Lower SBP tied to reduced risk of CVD in older patients

Blood pressure (BP) that is lower than currently recommended levels does not pose any harm in older patients without previous cardiovascular disease (CVD), according to a study. The association between lower systolic (S)BP and lesser risk of CVD suggests the benefit of having a lower SBP.

Of the 31,704 patients included, 26,663 were aged 40–75 years and 5,041 were 76–90 years. Mean follow-up was 2 years. There were no significant differences in risk of any outcome among younger patients, but an association was found between low BP and the lowest risk of CVD in the older group.

The incidence of CVD was lower in older patients in the 110–129 mm Hg group when compared with the reference group. After adjustment for covariates, older patients in this group had a hazard ratio (HR) for CVD of 0.60 (95 percent CI, 0.40–0.92) as compared with the reference group.

This study sought to compare the risk of CVD—nonfatal acute myocardial infarction (AMI) or stroke—at BP levels that met current recommendations with risk at lower levels, especially in older patients. The authors identified individuals with hypertension aged 40–90 years from a primary care register. Those with a history of cancer, diabetes mellitus or CVD were not included.

Patients were divided into age groups of 40–75 years and 76–90 years and into SBP groups of 110–129, 130–139 (reference), 140–149 and ≥150 mm Hg. The Kaplan-Meier estimator was used to examine the incidence of AMI, stroke and a composite of the two. HRs for outcomes were estimated using Cox proportional hazards regression.