Study: Many Hypotensive Older Adults Remain on Antihypertensives

New research finds that a sizable number of individuals over the age of 70 remain on antihypertensive medications despite having low blood pressure, which may contribute to a higher incidence of adverse events for this patient population.

In an effort to assess the prevalence of low blood pressure and impact on outcomes, especially in the presence of antihypertensive treatment, in a primary care population of older individuals, investigators conducted a retrospective observational cohort study in patients over the age of 70 who had registered with primary care providers in Kent, England.
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A total of 11,167 patients were analyzed. Of these patients, 6373 (57%) were women. Systolic blood pressure (SBP) was below 120 mm Hg in 1297 people (844 on antihypertensives), below 110 mm Hg in 474 (313 on antihypertensives) and below 100 mm Hg in 128 (89 on antihypertensives). Hypotension was independently associated with mortality, acute kidney injury, and hospital admission.     

"The results demonstrate that low systolic blood pressure is associated with adverse events, it is possible that the pursuit of [blood pressure] control at a population level may lead to overtreatment in certain groups of patients," wrote the authors, who note that it is unknown if the hypotension was the result of a severe illness that led to hospital admission or whether it was the hypotension itself that led to hospital admission.              

Ultimately, the overtreatment of certain patient populations "may result in an increased incidence of adverse events," the researchers concluded, "particularly in older people."

—Mark McGraw

Reference

Morrissey Y, Bedford M, Irving J, Farmer CKT. Older people remain on blood pressure agents despite being hypotensive resulting in increased mortality and hospital admission [published online June 30, 2016. Age Ageing. doi: 10.1093/ageing/afw120.