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June 1, 2016

Study sheds new light on effects of lowering blood pressure in elderly

Care systems need to be renewed in order to provide more personal care to patients, instead of giving general advice based upon aggregated information. It’s very important now to begin to look at how electronic medical records and value-based care models can incentivize the health care system to implement this. That at least is what a group of scientists state, based upon a research into the effects of lowering blood pressure with adults over 75.

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Dr. Jeff D. Williamson, of the Sticht Center on Aging at Wake Forest School of Medicine in Winston-Salem, North Carolina, told Reuters Health in a phone interview that keeping the top blood pressure number below 120 millimeter of mercury (mmHg) led to significantly lower rates of cardiovascular events and deaths from any cause. Up to now studies concluded that bringing the top number – called the systolic pressure – down below 120 mmHg might actually be risky for older individuals. If their blood pressure were too low, they’d be vulnerable to falls and other problems.

These new insights are very important, concludes Williamson, because there’s been a lot of news (about studies) using administrative databases and self report that has indicated to older people that it’s dangerous to treat blood pressure; you might fall more. He says that the new study by the Sticht Center is the most rigorous scientific study to ever look at that and it shows that that’s really not true.

“That’s actually been found the case in other blood pressure studies, but not to this level of detail.” Williamson believes health systems will need to make more accommodation for more accurate assessment of patients, especially in the area of blood pressure. “We can reassure patients, especially from this study, that lowering blood pressure is safe. There were no more serious adverse events or falls among people on intensive blood pressure control versus those on standard control.” Williamson says there’s so much hypertension in older people, that doctors and other health professionals  almost begin to see it as normal. “It can lull us to think this is not practical. The study shows that a lot of people are eligible to have better blood pressure.”

In the Sticht Center study , 1,317 patients were randomly assigned to have their systolic blood pressure brought down with medication until it was 120 mmHg. In another 1,319, doctors tried to achieve a target systolic blood pressure of 140 mmHg. Over a period of three years,  the group with the lower blood pressure target had significantly fewer cardiovascular events and fewer deaths.

These conclusions were published earlier the Journal of the American Medical Association. The rate of serious adverse events did not differ between the treatment groups.

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