From Our 2011 Archives
New Guidelines: Treat High Blood Pressure in Over-80s
High Blood Pressure Treatment Extends Life in the Very Elderly
By Daniel J. DeNoon
Reviewed by Laura J. Martin, MD
April 25, 2011 - New guidelines stress more aggressive treatment of high blood pressure in very elderly patients.
It's long been clear that people ages 65 to 79 benefit greatly from treatments that lower blood pressure. But now an expert panel convened by the American College of Cardiology (ACC) and the American Heart Association (AHA) endorses treatment for patients over age 80.
Because blood-pressure-lowering drugs can have dangerous side effects in very elderly patients, doctors have been wary of aggressively treating high blood pressure in people over age 80.
The result: Only one in three men and only one in four women over age 80 have their blood pressure under control.
Yet a groundbreaking 2008 study of 3,845 over-80 patients found that over two years, lowering blood pressure in over-80 patients with a water pill (and, if needed, a blood pressure drug called an ACE inhibitor):
"The real concern is that a majority of elderly people have suboptimal control of their blood pressure and -- until recently -- many clinicians didn't treat hypertension in octogenarians because they worried that doing so would increase mortality," guideline writing co-chair Wilbert S. Aronow, MD, says in a news release.
Those findings prompted the ACC and AHA to convene an expert panel. Their 78-page report, published today in the Journal of the American College of Cardiology, notes that doctors must consider individual factors for each of their elderly patients.
Nevertheless, the panel makes these general recommendations for people over age 80:
SOURCES: News release, American College of Cardiology.Aronow, W.S. Journal of the American College of Cardiology, online, April 25, 2011.Beckett, N.S. New England Journal of Medicine, May 1, 2008; vol 358: pp 1887-1898.