Intensive Blood Pressure Treatment Help Elderly Patients

Adults over 75, especially those who are frail and are struck with hypertension, can benefit from intensive blood pressure (BP) treatment that brings down the BP below the current medical guidelines.

"The reason I'm excited about this is the implications for public health," said Mark Supiano of the University of Utah and co-author of the study. "There are 5.8 million people age 75 and older who could potentially benefit. It's a large number and we need to pay attention to it."

Hence, the elderly adults included those who exhibited the same criteria as Systolic Blood Pressure Intervention Trial (SPRINT) participants, including high blood pressure, but no diabetes or history of stroke.

Medication was used by SPRINT, a large, randomized clinical trial, to bring down systolic blood pressure to 120 mmHg. This was lower than the currently suggested 140 to 150 mmHg. The trial suggested that the reduction brings down the risk of heart disease and death among participants.

The study looked at whether older adults sensitive to the side effects of such intensive treatment can benefit or not. The results showed that patients aged above 75 can benefit, even if they are otherwise not keeping good health.

Intensive blood pressure reduction may lead to 33 percent fewer cases of cardiovascular events and 32 percent fewer deaths. Moreover, frail patients show higher rates of heart disease and death, while intensive blood pressure treatment brought them down from 5.8 percent to 3.9 percent and from 4.28 percent to 2.95 percent.

The intensive blood pressure lowering treatment did not raise the risk in the frail group, hence making it relatively safe.

"This subgroup analysis of the SPRINT trial is significant because many physicians and patients have been concerned about blood pressure being too low in the elderly," said Alfred Cheung of the University of Utah and a member of the SPRINT Research Group. "These results are reassuring and could very well change current medical practice by lowering the blood pressure goal even in people over 75 years old."

More research is needed to examine the impact of intensive blood pressure treatment on different aspects of cognitive functioning, such as thinking and memory.

The findings were published in the May 19 issue of The Journal of the American Medical Association.