What is the relationship between blood pressure (BP) and survival in elderly hypertensive individuals?
An observational cohort study involving 4071 elderly hypertensive individuals (mainly men, recruited from the Veterans Affairs Administration) found a J-shaped relationship between BP and survival. Patients with BP of 130-139 mm Hg systolic or 70-79 mm Hg diastolic were more likely to die during 5 years of follow-up than those with BP 130-139 mm Hg systolic or 70-79 mm Hg diastolic. With each further 10 mm Hg decrease in systolic or diastolic BP to less than 100 mm Hg systolic or 50 diastolic, the risk increased, suggesting that overly aggressive BP control might be harmful in this age group. However, these relationships may be due to confounding and should not be used to set BP targets in this population.