期刊
JOURNAL OF HYPERTENSION
卷 40, 期 9, 页码 1786-1794出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000003219
关键词
activities of daily living; aged; antihypertensive; blood pressure; body mass index; cardiovascular; cognition; frailty; grip strength; older adults
资金
- Dutch Ministry of Health, Welfare and Sports
- Health Research Council of New Zealand program [HRC 09/068B]
- Ministry of Health New Zealand [345426/00]
- Nga Paeote Maramatanga (the New Zealand National Centre for Research Excellence for Maori
- funded Maori engagement and project management) project grant
- National Heart Foundation
- Oakley Mental Health Foundation
- Medical Research Council, Biotechnology and Biological Sciences Research Council
- Dunhill Medical Trust and the National Institute for Health Research School for Primary Care
- British Heart Foundation
- Unilever Corporate Research, Newcastle University
- NHS North of Tyne (Newcastle Primary Care Trust)
- MEXT KAKENHI [21590775, 15KT0091]
- Keio Global Research Institute (KGRI)
This study investigated the associations between systolic blood pressure (SBP) and health outcomes in very old individuals, taking into account factors such as blood pressure-lowering treatment, history of cardiovascular diseases, cognitive and physical fitness. The results showed that higher SBP was associated with lower all-cause mortality, but this association was not evident in fit octogenarians. SBP was not consistently associated with cognitive and functional decline.
Objectives: While randomized controlled trials have proven the benefits of blood pressure (BP) lowering in participating octogenarians, population-based observational studies suggest an association between low systolic blood pressure (SBP) and faster overall decline. This study investigates the effects of BP-lowering treatment, a history of cardiovascular diseases (CVD), and cognitive and physical fitness on the associations between SBP and health outcomes in the very old. Methods: Five cohorts from the Towards Understanding Longitudinal International older People Studies (TULIPS) consortium were included in a two-step individual participant data meta-analysis (IPDMA). We pooled hazard ratios (HR) from Cox proportional-hazards models for 5-year mortality and estimates of linear mixed models for change in cognitive and functional decline. Models were stratified by BP-lowering treatment, history of CVD, Mini-Mental State Examination scores, grip strength (GS) and body mass index (BMI). Results: Of all 2480 participants (59.9% females, median 85 years), median baseline SBP was 149 mmHg, 64.3% used BP-lowering drugs and 47.3% had a history of CVD. Overall, higher SBP was associated with lower all-cause mortality (pooled HR 0.91 [95% confidence interval 0.88-0.95] per 10 mmHg). Associations remained irrespective of BP-lowering treatment, history of CVD and BMI, but were absent in octogenarians with above-median MMSE and GS. In pooled cohorts, SBP was not associated with cognitive and functional decline. Conclusion: While in the very old with low cognitive or physical fitness a higher SBP was associated with a lower all-cause mortality, this association was not evident in fit octogenarians. SBP was not consistently associated with cognitive and functional decline.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据