Study: 'Mild' control of systolic pressure is adequate for adults age 65 or older

CORVALLIS, Ore. – A broad review of the use of medications to reduce blood pressure has confirmed that “mild” control of systolic pressure is adequate for adults age 65 or older — in the elderly, there’s no clear benefit to more aggressive use of medications to achieve a lower pressure, reported researchers from the College of Pharmacy at Oregon State University and Oregon Health & Science University in a recent review published in "Drugs & Aging." 

 

“The goal of a systolic pressure at or below 140 has been around a long time, and there’s still skepticism among some practitioners about accepting a higher blood pressure,” said Leah Goeres, an OSU postdoctoral fellow and lead author on the publication. “Keeping systolic blood pressure in older adults below 150 is important, it’s what we consider a mild level of control,” Goeres said. “But for older people that level is also good enough. After an extensive review, there was no significant evidence that more intensive management is necessary.”

 

The issue about how low is low enough, researchers say, is important because blood pressure medications can have unwanted side effects that increase as higher dosages of medications are used. The problem is common — in the United States, about 70% of adults age 65 or older have hypertension, and millions of people take medication to control it.

 

Historically, most medical practitioners tried to achieve control of systolic pressure — the higher of the two blood pressure readings — to 140 or less. Recently changed guidelines now suggest that for adults over 60, keeping the systolic pressure at 150 or less is adequate, and this extensive analysis confirms that, the researchers noted.

 

However, researchers also suggested that more work needs to be done studying blood pressure in older populations, since most of the research, and the medical guidelines based on them, were done using predominately younger adults.

 

The researchers said a goal for the future should be to do more studies, specifically with older adult populations and try to identify health situations and conditions that might benefit from different types of management. Such “individualized” treatments, they said, would consider a person’s entire health situation instead of treating them based on findings made with large groups.

 

In this study, the researchers did not find that one approach or another to lowering blood pressure stood out and was clearly better than other alternatives. A variety of medications can be used to treat the condition.