This study weighs the risks and benefits of giving blood pressure medications to frail elderly patients. 

Humans are living longer than ever before. This longer lifespan presents new medical challenges. The risk of stroke and heart problems increases with age. One of the methods used to counteract these risks is treatment with blood pressure medication. Lowering blood pressure can reduce the strain on the heart and blood vessels. This can reduce the risk of stroke and heart problems in older people. 

Currently doctors do not commonly give blood pressure medication to very frail elderly patients. This is because of a few different factors. For example, the patient may be on other medications and the doctor may be concerned about the side effects. The doctor may also be concerned about the side effects of lowering blood pressure in a frail elderly person. When blood pressure is lowered it can lead to side effects such as dizziness when standing up.

The aim of this study was to challenge the common belief that frail elderly people do not benefit from blood pressure medication.

The study used 2,656 patients with an average age of 83 years.. Patients were divided into two groups. The first group took blood pressure medications (indapamide [Lozol] or perindopril [Aceon]). The second group took a placebo (a substance with no therapeutic effect on the body, used as a control). All patients had high blood pressure. Frailty was examined by using a frailty index (FI, a measurement of physical problems occurring in older age). The FI score ranged from 0.0-1.0. At the beginning of the study both groups had a similar FI (0.16 in those given blood pressure medication, 0.17 in those given placebo). Patients were followed for an average of 22 months.

Patients who were less frail entering the study had less of a risk of heart problems. With every 0.05 increase on the FI, there was a 24% greater chance of death, a 23% greater chance of having heart problems, and a 26% greater chance of stroke. 

Treatment with blood pressure medications made it 36% less likely for a patient to have a stroke compared to placebo. Patients who were treated for high blood pressure were 59% less likely to have a heart attack. 

This study concluded that even frailer elderly people can benefit from treatment with high blood pressure medication. 

This article did not discuss the side effects experienced by patients due to blood pressure medication. 

Consult with your doctor about the risks and benefits of blood pressure medications.