Setting stricter BP goals safe for elderly hypertension patients

Intensive therapies for blood pressure control do not seem to intensify concerns about falling in elderly hypertensive patients, a recent study has shown.

The study included 2,313 elderly adults (mean age, 69±10.3 years) with hypertension, who received either intensive therapy, with a systolic blood pressure (SBP) target of 120 mm Hg, or standard therapy, which had a more lenient aim of 140 mm Hg. Concerns about falling were evaluated using the shortened version of the Falls Efficacy Scale International.

The mean falls self-efficacy (FSE) score at baseline was 8.96±3.46, during which time 18.0 percent of the population scored ≥11. By the 3-year follow-up, mean scores grew to 9.07±3.52, with 20.1 percent scoring ≥11. Regression analysis identified a 0.11-point annual increase in FSE scores. Changes in magnitudes over time were comparable between the standard and intensive therapy groups (p=0.95).

Subsequent analyses according to participant age showed that those who were ≥75 years of age saw significantly greater increases in FSE scores relative to their younger counterparts (0.3 points per year; p<0.0001). However, treatment allocation remained unrelated to concerns of falling regardless of age group (p=0.55).

“These results add to the literature demonstrating that lower blood pressure targets can be safe and are unassociated with declines in patient-reported outcomes,” said researchers.

“Risks and benefits of treatment intensification identified in the literature need to be applied to individual patients,” they added. “These discussions should incorporate this new information, so patients fully understand all implications of treatment intensification.”