Blood pressure & cholesterol medicine for a 97-year-old man?

What your dad needs is whatever HE wants, at this point. 97 and beginning new meds? I'd say it's his doctor who needs a treatment plan of some kind. Do you want to prolong his life by a few days or months, or do you want him to have a better quality of life in the time he has left. A higher BP will mean more energy, more life for your dad. Best of luck to him and you.

It is really popular to bad mouth cholesterol lowering medications and I see a lot of that on this forum, however the advice to discontinue statins in older adults is directed to people who are taking it prophylactically and have never had heart problems or stroke. I was amazed when the advanced ultrasound given to my mother showed a marked decrease in carotic plaques after her neurologist moved to aggressively treat her TIAs with statins, diet and different BP medications, I would never have believed it possible in a 90 year old woman. Unfortunately by then the damage had already been done, my chief regret is that something wasn't done 20 years sooner.
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Addressing your last question first: "Does a 97 year old man need to take this medicine when all his life he never took any medicine?" Maybe, maybe not. One can't determine that because we never took medication before that we don't need it now. We age. We get ill, We encounter issues that need treatment. So long as it's absolutely necessary and doesn't impact quality of life, I would have less issue with it, but I would still want to be informed about how much and why, DEtails, plus what to be concerned about for side effects.

I am a proponent of less or no meds and currently take OTC Vit D3 and 2 aspirin a day. In the past I was told to take Fosamax for early osteoporosis (looked it up and said nope, not happening!) and prior to that cholesterol meds - nope, I will figure this out and fix it without meds (and had to figure it out myself as docs were clueless then as to the REAL cause of some high cholesterol, such as blaming eggs, organ meats, cakes, cookies, pies, MILK, stuff I didn't even consume!) In my case, processed foods! Basically anything with a shelf life - ditch it! Eating various nuts will help raise the "good" HDL. My total runs over the recommended 200, but only because HDL is higher than suggested (and good!)

Have you discussed ALL concerns and questions in detail with his doctor(s), aka why so much, can it be reduced or eventually eliminated? His BP values before were not bad. The cholesterol - was that LDL, HDL or total? If total, why cholesterol meds? Anything under 200 is considered GOOD! What kind of doctor Rxed these meds (I see another post from you where they agreed to stop the cholesterol meds)? Regular PCP/GP or cardiologist?

We here are not doctors (there might be some among us who are, but no one should ever Dx or Rx without seeing a patient and test results!) We should not say yay or nay whether the meds are necessary.

Personally I would question his doctors about his condition(s) and any/all meds, especially given that 140/70 isn't that bad, esp at 97 (values could be higher when readings taken at doc office or hospital.) Our mother has been on multiple BP meds for a long time, and hers is still usually 140/something. Systolic 140 is on the highest end of "pre-high BP", diastolic 70 is "mid-average", so that shouldn't be a concern. If he gets okay to light exercise, he can likely get/keep his BP lower naturally. However there may be other reasons for the meds. Asking questions about the medications and dosages, monitoring his BP when at home (don't repeat over and over, take a couple of readings/day AT MOST, usually at the same time each day) and record it. If he is still running low-normal all the time, you have documentation to show to the doctor. Doc may be willing to adjust the meds (certainly don't stop them if his readings are 'normal' - the meds may be getting it under control.) I would also not rely solely on a PCP, unless he/she is a cardiologist. The type and dosage should be carefully formulated for your dad and your dad alone, preferably by a cardiologist, not for some point on a chart.

Best of luck getting and staying informed and hope for many more healthy years for dad!

I'm not sure why they would put him on cholesterol medication at this point even if it was high unless the medication is also used to help regulate his A-fib, they do often use a combination of medications for that which work in different ways and the right balance is what controls the A-fib. Controlling that is particularly important if that was the cause of his stroke, you don't need or want another stroke if it can be helped of course and A-fib can be a prime cause. As I recall either the A-fib it's self or something about getting it managed can elevate cholesterol temporarily too, seems like that happened with Mom. Unless the medication is actually being used for something else and it's just a cholesterol med too (maybe someone gave you that use because it seemed easier or like it would concern you less?) I'm with you on there not being any point in starting that at 97. If you want to give him something for high C try Red Yeast Rice, it's over the counter, natural supplement that works very well (funny story about how my husband tested that).

Managing the HR however is important and shouldn't be ignored here again because you don't need another stroke to deal with so I would make sure he has a good cardiologist along with the neurologist that has likely been the one in charge of his stroke care, they look at things differently. Mom was on a BP medication before being hospitalized for A-fib, I don't remember off hand if she was on it pre-stroke and heart surgery but when she went in with the A-fib it was one of the medications they used to get it under control by more than quadrupling her dose and had to bring that back down a bit because it dropped her BP too much, when they weren't able to manage the HR with that medication and maybe one other she had been on for a while...they added a blood thinner and adjusted the two until they had her rate under control and managed. It took time and as I say balancing but they were using the Metoprolol (known to us as BP med) first as I recall. I remember being shocked at how much higher a dose she was sent home on.

Sounds unlikely his blood pressure at 140/70 is not high for someone his age. Clearly something is taking it to a dangerously low level and one has to think this is the medication if it is the only change. Ask Drs to leave him off medication for a week and see if he is better.

