How old are you now?
At present, the more consistent standard at home and abroad is that the age is greater than or equal to 65 years old.
Elderly people have high blood pressure, how much blood pressure drops as well?
Of course, it is better to drop to normal and below 140/90mmHg. What can be tolerated can also be lowered even lower.
That said, there may be quite a few people who oppose it. Because in the impression of many people, the blood pressure of the elderly should be high.
Should blood pressure be high in the elderly?
Of course not. Thinking that the blood pressure of the elderly should be high is a misunderstanding, an illusion. It is because the elderly have more high blood pressure, and everyone thinks that the elderly should have high blood pressure (debunking: the blood pressure of the elderly should be high? Doctor: The standard for hypertension in old age is the same as in adults).
The elderly, as they grow older, the arteries will also harden, the elasticity will weaken, the resistance encountered when the heart shoots blood is large, and the strength of the heart to retract when it does not shoot blood is insufficient, so it is often "high pressure" and low "low pressure", which is the result of arteriosclerosis. Older people are also prone to atherosclerosis. Atherosclerotic stenosis occurs in the cerebral arteries, carotid arteries, and renal arteries, which will affect the blood supply of the corresponding organs, and the body will regulate the blood pressure to ensure blood supply, and the blood pressure will rise. The body's ability to regulate the elderly is poor, and salt and water are not easy to excrete. There is more salt and water in the body, more blood volume, and blood pressure is easy to rise.
A survey by the mainland in 1991 showed that the prevalence of hypertension in the elderly, ≥ 60 years old, was 40.4%; in 2002, it increased to 49.1%; then by 2015, the prevalence rate reached 52.3%, accounting for more than half. According to foreign surveys, 75% of people around the age of 80 have high blood pressure, and over 80 years old, 93% have high blood pressure. The same is true of the continents. By the end of 2017, there were 158.31 million people aged 65 and over in mainland China, with more than 50% of people suffering from hypertension, and among the elderly people aged 80 years and over, the prevalence was close to 90%.
Elderly hypertensive patients are often combined with coronary heart disease, cerebrovascular disease, diabetes, etc., and their blood pressure is high, and the risk of these diseases is also high.
In turn, antihypertensive therapy for elderly hypertension found that the elderly reduced blood pressure to normal, which can also reduce the onset of cardiovascular disease, reduce the acute events of coronary heart disease, reduce stroke, protect kidney function, and also delay the cognitive decline associated with increasing age and reduce the risk of dementia. Therefore, elderly patients with hypertension can obviously benefit from antihypertensive therapy.
A study of antihypertensive hypertension in the elderly aged 80 or older found that after lowering blood pressure, all strokes in patients decreased by 30%, heart failure and cardiovascular events were also significantly reduced, and all-cause deaths were reduced. Mainland antihypertensive therapy in patients after stroke resulted in a 29% reduction in the incidence of stroke. Moreover, the mainland has found that the antihypertensive treatment of the elderly aged 80 to 90 years old can also tolerate antihypertensive therapy well, and the safety is good.
Therefore, it is not the elderly who should have high blood pressure, it is the high prevalence of hypertension in the elderly. Hypertension in the elderly should also be treated, and older people can also benefit from antihypertensive therapy.
And because the cardiovascular risk of hypertension in the elderly is higher and the damage to the target organs is more obvious, the benefits of antihypertensive therapy are greater, and there is more emphasis on antihypertensive therapy.
Like the first degree hypertension of young people, if the risk is not high, it is also allowed to improve lifestyle observation; while the elderly hypertension, once clearly diagnosed, do not wait any longer, while improving the lifestyle, begin drug antihypertensive therapy.
≥ 65-year-olds, blood pressure ≥ 140/90mmHg to lower blood pressure; ≥ 80-year-olds, blood pressure can be relaxed to ≥ 150/90mmHg to start to lower blood pressure.
Elderly people have high blood pressure, how much is the blood pressure dropped as well?
The "Guidelines for the Management of Hypertension in the Elderly in China (2019)" recommends that the blood pressure of the elderly who ≥ 65 years old drops below 140/90mmHg; ≥ 80-year-olds, the blood pressure first drops to less than 150/90mmHg, and if it is well tolerated, it will be further reduced to less than 140/90mmHg.
So, overall, it is better to drop below 140/90mmHg.
Between the ages of 65 and 79, if there is coronary heart disease, heart failure, or proteinuria, and diabetes mellitus, it is recommended to further reduce blood pressure below 130/80 mmHg, which is more beneficial to the patient.
Some elderly people have a variety of diseases, the body is particularly weak, and the principle of individualization is also emphasized in the antihypertensive treatment of this part of the patient. That is, blood pressure can be relaxed to more than 160/90mmHg to start to lower blood pressure, antihypertensive drugs start from small doses, and antihypertensive should not be rushed.
In 2021, Professor Cai Jun of Fuwai Hospital in Mainland China published a research paper on intensive blood pressure reduction in elderly patients with hypertension. The results showed that for patients with hypertension aged ≥ 60 years old, the systolic blood pressure was reduced to less than 130 mmHg, and the systolic blood pressure was controlled at 130 to 150 mmHg, which significantly reduced the adverse cardiovascular outcomes. This provides strong evidence for antihypertensive therapy in elderly hypertensive patients in mainland China.
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