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Observed Blood Pressure and Mortality Among People Aged 65 Years and Older: A Community-Based Cohort Study
- Source :
- Journal of the American Medical Directors Association. 17:654-662
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- The 2014 Eighth Joint National Committee guidelines for hypertension management emphasize the upper limit of blood pressure (BP) as the target for treatment in the elderly population. Given the uncertainty regarding optimal BP range, we aimed to investigate the association between observed BP and subsequent mortality in older people.We extracted data from 128,765 participants ≥65 years of age who underwent annual health examinations in a retrospective, observational community-based study from 2001 to 2010. Seated BP was measured using an oscillometric device. The outcomes were all-cause and cardiovascular mortality.As compared to participants with systolic BP at 130 to 139 mm Hg, the risk of all-cause mortality was significantly higher among those with110 (adjusted hazard ratios [aHRs], 1.12; 95% confidence interval [CI], 1.05-1.20), 140 to 149 (aHR, 1.08; 95% CI, 1.03-1.14), 150 to 159 (aHR, 1.07; 95% CI, 1.01-1.17), 160 to 169 (aHR, 1.11; 95% CI, 1.04-1.19), and ≥170 mm Hg (aHR, 1.25; 95% CI, 1.17-1.33), whereas the differences were not significant for those with 110 to119 (aHR, 1.06; 95% CI, 1.00-1.12) and 120 to 129 mm Hg (aHR, 1.03; 95% CI, 0.97-1.08). Similarly, diastolic BP at 40 to 79 mm Hg was associated with the lowest risk of all-cause mortality. The J-shaped curve relationship between BP and cardiovascular mortality was also observed.Observed systolic and diastolic BP other than 110 to 139 and 40 to 79 mm Hg, respectively, were associated with a worse outcome. Our large cohort study supports the J-shaped mortality with observed BP in older people.
- Subjects :
- Male
Gerontology
Diastole
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Outcome Assessment, Health Care
Humans
Medicine
030212 general & internal medicine
General Nursing
Aged
Proportional Hazards Models
Retrospective Studies
Cardiovascular mortality
Proportional hazards model
business.industry
Health Policy
Blood Pressure Determination
Retrospective cohort study
General Medicine
Blood pressure
Hypertension
Female
Observational study
Geriatrics and Gerontology
Older people
business
Demography
Cohort study
Subjects
Details
- ISSN :
- 15258610
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Journal of the American Medical Directors Association
- Accession number :
- edsair.doi.dedup.....3e7a2d671913ab2ffb978157a3b67bb2