Doctors often do not aggressively treat high blood pressure in older adults for fear that high blood pressure medications may make them more likely to fall or have other unwanted side effects.
In the general population, a cardiologist usually intervenes to keep blood pressure below 130/80. They use the same approach with older adults who are in good health.
But for frail older people, cardiologists are concerned that the treatment may be more dangerous than high blood pressure. “As patients get older, there is more consideration given to what comorbidities they have and whether intensive blood pressure lowering still makes sense,” says the Cleveland Clinic. says cardiologist Ashish Saraju.
He added: “You definitely don’t want to be in a situation where you’re actively lowering your blood pressure and increasing your risk of falls.”
Falls are not the only thing to consider. For example, older people on kidney dialysis often have better kidney function if their blood pressure doesn’t drop below 130, he added.
Advertisement – SCROLL TO CONTINUE
None of this changes the fact that high blood pressure is bad for your health, and millions of Americans could improve their health by making lifestyle changes and taking blood pressure-lowering medications. . However, there are other risks involved for certain elderly people.
“Ultimately, high blood pressure should be considered perhaps one of, if not the biggest, modifiable factor for reducing cardiac death in the United States,” Saraju says.
As people age, their systolic blood pressure increases—First number of blood pressure reading –—It tends to rise. Arteries in older adults become stiffer, often leading to high blood pressure in combination with other physiological changes in the cardiovascular system. According to the study, approximately 65% of men and 75% of women will have high blood pressure by the age of 70. one study.
Advertisement – SCROLL TO CONTINUE
High blood pressure increases your risk of heart attack and stroke.it also makes you richer tending to Kidney problems, vision problems, sexual dysfunction, etc.
High blood pressure is bad news for older people, but developing it early in life is even worse. The Lancet Commission on Dementia Prevention found that middle-aged people with a systolic blood pressure above 130 were 60% more likely to eventually develop dementia.
If diagnosed with high blood pressure, your doctor will recommend Lifestyle changes To lower your blood pressure, you can lose weight, exercise regularly, eat a healthy diet with less salt, limit your alcohol intake, and stop smoking.
Advertisement – SCROLL TO CONTINUE
Your doctor may also prescribe medication to lower your blood pressure. So when it comes to older adults, other considerations need to be made, said John Murrow, a San Antonio cardiologist who serves on the American College of Cardiology’s Aging Committee.
Murrow, who is 71 years old himself, said he looks at the overall health of older adults before deciding whether antihypertensive drugs are the best treatment. “It’s very nuanced and complex, and it’s not black and white,” he says. “You can win in cardiology but lose in other things.”
For healthy older adults, lowering blood pressure to ideal levels is still a good idea, Murrow says. He says you’re 75 years old, run and exercise regularly, eat well, and take few medications, but you have high blood pressure. In such situations, they will still prescribe medication to lower blood pressure.
Advertisement – SCROLL TO CONTINUE
“If a patient has fewer problems, they can be treated as a younger patient,” Murrow says.
Deborah Kado, a geriatrician and co-director of the Stanford Longevity Center, also focuses on a patient’s overall health when treating blood pressure. Kado, who has conducted extensive research on bone density, said the risk of falls is a major concern for frail patients. If you fracture your hip, your risk of dying in the next year is about 25% to 30%.
But she points out that each patient is different and must be evaluated individually. “From a geriatrics perspective, what I primarily want to think about is not chronological age, but functional age or physiological age,” Kado says. “Don’t use chronological age alone to decide how aggressively you should treat your blood pressure.”
Email Neal Templin at neal.templin@barrons.com.