A randomised controlled study published in Age and Ageing, reveals a link between low blood pressure (BP) and higher mortality rates in older patients.
The study was conducted on adults >75 years of age (n=415,980). Associations between baseline BP and mortality/cardiovascular outcomes at follow-up of ≤10 years were stratified by frailty; non-frail 85 years.
The risk of cardiovascular outcomes increases with systolic blood pressure (SBP) >150 mmHg.
SBPs above 130-139 mmHg were associated with lower mortality risk, particularly in those with moderate-severe frailty or >85 years.
The lowest mortality risk was at SBP >140-160 mmHg and diastolic blood pressure (DBP) of 80-90 mmHg.
Higher mortality was seen at follow-up in those with SPB
Patients of 85 years and older who had raised blood pressure actually had reduced mortality rates, compared to those with lower blood pressure.
International guidelines are tightening blood pressure targets, which may not be appropriate in frail older adults. Further work is required to evaluate the safety of BP reduction in the frail elderly population.