Does it really make a difference if the systolic blood pressure in the elderly is around 150 vs. a little bit under 140?
The guidelines that systolic blood pressure should be below 140 are based on research that has, historically, targeted non-elderly people.
A report appears in Drugs & Aging, in which Leah Goeres, lead study author, points out that the goal of keeping the systolic blood pressure under 140 has been a longstanding protocol.
“Yet at the same time, there’s been some reservations among some doctors about how important this guideline is…in that, would 149 vs. 139 really make a difference in an elderly person?
“Keeping systolic blood pressure in older adults below 150 is important,” says Goeres in the paper. She says this is a “mild level of control.”
Then she adds that for the person over age 65, “that level is also good enough.”
After extensive analysis, Goeres maintains that more intensive blood pressure management, to keep it under 140, is not necessary for the older adult.
A potential side effect of drugs that lower blood pressure is orthostatic hypotension: Blood pressure quickly drops when someone rises from a chair, and this can cause passing out.
This problem is much more prevalent in people 80-plus.
The report explains that as men and women get older, the evidence becomes thinner that strict control of the systolic should continue to be very important.
Morton Tavel, MD, Clinical Professor Emeritus of Medicine, Indiana University School of Medicine, and author of “Health Tips, Myths and Tricks: A Physician’s Advice,” concurs with the study’s findings.
“As a practical matter, in someone over 70 years of age, I consider a systolic pressure of 150 acceptable.
“Although it is a bit more desirable to go even lower than this in this group, this is difficult to achieve in the elderly without the use of multiple drugs, which increase the likelihood of objectionable side effects.
“So it’s usually best to strike a happy compromise with a less aggressive approach.”