Sunday, August 12, 2007

Blood pressure meds and the oldest of old

[This study] is fascinating and hopefully will convert the very last knuckleheads who still argue that blood-pressure elevation in the elderly is a compensatory phenomenon serving to force blood through sclerotic arteries to the target organ.
---Franz Messerli MD, Columbia University

Dr. Messerli is referring to the HYVET, aka Hypertension in the Very Elderly Trial which studied the use of blood pressure medication in 80+ year olds with respect to decreasing the risk of stroke and dying. Preliminary results were so significantly favorable that the trial was halted, and those oldsters in the control group will now be offered the real deal meds.

Through the years, controversy has surrounded the issue of whether or not to treat hypertension in this population. Those who say nay argue that blood pressure elevations in this group are largely a result of their stiff old arteries. Furthermore, they note, lowering blood pressure diverts blood from those vessels most blocked by cholesterol schmutz.

So back off nay-saying knuckleheads and treat granny's elevated pressure with meds.


Mauigirl said...

Thank you for posting this. My father-in-law has it in his head that 140 over 90 is just fine (he's already on meds and is annoyed that his doc just added more because he wanted to bring the BP down further). He has used that exact argument - he needs the pressure to get the blood to his brain. Now I can say, "No, Dad. Not so!"

Femail doc said...

Conventional wisdom used to hold that appropriate blood pressure as one aged was 100 plus one's age. No wonder arteries grew stiff with age under that pressure head!

My mom started smoking on her doctor's recommendation. How times have changed!