A drop in blood pressure is a sign you have 14 years or fewer left to live, a study of almost 47,000 Britons who had died at age 60 or older suggests.
The large sample size included people who were healthy as well as those who had conditions such as heart disease or dementia.
“Our large scale study has shown for the first time that blood pressure drops for around 14 years before death, in older patients.”
Professor David Melzer, study co-author, University of Exeter Medical School
Researchers from the University of Exeter Medical School and UConn Health in the United States found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure to begin with. But long-term declines also occurred in healthier people.
Professor David Melzer, from the University of Exeter Medical School, said: “Our large scale study has shown for the first time that blood pressure drops for around 14 years before death, in older patients. We now need more research to understand why this happens. It is important for physicians to understand as much as possible around ageing and blood pressure, to help personalise treatment.”
Professor George Kuchel, one of the study authors and director of the University of Connecticut Center on Aging at UConn Health, said the findings should not be taken as a sign by any patient to alter their medicine.
“I would be very concerned if anyone were to interpret our article as suggesting that hypertension should not be treated in late life or that they should stop their blood pressure medications,” he emphasised.
Q and A
What is raised blood pressure (hypertension)?
A condition in which the blood vessels have persistently raised pressure, putting them under increased stress. The higher the pressure, the harder the heart has to pump.
What should my blood pressure be?
Normal adult blood pressure is defined as a blood pressure of 120 mmHg (millimeters of mercury—the units used to measure blood pressure) when the heart beats (systolic) and a blood pressure of 80 mmHg when the heart relaxes (diastolic). When systolic blood pressure is equal to or above 140 mmHg and/or a diastolic blood pressure equal to or above 90 mm Hg the blood pressure is considered to be raised or high.
What are the symptoms?
Most people with hypertension have no symptoms at all, which is why it is known as the “silent killer”. Sometimes hypertension causes symptoms such as headache, shortness of breath, dizziness, chest pain, palpitations of the heart and nose bleeds, but not always.
The findings should make both doctors and researchers carefully consider what dropping blood pressure really means for older patients, he added. Doctors have long known that in the average person, blood pressure rises from childhood to middle age. But normal blood pressure in the elderly has been less certain.
Sales of £15 DIY blood pressure monitors are becoming increasingly popular. However, a study published earlier this year revealed many of the devices are actually too inaccurate to be useful.
The researchers found 70 per cent of the time readings by patients seeking to manage their hypertension – meaning high blood pressure – were not correct within 5 mmHg, which they explained was clinically important.
“I would be very concerned if anyone were to interpret our article as suggesting that hypertension should not be treated in late life or that they should stop their blood pressure medications.”
Professor George Kuchel, study co-author, University of Connecticut
Some studies have indicated that blood pressure might drop in older patients and treatment for hypertension has been hypothesized as explaining late-life lower blood pressures. But this study found blood pressure declines were also present in those without hypertension diagnoses or anti-hypertension medication prescriptions.
The declines were not due simply to the early deaths of people with high blood pressure, the authors said.
More research is needed to figure out why blood pressure declines in the elderly in this way. “Observational studies such as ours need to be followed by rigorous clinical trials in order to guide clinical care guidelines,” said Professor Kuchel.
The study is published in the Journal of the American Medical Association Internal Medicine.
