Thursday, July 19, 2012

Hypertensive Frail and Elderly May Live Longer | dailyRx

Various studies have linked lower blood pressure to increased longevity among adults. That may not hold true for frail and elderly patients. They may actually live longer with higher blood pressure.

Lower blood pressure was still found to offer protection to active adults over the age of 65, the recent study found.

Discuss blood pressure management strategies with your cardiologist.

Michelle Odden, lead author and a public health epidemiologist at Oregon State University, noted that with age, blood vessels tend to lose elasticity and stiffen. She said it may be that high blood pressure provides a mechanism that compensates for that loss by assisting blood pump to the brain and heart.

During the study, researchers examined a group of 2,340 adults over the age of 65. The study used walking speed to determine which participants were considered frail. Participants walked 20 feet at their normal rate, with slower walkers moving 0.8 meters per second.

The faster walkers were considered more robust adults and were less likely to have diabetes, coronary heart disease or heart failure. A third group, or the "frail participants," were unable to complete the walking test, commonly because of an inability to walk that distance.

Researchers found that faster walkers with high blood pressure were at a 35 percent greater risk of dying versus individuals with normal blood pressure.

However, that same link was not found among slower walkers.

Investigators determined that frail participants who were unable to complete the walking test had the opposite results. Those with higher blood pressure were 62 percent less likely to die.

"There is a profound difference in the physiological age of an 80-year-old man who golfs every day, and someone who needs a walker to get around," Odden said. "So in the fast walkers, high blood pressure may be more indicative of underlying disease, not just a symptom of the aging process."

The research is the first to make an association between walking speed, mortality and blood pressure so additional studies will be needed.

The study was recently published in the Journal of the American Medical Association's Archives of Internal Medicine.

Hypertension (high blood pressure)

It is estimated that close to 30% of the United States population has high blood pressure (hypertension), or about 90 million people. Blood pressure is measured as the force the pumping blood exerts on the walls of the arteries in the body.

When this pressure is higher than normal (120/80 mmHg), patients are at risk for heart attack, stroke, congestive heart failure, kidney failure, and aneurysms in the arteries and brain. Even moderate high blood pressure can lead to a shortened life expectancy. Most high blood pressure is asymptomatic, and is discovered during a routine checkup.

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As blood pressure reaches dangerously high levels, some people may experience symptoms such as headache, ringing in the ears, visual changes, and irregular heartbeat. These symptoms are a medical emergency. At particularly high risk for high blood pressure are African Americans, people who are obese, smokers, diabetics, having high salt intake, and having a family history. Alcohol abuse and cocaine use can also cause hypertension.

Diagnosis is made by measuring blood pressure over several doctors visits, and is treated by lifestyle modification first, such as smoking cessation, weight loss, dietary changes, and exercise. There are hundreds of different medications to treat hypertension, such as beta-blockers (Lopressor, Inderal), diuretics (Diamox, HydroDiuril), Calcium channel blockers (Norvasc, Procardia), and ACE inhibitors (Lotensin, Vasotec, Capoten).

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Source: http://www.dailyrx.com/news-article/high-blood-pressure-associated-lower-mortality-frail-elderly-19981.html

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