Wednesday, July 18, 2012


This morning in my reading, I picked up an interesting article, on a subject, not so well studied. What is normal, good BP for the elderly.
Dr M Odden of Oregon and colleagues, did a study on this and published their findings in the 16th July, online edition of the Arch. Int Medicine. The looked into the health records of 2,340 individuals who were part of the NHANES ( National Health and Nutritional Examination Survey ) study group. She took out those who were 65Yrs and above. Some were hypertensives on treatment and some were not. They were asked how fast they take to walk 6 meters, and divided them into 3 groups. Gp 1,  those who could walk 6 M is 5 secs or less, Gp 2. those who would take about 5 secs to walk 6 M and those who could not complete. They also had their BPs checked. They were tracked for 7 years and any deaths were identified through their death certificate through the coroner's office. Using this simple test, the researches found that for those in Gp 1,  BP above 140/90 was an independent predictor of CV mortality. Whereas those in GP 1 whose BP was normal, had no increase mortality.

Whereas in Gp 3, those with normal BP had increase CV mortality. Whereas a raised BP of 140/90mmHg confer some protection.
Dr Odden and colleagues concluded that the elderly is a rather mixed group and we should look at them as a special group. Their BP levels may have to be individualised. a 6 M walk test is a simple way, to see whose BP should be lowered and whose should not be. You will wish to lower those who can walk 6 M in 5 secs and not lower those who cannot complete the walk.
Nice simple study, full of messages for us to comprehend.
As always, even with treatment regimes and guidelines, all patients must be individualised. That remains an important role of a physician dealing with patients.

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