Is blood pressure level associated with five-year survival in people aged 85 or more?
In very old individuals (aged 85 or more), lower blood pressure is associated with increased mortality, challenging the traditional paradigm that lower blood pressure is always better in the elderly.
During 1977-8 we measured blood pressure in 561 old people (83% of those aged 85 or more living in Tampere) and analysed their five year survival according to their blood pressure group. The subjects were divided into six groups on the basis of their blood pressures (from less than 120 to greater than 200 mm Hg systolic, from less than 70 to greater than 110 diastolic). The greatest mortality was observed in those in the lowest systolic and lowest diastolic groups. Mortality was least in subjects with systolic pressures of 160 mm Hg or more and diastolic pressures of 90 mm Hg or more. The most essential finding in this series of the very old was an increased mortality in the lowest blood pressure groups.
Mattila et al. (1988) studied this question.