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Editorials

Managing blood pressure in older adults

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k2912 (Published 06 July 2018) Cite this as: BMJ 2018;362:k2912
  1. Stephen Makin, clinical lecturer in geriatric medicine,
  2. David J Stott, David Cargill professor of geriatric medicine
  1. Academic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
  1. Correspondence to: D J Stott david.j.stott{at}glasgow.ac.uk

Age alone is no barrier to treatment

In a recent paper in The BMJ, Liv and colleagues reported the results of a large cohort study investigating the link between blood pressure and mortality in community dwelling Chinese people with a mean age of 92 years.1 Studies of very elderly people are challenging and rarely performed so these data are of particular interest. Both high and low systolic blood pressure were linked to an increase in mortality (a “U shaped curve” relation). Systolic blood pressure >154 mm Hg was associated with increased cardiovascular mortality, and <107 mm Hg with non-cardiovascular death.

The finding that low systolic blood pressure predicts increased risk of death is consistent with many other epidemiological studies in older people. Although low blood pressure may in itself cause harm, it is also likely to be a marker of ill health, with systolic blood pressure falling for up to two years before death.2 Any link between high systolic pressure and mortality has been much less consistent in later life. In very elderly people (≥85 …

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