Low Blood Pressure Linked with Higher Mortality

We sometimes hear high blood pressure referred to as the “silent killer.” That’s because high blood pressure often has no symptoms, despite increasing our risk of heart attack and stroke. But few realize that low blood pressure can be just as deadly for some people. A new study has the details.

Blood Pressure Guidelines Changed

Recently, the American College of Cardiology (ACC) and American Heart Association (AHA) changed the guidelines for detecting and treating high blood pressure. The ACC and AHA now recommend managing high blood pressure with lifestyle changes and, in some cases, medication, starting at 130/80 mm Hg rather than old guidelines which made that recommendation at 140/90. 

The result of the new guidelines? Almost half of the adults in the U.S. are now estimated to have high blood pressure, also known as hypertension. These same revisions also changed the definition of normal blood pressure to be under 120/80 mm Hg.

Moreover, some other countries changed their definitions of high blood pressure in the same way. These changes were designed to urge doctors to keep their patients’ blood pressure at healthier, read lower, levels. 

But someone got left out.

No previous research about safe guidelines had included elderly adults. To fill that gap, a recent study focused on the medical records of older adults in England. 

Elderly Adults’ Medical Records Revealed Low Blood Pressure Risks

To conduct the blood pressure study, University of Exeter researchers analyzed 415,980 electronic medical records of elderly adults in England. 

The researchers compared adults aged 75 and older with blood pressure below 130/80 to those with blood pressure at or above that level. They found that individuals with lower blood pressure had higher mortality rates. In older adults categorized as “frail,” there was a 62 percent increased risk of death within 10 years. 

High blood pressure guidelines are intended to reduce the risk of potentially deadly health problems, such as heart attacks. But as the new study shows, applying these guidelines to elderly adults may be just as risky:

• High blood pressure in frail adults above 75 years was linked to higher mortality rates.
• But older adults aged 85 and over with high blood pressure have lower death rates compared to individuals with lower blood pressure. 
• The lowest mortality risk in adults older than 75 is at blood pressure levels 140–160/80–90 mm Hg.
• Higher death rates in adults over 75 occurred in those with blood pressure levels below 130 mm Hg.

How We Can Benefit From the Low Blood Pressure Study

The low blood pressure research on older adults has two benefits. First, the study shows that low blood pressure isn’t always healthy. If we are on high blood pressure medication as we age, we may want to talk with our health care providers about safer options or about how to classify our blood pressure on an individual level. Always be sure to talk with a doctor before stopping or changing any dosage of any medications.

Considering Studies Based on Age, Sex and More

Beyond blood pressure information, this study has a message applicable to all types of health research as the researchers noted that older adults often are excluded from studies and the results can even be catastrophic as poor advice is given that may not apply to them.

The takeaway? When we learn about new health research, we can all benefit from considering whether the study actually included our own age group, sex, or other pertinent subsets. If not, we can ask our doctor how to better interpret the research to apply to our own health. 

Ultimately, it’s important to remember that neither high nor low blood pressure may necessarily result in symptoms. And of course, we should all be aware that the guidelines for those outside the senior age group have changed. And now we know that depending on our age, these conditions may increase, or decrease, our mortality risk.  To get a diagnosis for any blood pressure concerns, be sure to visit a healthcare provider. 

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