Some high blood pressure in people over the age of 60 should be treated more aggressively, according to a study published Tuesday.
A review of medical literature covering nearly four decades found that systolic blood pressure -- the higher number in blood pressure readings -- should be treated when the level is 160 or higher, the study said.
“We now know that it is associated with significant risk, and that potentially by treating and lowering blood pressure, we can reduce stroke, heart disease, heart attack and even heart failure in our patients,” said JoAnne Foody, a physician at Yale University School of Medicine, who co-authored the report.
The study said in those aged 60 and older, systolic hypertension is a much more important heart disease risk factor than diastolic hypertension -- the level measured by the lower number in a blood pressure reading.
Systolic hypertension on the rise
Despite that, it said, systolic hypertension is a growing problem. One recent study found high systolic pressure was being detected in 76 percent of patients diagnosed with blood pressure problems in 1999, compared to 57 percent during the 1990-1995 period.
Robert Phillips, a physician who chairs the Department of Medicine at New York’s Lenox Hill Hospital, said in an interview that it was not clear until the early 1990s that lowering the systolic level in older people was beneficial. But it takes an average of 10 years for research to be reflected in the way doctors practice medicine, he said.
“So many physicians may say they don’t want to bother (with systolic treatment) because the patient may fall or faint, might fracture their hip,” if put on blood pressure control medication, he said.
“But the data is the opposite. When you treat elderly people and lower the pressure, they feel better; they fall less,” he said.
Phillips said the systolic number is the most important one to monitor beyond the age of 65, and that a lower diastolic number at that point “can actually represent more disease.” He advocates lowering systolic pressure to less than 150 in persons 65 and over.
