Intensive treatment of high blood pressure reduces older adults' risk of heart disease without increasing their risk of falls or other complications, a new study shows.
"These findings have substantial implications for the future of high blood pressure therapy in older adults because of its high prevalence in this age group, and because of the devastating consequences high blood pressure complications can have on the independent function of older people," said study author Dr. Jeff Williamson, a professor of gerontology and geriatric medicine at Wake Forest Baptist Medical Center, in Winston-Salem.
The study included more than 2,600 patients, aged 75 and older. They were randomly assigned to one of two groups: either an intensive systolic blood pressure target of 120 mm Hg or the standard target of 140 mm Hg.
Systolic pressure, the top number in a blood pressure reading, measures the pressure in your blood vessels when your heart contracts. On average, patients in the intensive target group required one additional medication to achieve their goal.
Compared to those in the standard target group, patients in the intensive target group were nearly one-third less likely to have a heart attack, heart failure or stroke, and nearly one-quarter less likely to die, the study authors said.
There was no difference in rates of complications from lower blood pressure, such as fainting, falls, hospitalization and acute kidney injury, according to the study.
"Some of the most vulnerable ambulatory people in the community who may suffer complications of high blood pressure can benefit from intensive blood pressure lowering and it is safe to do so," Williamson said.
"If you look at elderly people who are hospitalized in the year that they become disabled and have to leave their home, about half the time those diagnoses or hospitalizations result from complications of high blood pressure, like heart failure, stroke and heart attack," he said.
Most of the medications used in the study were generic, Williamson said. "This is a fairly inexpensive way to help prolong the time that people can live independently in their homes and avoid those common conditions that often cause a person to have to move to higher level of care or an institution," he said.