LITTLE ROCK — In the last year, there has been a great array of information regarding blood pressure and disease prevention. While everyone agrees that managing high blood pressure and lifelong health go hand in hand, there is some debate on exactly what range is ideal. This is especially true with advancing age.
Recently, a variety of research has shown that what was previously called a normal blood pressure may actually be high. A "high normal" blood pressure can increase your risk of heart attack and stroke. This "high normal" blood pressure is associated with a systolic (top) measurement between 135 and 140 and a diastolic (bottom) measurement greater than 85. Most physicians pay more attention to the systolic rather than the diastolic blood pressure, as an elevation of the systolic blood pressure is a far more important risk factor for disease.
However, a closer look at the research reveals that most of the studies that examine the "high normal" blood pressure range have been funded by drug companies. Targeting a much lower blood pressure requires more medications and hence more profit for the companies that produce them. While the pharmaceutical-funded studies may be 100 percent legitimate, it is still an important factor to note.
Today, experts recommend therapy aimed at maintaining a systolic blood pressure below 120 and a diastolic below 80. Whilethis may be ideal for younger individuals, it may not be appropriate for older patients. In an elegant research study presented at the recent American Geriatric Society meeting, Gina Fujikami, a fourth-year medical student at the University of Hawaii examined the effect of blood pressure on the risk of memory loss. Following 3,734 Japanese-American men who have participated in the Honolulu-Asia Aging Study, Fujikami monitored blood pressure and the development of memory loss over the past 15 years in these men who, at the study's commencement in 1990, ranged in age from 71 to 93.
Fujikami's research clearly showed a two-fold higher incidence of Alzheimer's disease (but not other causes of memory loss) in those individuals whose blood pressures were consistently below 120 systolic. In addition, research done in older people has shown that a diastolic blood pressurebelow 60 increases the risk of a heart attack and heart failure.
If you are 70 or older, it is vitally important that you maintain a healthy blood pressure range, neither too low nor too high. A study published in the New England Journal of Medicine provides additional very useful information. This research showed that for healthy adults over the age of 80, lowering the blood pressure from an average of 175 systolic to about 150 systolic resulted in a 30 percent or more reduction in the risk of heart attacks and strokes. In addition, this blood pressure range was also associated with a 64 percent reduction in deaths from heart failure, a leading cause of death in those over the age of 80.
From all this information and much more, here are my recommendations for treating high blood pressure: for anyone under the age of 70, a systolic blood pressure consistently above 135is too high. Treatment should aim to achieve a systolic blood pressure that is preferably below 120, but definitely below 135. The diastolic should be around 80 but never below 60.
If you are over the age of 70, a target blood pressure should be 130 systolic and 80 diastolic. Beyond age 80, the systolic should be between 140 and 150 with a diastolic of 80. It is probably safe to say that beyond age 80, using medications to treat a person whose blood pressure is below 145 systolic may not be necessary.
Regardless of age, everyone should measure blood pressure at least four times annually. If your blood pressure is consistently elevated, treatment is essential. Any treatment plan to lower blood pressure should first begin with exercise and diet and follow with medications if lifestyle changes are not sufficient. If you are being treated, measure and record your blood pressurefrequently and take the values to your physician at each visit. Discuss the levels and make sure your treatment is ideal - the benefits are clearly life-saving.
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High Profile, Pages 52 on 05/18/2008