Previous studies reveal that lower systolic blood pressure or SBP is beneficial in adults 80 years old and over. However, some non-randomized epidemiological studies demonstrate lower SBP may be linked to increased risk of mortality.
A clinical trial conducted by a team of London-based researchers revealed that during the final two years of life, the systolic blood pressure declines significantly. These findings suggest that the increased mortality in the patients with low systolic blood pressure shown in the non-randomized epidemiological studies may be associated with reverse causation.
Unfortunately, evidence collected from clinical trials may not prove universal relevancy in specific groups of aging adults, whether healthy or in the final stages of life. Therefore, physicians need to develop individualized treatment plans for frail older adults. There were also a handful of patients with extremely low SBP (<110 mm Hg) being treated with antihypertensive medications, which indicates the intensity of the treatment needed to be reduced.
The researchers note that further studies are needed to clarify which elderly patients could likely benefit, rather than be harmed by antihypertensive treatment.
The study was published online in the journal Circulation on April 21, 2017.