know that treatment decisions should still be personalized for frail individuals and those with multiple health conditions,” she concluded. “A slightly higher blood pressure target may be safer.”
More information
Harvard Medical School has more on blood pressure guidelines.
SOURCE: Journal of the American College of Cardiology, March 17, 2025
Source: HealthDay
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