A BRADFORD doctor has completed the biggest review of its kind looking into how the frailty of older patients should be considered when treating high blood pressure.

Dr Oly Todd, a PhD researcher and specialist registrar in geriatric medicine at Bradford Royal Infirmary, led a team bringing together nine studies which involved 22,000 people from across the world to carry out the review.

Dr Todd hopes his work, with the help of his team from Bradford Institute for Health Research, can define future guidelines for treatment of frail older people.

The review found different doctors have different rules, and Dr Todd is aiming to codify treatment to help clinicians globally.

Many frail, elderly patients with high blood pressure are given medication to bring it down, with more than half of UK residents aged 80 and over prescribed two or more medicines for the condition.

However, Dr Todd explained, this can have dangerous consequences.

He said: “We see a lot of people coming into A&E because of the complications of low blood pressure.

“Lowering blood pressure too much can lead to a lack of blood supply to the brain causing dizziness or a fall, increasing the risk of a broken bone which can be catastrophic for an older person.”

Ten per cent of all people treated for high blood pressure develop side effects, which can be particularly dangerous for frail older patients.

The people used in Dr Todd’s study were selected because they matched key characteristics of patients from Bradford.

The study found in patients with no signs of frailty, lower blood pressure was linked to less chance of dying, whatever their age.

However for frail patients, there was no difference in mortality rates with lower blood pressure.

Studies looked at did not consider other measures such as quality of life, and authors recommended each person be considered in the context of their level or frailty and personal circumstances and be treated accordingly.

Dr Todd added: “Nearly all the trials we currently have are based on people who are fit and have little in the way of medical problems other than high blood pressure.

“We don’t have evidence drawn from elderly people who live with multiple problems, despite the fact that such people represent the majority of our patients. We need to change this.

“Older people are now living longer than before and we simply don’t have enough evidence to inform their best care.”

In time, Dr Todd hopes better evidence can be collated, looking in greater depths at the results for older people which will deliver better evidence for their best care.

He hopes this study, which has been published in an international medical journal. will help inform the next set of guidelines on treatment of older people with high blood pressure.

There is no rest for Dr Todd, who is also leading a second, larger international study on the same issue.

The second study, funded by the Dunhill Medical Trust, will use data from anonymous NHS GP records, and may also help answer questions clinical trials cannot answer.

To read the paper, visit: https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afz072/5511443