Maintaining a systolic blood pressure below 130 can significantly reduce the risk of heart-related death by about 26% among individuals aged 80 and older, according to a new study published in the Journal of the American College of Cardiology.
The research, led by senior investigator Dr. Yuan Lu, an assistant professor of cardiology at Yale School of Medicine, emphasizes the importance of controlling blood pressure in older adults. “We found that individuals with a systolic blood pressure below 130 experienced a lower risk of dying from heart disease and stroke,” Dr. Lu said in an interview. “Conversely, blood pressure levels above 145 were linked to an increased risk of heart-related death.”
In 2017, U.S. health authorities revised the threshold for diagnosing high blood pressure, setting 130 systolic as the new standard. Prior to this change, the threshold was 140 for those under 65 and 150 for seniors aged 65 and older.
Despite these revised guidelines, the researchers note that evidence for the optimal blood pressure targets in people over 80 remains sparse and inconsistent across various health guidelines. This is due to previous studies often excluding seniors or lacking long-term follow-up, making it difficult to draw firm conclusions about the most effective treatment strategies for this age group.
“The crucial question is whether aggressively lowering blood pressure is beneficial or if a more moderate approach is safer for older adults,” Dr. Lu explained. “Some studies suggest that overly lowering blood pressure could potentially be harmful in this population.”
This issue is particularly important as heart disease affects over 85% of individuals who live to 80, according to the researchers.
The study examined the medical records of nearly 1,600 individuals aged 80 and older, all of whom were prescribed blood pressure medication between 1988 and 2014. Their deaths were tracked through 2019. The findings revealed that nearly half (46%) of the deaths among these seniors were due to heart disease.
The study’s results show that maintaining systolic blood pressure below 130 was associated with a reduced risk of heart-related mortality, suggesting that aggressive blood pressure management may be beneficial for older adults.
Dr. Lu emphasized, however, that treatment should be personalized, particularly for frail individuals or those with multiple health conditions. “While our study suggests that lowering blood pressure below 130 may reduce cardiovascular risk, treatment plans must be tailored to the individual, with slightly higher blood pressure targets potentially safer for some.”
The findings offer new insights into blood pressure management for older adults, highlighting the need for careful, personalized treatment strategies to balance heart health and overall well-being.
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