Many of you in your 60s or older who have been fit and health-conscious may be worried—or aggravated—about what your doctor is telling you about your blood pressure. It’s up a little. In fact, it has been creeping upward to the point where now the doctor wants to put you on meds, even though research says that most people with mild high blood pressure don’t need medication.

Or maybe you’re already on a blood pressure–lowering drug because your pressure really was quite high—and it has stayed somewhat high even with medication. Your doctor is still scaring you with factoids about heart attack and stroke and wants to increase your medication dose.

Before you become a victim of your doctor’s prescription pad, here’s important news that puts a new light on blood pressure control in older people. The treatment, and the blood pressure goals, that make sense for people who are middle age and younger are not necessarily right for more mature folks.

In any case, your doctor is probably harping about upping your medication because he or she is simply following guidelines—professional standards issued by medical societies such as the American Heart Association. The problem is that guidelines are generally based on information from a broad population that mostly includes people in their prime. As people age, their blood pressure naturally tends to increase, and older bodies metabolize drugs differently than younger ones. Given these facts, it does not make sense to treat high blood pressure in older people based on information gathered from younger people. It might even be harmful.

A recent study showed that, if you are on an antihypertensive drug, you’ll probably be just fine without upping your medication dosage or switching to a stronger drug as long as your treatment keeps your systolic blood pressure (the first number on your blood pressure readings) at about 150 mmHg (in the range of mild high blood pressure). So, take a deep breath, relax and read on.

MORE MEDS DON’T EQUAL MORE BENEFIT

To learn more about cardiovascular disease and medication-related risks in hypertensive people age 65 and older, a team of researchers from the Oregon State University College of Pharmacy analyzed a group of well-designed published studies on the topic. The studies compared different types of antihypertensive drugs against either each other or placebo and/or looked at the benefits and risks of using drugs to achieve different blood pressure targets as recommended by different sets of guidelines and/or evaluated the risks and benefits of antihypertensive drugs.

The results: Whereas antihypertensive drugs were more beneficial than no treatment for older people in terms of lowered incidence of heart attack and stroke, strict control of systolic blood pressure (getting it down to 140 mmHg or lower) was no better than mild control (getting it to 150 mmHg). As for diastolic blood pressure, most of the studies reviewed didn’t emphasize or report the findings.

As for the risks and benefits of antihypertensive drugs, some studies showed no age-related side effects and some showed that, compared with younger people, older people were more likely to experience dizziness and weakness, possibly due to orthostatic hypotension (a condition in which blood pressure suddenly drops when you stand up), and bradycardia (slowed heart rate), which itself causes faintness, weakness, shortness of breath, chest pains and mental confusion.

WHAT DOES THIS MEAN FOR YOU?

The study authors note that more research is needed to determine the best methods for managing high blood pressure in older people. So the take-home from this study is that, if you’re a mature adult and need medication to control high blood pressure, discuss these recent findings with your physician and ask if your current treatment goals are the right ones for you.