I did read your earlier response. 140/70 is not bad for an older person. Too low means they have a hard time functioning. Usually B/P meds are given when pain makes ur b/p shoot up. With my husband its when he has an Afib problem, once in a blue moon. With Mom her B/P med was upped for pain. DH got it during an AFib incident. I questioned both at discharge. Answer, because of pain and bp went up. I told them Mom was no longer in pain and DH bp was normal. My Mom couldn't get up off the couch and the PCP couldn't believe my husband could walk because their bp was too low. I no longer go with hospital recommendations. I have both see their PCPs right after a hospital stay. I have even asked hospital doctors to consult with PCP, they won't.

There is no reason for a cholesterol med if ur under 200. A statin will effect them cognitively.

Hello.. Prayers to you & Dad..

With my Dad, I talked to Dr/NP.. Discontinued his BP med.. First, with that low of BP, they become a fall risk.. Can develop orthostatic hypotension..Also, Some BP meds have a diuretic tied into them, ie., losartan hctz(sp?), causing/exacerbating dehydration..I took Dad off cholesterol med..He lost weight, so his numbers were good w/o meds..

Pls rest, as one caregiver to another.. Hug your Dad every day❤️

When my mother's BP dropped to frighteningly low levels multiple people in the healthcare system assured me that she was end of life. Sorry but no, she was on multiple medications that needed to be tweaked, several of which lowered BP. I'm convinced that this period of excessively low BP contributed to her vascular dementia because her brain was starved of oxygen. BTW, she lived a decade after I was initially told she was EOL, and several years after discontinuing almost all her blood thinners, BP and cholesterol meds.

It's important to ask questions of the doctors and other medical staff. I worked in a field in which I provided technical advice to doctors as well as educational presentations. Some of them are brilliant and keenly interested in giving their patients the best care, others less so, and a few others who made me wonder how they made it through high school.

I could go on all day. My life became centered around providing therapy and healing! What a beautiful, cherished time!

Play...
Checkers, and any games he likes, I could literally see improvement with each game of Checkers. Make sure games are “easy” enough that he doesn’t get stressed out, and just sees this as fun. Rummicub is great since he likes cards- and working with the “tiles” is good for fine motor skills. Go to the movies (discuss afterward). Take him to beautiful places where he can watch birds. Play music from his era (easy through Amazon). The music will take ten years off!

Do things that Improve hand-eye coordination (table tennis?)

Try to help him get some exercise every day. We would go to the shopping mall. In the beginning, we would walk and sit on every bench. He was holding onto me like a walker. That meant we would walk 20 feet, sit down for 10 minutes get up walk 20 feet. He started saying, “let’s keep going” and we would skip a bench. In about a month we worked up to two miles without stopping. Walking at the mall was nice because the temperature was constant, the floor surface was perfectly smooth and safe. He got Vans (skateboarding shoes). Their smooth, flat, solid, large sole promotes balance. He loved all the “cool shoes” comments and he looked sharp! If your dad is a veteran, get him one of those nice caps - he’ll get friendly interactions and “thank yous” from strangers that will lift his spirits and make him feel valuable and appreciated.

My dad also liked using a stationary bike, and that was nice because he didn’t have to focus on balancing, like he did when when walking

I’m so happy for you that you have this time together! You are so lucky.

Enjoy!

Your instincts are great. I’m sure that he doesn’t need exactly what he’s been given. He may need some heart medication. It’s always possible he was “off” around the time he was suffering the stroke, and doesn’t need them now. (It can be hard to find a doctor willing to listen to your concerns about reducing medications—keep trying).

How lucky he is to have you as an advocate!

Its very important to work with a cardiologist to wean slowly (and not take him off meds yourself). Don’t settle for anyone who isn’t a specialist.

These days lots of people live past 100, and it sounds like he didn’t have much damage from the stroke.

Does he read? The first 3 months following a stroke are important - the brain can repair and can greatly improve with therapy. Does he have PT and OT?

If not, puzzles of any type, helping with household chores, reading, writing and short walks will all be very therapeutic. Have him write lists of things, fruits, countries of the world, zoo animals. Lists of anything that might interest him.

If he can, ask him to write short notes to friends and family members. Those will be treasured.

I wish you the best.

Probably not. What they're trying to do is prolong quantity of life instead of quality of life. Talk with his doctors and see what you can do to get him off these meds. Then get hospice involved as it sounds like he's done. Living all those years without medication and then having a stroke is nature's way of moving things along. I'm so sorry to hear that he's lost so much of his independence. But at least he has you. Hugs, hang in there. We're here for you.

No 97 yr old needs to be started off on cholesterol meds. My Ma needed BP meds until she turned 92 now off them as she drops too much. A very common problem in the aged and needs that geriatrician needed to assess his need and response. Seek a second opinion

Mmm. Tricky one.

Was that cholesterol reading before or after the meds? As I'm sure you know, it certainly doesn't seem to need intervention. The blood pressure is a teensy bit higher than ideal, I believe? - but in a 97 year old, surely any tinkering with it needs to be done with extreme caution.

The thing is, the px seems standard, what you would expect; but your father is not a standard patient. All I can say is if it were me, I would go to his established GP (if he has one you're happy with) or back to his cardiologist/attending physician, and say the equivalent of "not happy, what are we doing, could we go back to the drawing board please." With as much polite jumping up and down and snarling as necessary.

Changes have to be clinically justified in each individual patient, not just made for their own sake. Make them concentrate on *him*.