More on Blood Pressure and Mortality in the Very Old

Because we have little guidance from randomized trials on the benefits and harms of treating hypertension in the “oldest old,” we must look to observational studies for insights. In this retrospective cohort study, researchers analyzed data on 4071 hypertensive outpatients, aged 80 and older, from 10 U.S. Veterans Affairs clinics. Most patients were taking antihypertensive medication, resulting in an average blood pressure of 148/72.

During 5 years of follow-up, nearly half of the patients died. In analyses adjusted for potential confounders (including comorbidities and individual BP drug classes), mortality was higher among subjects with lower systolic blood pressures, up to a systolic BP of 140 mm Hg. Above 140 mm Hg, there was no associat…