MedicalResearch.com Interview with:
Dr. Rathi Ravindrarajah PhD
Division of Health and Social Care Research
Faculty of Life Sciences & Medicine
King’s College London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Clinical trials show that it is beneficial to lower systolic blood pressure (SBP) in adults aged 80 and over, but non-randomized epidemiological studies suggest that lower systolic blood pressure may be associated with a higher risk of mortality.
Our main findings were that there was a terminal decline in systolic blood pressure in the final 2 years of life suggesting that the higher mortality in those with a low SBP shown in non-randomized epidemiological studies might be due to reverse causation.
MedicalResearch.com: What should readers take away from your report?
Response: Our results help to understand why non-randomised studies suggest an association between low BP and higher mortality.
However, findings from clinical trials might not be universally applicable to a cohort of older adults, which may include healthy as well as dying individuals. Hence, treatment plans need to be individualized when treating frail older adults. There was also a small number of patients with very low systolic blood pressure (<110 mm Hg) who were treated with antihypertensive treatment which suggests that the intensity of therapy should be reduced in these patients.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Further work should aim to clarify further which older patients are more likely to be helped than harmed by blood pressure treatment.
This study was funded by the Dunhill Medical Trust.
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Rathi Ravindrarajah, Nisha C. Hazra, Shota Hamada, Judith Charlton, Stephen H. D. Jackson, Alex Dregan, Martin C. Gulliford
Originally published April 21, 2017
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