Should blood pressure targets be adjusted in frail, older patients?

  • Todd OM & al.
  • Age Ageing
  • 5 Jun 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Low systolic blood pressure (SBP
  • No association was observed between low SBP and mortality risk in those with frailty.

Why this matters

  • Findings suggest that in the absence of frailty, blood pressure targets should be considered independently of age.

Study design

  • Meta-analysis of 9 observational studies (n=21,906; mean follow-up, 6 years) identified after a search across MEDLINE, EMBASE and CINAHL databases.
  • Primary outcome: all-cause mortality.
  • Funding: Dunhill Medical Trust, UK, and others.

Key results

  • Pooled results of 6 studies demonstrated that in older adults with frailty, SBP 140 mmHg (HR, 1.02; 95% CI, 0.90-1.16; P=.74).
  • In older adults without frailty, SBP 140 mmHg (HR, 0.86; 95% CI, 0.77-0.96; P=.009).
  • A 10-mmHg difference in SBP was not associated with mortality in older adults with (HR, 1.02; 95% CI, 0.96-1.07) and without (HR, 1.00; 95% CI, 0.97-1.04) frailty.
  • No association was observed between diastolic BP and all-cause mortality in older adults with and without frailty.

Limitations

  • Study did not report non-fatal outcomes.
  • Variation in the criteria for hypertension diagnosis and the thresholds for treatment.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit