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Low Blood Pressure is Linked to a Higher Death Rate among Seniors

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The old “normals” for total cholesterol, blood pressure, blood sugar, and LDL are coming under new scrutiny. We may not live longer or better with lower cholesterol readings, lower blood pressure numbers, and lower blood sugar levels.

For example, the October 2008 issue of the Journal of the American Geriatrics Society suggests that lower systolic blood pressure is associated with higher mortality in people aged 85 years and older. This is not the first research study to link a higher mortality rate with lower blood pressure among seniors and among those who have suffered a stroke.
The difference in the death rate was significant. At four years of follow-up, 81.4% of those with a systolic blood pressure (the upper number in a blood pressure reading) of 120 mm Hg or less had died, versus 46.6% of those with a systolic blood pressure reading of 141–160 mm Hg. The study’s Swedish authors “imply the need of an expanded discussion about if and when high blood pressure should be treated in the oldest.”

In the rest of the population, high blood pressure is a critical problem, affecting as many as 50% of the American public. According to a 2006 Commonwealth Fund study, most adults in 2003 (90% of those studied) had their blood pressure measured in the previous two years and could recall if it was high or low. Almost 2/3 of adults with high blood pressure were taking blood pressure medication but less than 1/3 of those had their blood pressure under control.
In 1997 while at Harvard, Thomas Moore, M.D., published the now-famous Dietary Approaches to Stop Hypertension (also known as DASH). This elegant research confirmed the approach used by most integrative physicians: to lower blood pressure, have the patient eat a diet rich in vegetables and fruits, lose their excess weight, and get more physical activity. Yet there has been little government effort to educate consumers about this approach.
The US Agency for Healthcare Research and Quality (AHRQ) has found that 87–93% of American doctors receive less than five hours of “stop smoking” training. Less than 6% of US doctors know the AHRQ treatment guidelines for smoking addiction. It is likely that a similar percentage would be familiar with the DASH/lifestyle-based approach to normalize blood pressure.

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