Aging by the numbers

While it has become popular to believe that optimum health means we should forever have the health indices we had at the age of twenty, the evidence increasingly shows that not to be the case. Aging is actually a normal part of life, not a disease. And whether, for example, it’s the natural increases in our body weights, cholesterol levels, blood pressures or blood sugars, one-size-fits-all clinical guidelines are not best for everyone.

Reuters Health recently reported the results of a study published in the Journal of the American Geriatrics Society, led by Dr. Daniel J. Oates, M.D., MSc at Boston Medical Center. Like the research showing weight gain to be protective as we mature, a notable body of evidence shows higher blood pressures to be protective for older people. Researchers recently cautioned that current clinical guidelines for weight management put mature adults at greater risk of dying. Similarly, these researchers caution that current guidelines for blood pressure control put seniors at risk.

“Clinicians should use caution in their approach to blood pressure lowering in this age group,” they concluded. Fainting and falls, weakness, weight loss and memory loss were specific concerns they noted among seniors whose blood pressures had been managed too aggressively.

Low blood pressure in elderly linked to mortality

Aggressive treatment of high blood pressure (hypertension) in patients who are 80 years or older is associated with lower five-year survival rates than their counterparts with blood pressure levels at or higher than treatment target levels, researchers report....[They] evaluated five years of data from 10 Veterans Affairs sites and Social Security files. The study group involved 4,071 ambulatory patients 80 years or older with hypertension.

The researchers found that patients with normal or higher blood pressures were less likely to die during follow-up than those with lower blood pressures. Specifically, for each 10-point decrease in blood pressure, the researchers estimated that the mortality risk increased by about 17 percent. This effect was seen up to a systolic blood pressure of 139 mmHg (the top number) and a diastolic blood pressure of 89 mmHg (the bottom number).

However, in patients with uncontrolled hypertension, defined as systolic pressure of 140 mmHg or higher and diastolic pressure of 90 mmHg or higher, there was “no significant association between survival and blood pressure levels."

[Reuters corrected error in original story 4.23.07.]