All this week, I’ve been discussing the different causes and treatments for high blood pressure (BP). Today, I’m going to focus on high BP among older adults.
Frankly, I’ve long believed that we need to rethink what the mainstream considers to be “high” BP in older adults. And now, a new, large study out of the U.K. has confirmed my line of thinking…
It found that slightly higher BP may actually help reduce mortality risk in older adults. Especially frail older adults.
I’ll tell you all about that important study in a moment. But first, let’s back up to discuss why higher BP seems to benefit older adults…
We didn’t always try to push blood pressure down so low in older adults
As I’ve explained before, your body makes a number of natural adjustments to its biochemical and physiological functions as you get older.
For example, both testosterone (in men) and estrogen (in women) naturally decline with age. This decline protects men from heart and prostate diseases. And it protects women from certain cancers. (On the flip side, thwarting this natural decline in sex hormones with artificial hormone treatments seems to increase cancer risk in both men and women.)
Likewise, as I explained last month, older men and women may benefit from moderately higher blood sugar as they get older. In fact, studies show that pushing blood sugar down too low in older adults with Type II diabetes does not improve outcomes, it harms them! Lower blood sugar can lead to cognitive impairments, cardiovascular events, falls, fainting, fractures, reduced quality of life, and even a higher mortality risk.
And now, we’re observing a similar pattern when it comes to blood pressure…
In fact, back when I was in medical training in the 1970s, the rule for “normal” BP numbers was 100 plus your age. So, at age 20, you were normal at a systolic reading of 120. But by age 70, it could be 170. Physicians then regarded the increase as the “asymptomatic rate of rise of blood pressure with age.”
We also observed that moderate increases in BP in older people helps deliver energy, oxygen, and much-needed nutrients to the tissues—including to the heart and brain! Meanwhile, we observed that using more and more drugs to push BP lower and lower does not confer many benefits. Rather, it can cause great harm.
Well, today, more modern studies show that a systolic reading of 170 is probably too high in older people—and may increase stroke risk.
But at the same time, 120 may well be too low in older adults to deliver those much-needed nutrients around the body.
So, I’ve always thought the key is to strike a balance between dangerously high and dangerously low blood sugar, and blood pressure, in older people. As always, it’s a question of moderation.
And that point brings me back to the new, large study I mentioned at the beginning of this Dispatch…
Low blood pressure linked to higher death rates in frail, older adults
In the new study, U.K. researchers looked at BP readings, cardiovascular events (such as heart attack), and mortality (death) rates for more than 400,000 people, ages 75 years and older. They also categorized the participants according to their degree of frailty, using a standard frailty index.
As we would now expect, those with systolic blood pressure readings above 150 mmHg
had a higher risk of suffering a cardiovascular disease incident, like a heart attack or stroke.
However, across the board, “low” blood pressure (below 130 mmHg) was a big problem in terms of death rate…
In fact, all the participants with BP readings below 130/80 had a higher death rate compared to those with “normal” BP.
This increase in death rates was especially pronounced in “frail” people. In fact, frail people with “low” blood pressure had a staggering 62 percent increased risk of death during the 10-year follow-up period.
Plus, slightly higher systolic BP readings (130 – 140) actually had a protective effect among the very old and frail. Specifically, men and women with moderate-to-severe frailty or above the age of 85 years with systolic readings 130 – 140 had a lower risk of dying. Even systolic readings higher than 180 were not associated with an increased risk of dying in adults over 85 years or those with severe frailty.
In the end, this is yet another study showing that persistent efforts to aggressively lower BP targets in older adults with more and more drugs may cause more harm than good. And as the researchers themselves concluded, “low blood pressure is as dangerous as high blood pressure.”
Which leads me to question…is so-called “high” blood pressure in many older adults really high? Or is it just a normal, natural, and even protective part of aging?
As I’ve said before, my thinking about how to manage BP has evolved during the years, thanks to an outpouring of new studies just like this one. And I gathered all the pertinent research into the many safe, effective, natural approaches to protect your heart and put it into a comprehensive learning tool called my Heart Attack Prevention and Repair Protocol. To learn more about this innovative, online learning tool, or to enroll today, click here now!
“Blood pressure in frail older adults: associations with cardiovascular outcomes and all-cause mortality.” Age and Ageing, afaa028. doi.org/10.1093/ageing/afaa028