ExploreFinding
Finding mixed
The relationship between on-treatment systolic blood pressure and primary outcome in very old hypertensive CAD patients follows a J-shaped curve, with the hazard ratio nadir at 140 mm Hg -- higher than the nadir for younger age groups (110-135 mm Hg), suggesting that lowering systolic pressure below 140 mm Hg in this population increases risk.
Effect sizeHR nadir at SBP 140 mm Hg for very old (vs 110 mm Hg for aged <60 and 60-<70, and 135 mm Hg for aged 70-<80)
ComparatorSame cohort at different on-treatment systolic blood pressure levels (reference SBP = 140 mm Hg, HR = 1.0)
Effect summarymixed; HR nadir at SBP 140 mm Hg for very old (vs 110 mm Hg for aged <60 and 60-<70, and 135 mm Hg for aged 70-<80)
Effect modifiers[{"modifier": "age group", "interaction_p": "P<.001", "direction": "amplifies", "stratum_details": "SBP at HR nadir: <60yr = 110 mmHg; 60-<70yr = 110 mmHg; 70-<80yr = 135 mmHg; >=80yr = 140 mmHg", "plain_language": "The older you are, the more dangerous it is to push systolic blood pressure too low -- the 'safe floor' moves up with age", "annotation_notes": "Progressive increase in SBP nadir with age. The biggest jump is between 60-<70 (110 mmHg) and 70-<80 (135 mmHg)."}]

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Source

PMC3008373
Blood Pressure and Outcomes in Very Old Hypertensive Coronary Artery Disease Patients: An INVEST Substudy
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