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Researchers from the University of Connecticut in the US and the University of Exeter Medical School in the UK looked at the electronic medical records of 46,634 people who had died at age 60 or older.
The large sample size included people who were healthy as well as those who had conditions such as heart disease or dementia.
They found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure, to begin with.
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The findings, published in Journal of the American Medical Association Internal Medicine, should make both doctors and researchers carefully consider what dropping blood pressure really means for older patients, Kuchel added.
Doctors have long known that in the average person, blood pressure rises from childhood to middle age. However, normal blood pressure in the elderly has been less certain.