Is hypertension dangerous to everyone?
Chronic hypertension is seen as increasing the likelihood of a cardiovascular event like stroke or heart attack, as well as diabetes and some metabolic problems, which means that high blood pressure administering has become a routine global treatment for the elderly, in particular. A recent study questions this practice and states that it may not be universally beneficial to correct blood pressure.
Who is thought to be hypertensive?
Let’s define the high blood pressure before investigating the study itself:
- According to the latest US guidelines released by the American Heart Association and the American Cool of Cardiology in 2017, hypertension is considered for any blood pressure with a (upper) systolic reading above 130.
- The guidelines in Europe differ, as the European Cardiological Society and the European Hypertension Society suggests that hypertension is a systolic over 140 reading.
It is essential that not all patients over the age of 70 are given treatment to lower the systolic blood pressure to 120 and usually in clinical practice doctors decide which upper limit is best for each patient.
Is high blood pressure really bad for everyone?
In general, older adults are more likely to have hypertension, so any adult after 70 is advised to monitor blood pressure continuously and to take some kind of medicines or a combination of them to normalize their blood pressure.
An astonishing conclusion came from a study by Charité-Universitätsmedizin Berlin, in Germany, which surveyed the mortality rates for 1,628 adults over 70. They found that adults over 80 can do better without lowering their blood pressure below 140/90. The study is discussed in detail below.
The study was published in the European Heart Journal in 2019 and analyzed seniors with and without cardiovascular events. They measured and recorded the blood pressure of the participants and what drugs they took and six years later checked how many participants died.
Importantly, participants ‘ average age was 81 years. The survey also monitored a number of factors, including biological sex, lifestyle choices and BMI. Blood pressure levels below 140/90 have therefore not decreased mortality risk but increased by 26 percent. Now this refers to an average population of 81 years, but we can observe an interesting trend in detail:
- the mortality rates of those with normal blood pressure aged 70-79 years decreased (slightly).
- Blood pressure below 140/90 increased the risk of death of 80 or older people by 40 percent.
Unfortunately, the role of a relative high blood pressure in taking care of the elderly and what “normal blood pressure” should be considered for this age group is still unclear. However, it is clear that a general approach to mass blood pressure reduction can not also be the right treatment strategy.
Therefore, the study concluded that patients over the age of 80 have a better targeted and individualized treatment of blood pressure, rather than a constant objective of reducing blood pressure by less than 140/90.
And while the research has made some courageous statements, the criteria for individualized treatment should be taken into account in the practice of doctors are still unclear. Researchers are however optimistic and the next goal is to distinguish between those who need antihypertensive treatments and those who don’t need them.