Excess mortality observed for older adults with BP below 130/80 mm hg

(HealthDay)—For older adults, blood pressure (BP) < 130/80 mm Hg is associated with excess mortality, according to a study published online March 5 in Age and Ageing.

Jane A.H. Masoli, M.B.Ch.B., from the University of Exeter Medical School in the United Kingdom, and colleagues conducted a prospective observational analysis using electronic health records to examine the correlation between BP and mortality/cardiovascular outcomes in a primary care population aged older than 75 years and stratified by frailty.

The researchers found that with systolic BPs (SBPs) > 150 mm Hg, the risks for cardiovascular outcomes increased. There was variation noted in the associations with mortality between nonfrail <85-year-olds and frail 75- to 84-year-olds and all older than 85 years. There was a correlation for SBPs above the 130- to 139-mm Hg reference with lower mortality risk, especially in those with moderate-to-severe frailty or aged older than 85 years (e.g., hazard ratios for 150 to 159 versus 130 to 139 mm Hg at age 75 to 84 years: 0.94 for nonfrail and 0.84 for moderate/severe frailty). Independent of the BP trajectory toward the end of life, a consistent association was seen for SBP <130 mm Hg and diastolic BP <80 mm Hg with excess mortality.

"Internationally, guidelines are moving towards tight blood pressure targets, but our findings indicate that this may not be appropriate in frail older adults," Masoli said in a statement.