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BP Variation With Age
BP Variation With Age  
Hello Dr Ahmed,

I got the attached image from the journal Hypertension.  (Link to document at :- http://hyper.ahajournals.org/content/25/3/305.long )

It shows that after rising with age, the diastolic BP starts to fall around age 60, and continues to do so.  This contrasts with the systolic BP, which continually climbs past age 60.

Why does the diastolic drop around age 60?  A complete mystery to me.

Regards,
Usuff

PS - This increases the "pulse pressure", which I know is another risk factor.

Answer
Hi, (a colleague of mine will post regarding this topic on http://blog.myheart.net soon) It's an interesting question and one my colleagues and I have actually addressed in research work.

Over the past few years, the role of diastolic blood pressure as an important determinant of cardiovascular morbidity and mortality has been further appreciated. A relatively novel finding is the increase of poor outcomes associated with low diastolic blood pressure, especially in the elderly.

Aging is associated with an increase in systolic blood pressure and a decrease in diastolic blood pressure with an accompanying widening of pulse pressure in older adults. The exact mechanism of these age-related vascular changes are not completely understood, however, decreased vascular elastance and compliance due to stiffness of the major arteries are believed to play a major role. This stiffness is most likely due to age-related fibrosis in the vessel walls of the major and minor arteries.

Additionally, as patients get older they are receiving more antihypertensive therapy for other comorbidities, which might further lower their diastolic blood pressure. The recently published 2014 guideline for the management of high blood pressure in adults recommended a more conservative treatment goal for patients more than ≥60 years of age as compared to younger patients. The goal for patients ≥60 years of age is to achieve a systolic blood pressure <150 mm Hg and a diastolic blood pressure <90 mm Hg."

Hope that was helpful,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

Experience

Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

Organizations
http://blog.myheart.net

Publications
Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

Education/Credentials
MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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