Risks For Intensive Blood Pressure Control

Elderly hypertension patients taking prescribed medications experiencing low blood pressure of systolic blood pressure under 110 mmHg have been found to be twice as likely to experience a fall or faint as those whose treated blood pressure remains above 110 mmHg.

To determine effects of blood pressure reduction among hypertension patients electronic health records from upwards of 475,000 Kaiser Permanente patients prescribed medication to treat hypertension were examined. Over a one year period mean and systolic blood pressure readings of less that 110 mmHg were associated with higher rates of fainting and serious falls resulting in ER department visits and/or inpatient encounters.

27% of the subjects had systolic blood pressure under 110 mmHg during at least one visit, 3% had an average systolic pressure reading of less that 110 mmHg over the year period, subjects with a single episode of systolic pressure lower than or equal to 110 mmHg during the period were twice as likely to experience a fall or faint, and subjects with an average systolic blood pressure lower than 110 mmHg over the period had 50% greater risk of falls or fainting.

Researchers suggest physicians considering lower blood pressure targets for patients should weigh risks vs benefits of aggressive blood pressure lowering based on an individual basis among older patients and be more aware of characteristics, as older patient are more likely to have acute reductions in blood pressure and have slower reflexes to compensate and normalize their blood pressure, as well as being more susceptible to side effects of low blood pressure.