Don’t over treat blood pressure in the over 75s

Adapted from BMJ Oct 10 2020

The lowest mortality in people over the age of 75 occurred in those with a systolic blood pressure of 140-160 and a diastolic pressure of 80-90.

These figures are different than for the middle aged, young retirees and those with diabetes, who are often told to shoot for systolic BPs of 130 to 140.

It was reported Age and Ageing that an analysis of a primary care database that strict blood pressure control can actually be detrimental. Frail older adults do particularly poorly when their blood pressures are too low.

My comment: I remember doing four house calls in a row one warm summer’s day to see older adults, all at different addresses, who had collapsed from over treated blood pressure. None came to serious harm but they could have had fractures, sustained head injuries or collapsed in the street. I have read that a higher blood pressure in older life helps to perfuse the kidneys better. For many patients, they see nurses at nurse led clinics and lower blood pressures are not remarked on. They are told “good, come back in six months or a year”. They only see GPs when the blood pressure is considered to be too high. Instead, patients may be better to have realistic targets set by their GP depending on their age and ongoing health issues and check their blood pressure at home where it is less likely to be artificially raised by anxiety that is common in the health care setting.

2 thoughts on “Don’t over treat blood pressure in the over 75s”

  1. I so agree with this. It is ridiculous. I have naturally low blood pressure. I hover around 110/60. My CDE is concerned that I do not have an ACE inhibitor. So I was prescribed and took 2.5 mg of lisinopril. After two weeks I was falling. So thankfully my endo told me to not take it. Now I am not faulting my CDE, she was getting pressure from my insurance and, blah, blah, blah. I mean come on let it be sometimes.

    Liked by 1 person

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