Copyright © 1997 by the European Society of Cardiology.
© 1997 The European society of Cardiology
Blood pressure and mortality in an older population
A 5-year follow-up of the Helsinki Ageing Study
Division of Geriatrics, Department of Medicine, University of Helsinki Helsinki, Finland
Received 2 July 1996; accepted 8 July 1996.
Correspondence: Professor Reijo S. Tilvis, MD, Division of Geriatrics, Department of Medicine, University of Helsinki, FIN-00290 Helsinki, Finland
Abstract
OBJECTIVE: Hypertension is an established risk factor of cardiovascular diseases, and in clinical studies its treatment has reduced cardiovascular complications in subjects up to 80 years of age. In the older age groups, prognostic data on blood pressure is sparse. We evaluated the prognostic significance of different blood pressure levels and the history of elevated blood pressure in an older population.
DESIGN: In the Helsinki Ageing Study random individuals 75, 80, and 85 years of age (n=521) were evaluated at baseline using postal questionnaires, structured interviews, clinical examinations, laboratory investigations, and blood pressure measurements (supine, seated, standing). Date of death during a 5-year follow-up was verified using computerized registers, and thus the follow-up was 100% complete. The data were analysed using life-table analyses and Cox proportional hazards models.
RESULTS: At 5 years, 240 subjects (40%) had died, 50% of them of cardiovascular disease. In crude analyses, an inverse relationship between both systolic and diastolic blood pressure and mortality was observed in all groups combined (P<0·01), and separately in the 80 and 85-year-old groups. However, a J-shaped link between diastolic blood pressure and mortality was found in the 75-year-old group. After controlling for age, gender and the presence of clinically significant diseases (in 72% of subjects) baseline blood pressure was associated with favourable 5-year survival. The risk ratios of systolic (per 10 mmHg) and diastolic blood pressure (per 5 mmHg) were 0·90 (95% CI 0·85–0·96) and 0·92 (95% CI 0·86-0·99), respectively. Neither isolated systolic hypertension nor a history of hypertension treatment were associated with 5-year survival.
CONCLUSION: At the population level, among subjects aged 75 years and over, favourable 5-year survival is indicated by a high, but not a low, blood pressure.
Key Words: Blood pressure • survival prognosis • elderly • hypertension
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. Pinto Blood pressure and ageing Postgrad. Med. J., February 1, 2007; 83(976): 109 - 114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. Strandberg, R. S. Tilvis, K. H. Pitkala, and T. A. Miettinen Cholesterol and Glucose Metabolism and Recurrent Cardiovascular Events Among the Elderly: A Prospective Study J. Am. Coll. Cardiol., August 15, 2006; 48(4): 708 - 714. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. H. Messerli, G. Mancia, C. R. Conti, A. C. Hewkin, S. Kupfer, A. Champion, R. Kolloch, A. Benetos, and C. J. Pepine Dogma Disputed: Can Aggressively Lowering Blood Pressure in Hypertensive Patients with Coronary Artery Disease Be Dangerous? Ann Intern Med, June 20, 2006; 144(12): 884 - 893. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. O'Hare, D. Bertenthal, K. E. Covinsky, C. S. Landefeld, S. Sen, K. Mehta, M. A. Steinman, A. Borzecki, and L. C. Walter Mortality Risk Stratification in Chronic Kidney Disease: One Size for All Ages? J. Am. Soc. Nephrol., March 1, 2006; 17(3): 846 - 853. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. O'Hare, R. Katz, M. G. Shlipak, M. Cushman, and A. B. Newman Mortality and Cardiovascular Risk Across the Ankle-Arm Index Spectrum: Results From the Cardiovascular Health Study Circulation, January 24, 2006; 113(3): 388 - 393. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Keith, G. A. Nichols, C. M. Gullion, J. B. Brown, and D. H. Smith Longitudinal Follow-up and Outcomes Among a Population With Chronic Kidney Disease in a Large Managed Care Organization Arch Intern Med, March 22, 2004; 164(6): 659 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Goodwin Embracing Complexity: A Consideration of Hypertension in the Very Old J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): M653 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Denson Commentary: Help! Grandma's Stroking: Balancing Morbidity and Mortality in the Treatment of Hypertension Among the Very Old J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): M660 - 661. [Full Text] [PDF]
|
|
|
|
|
|
H. Arima, Y. Tanizaki, Y. Kiyohara, T. Tsuchihashi, I. Kato, M. Kubo, K. Tanaka, K. Ohkubo, H. Nakamura, I. Abe, et al. Validity of the JNC VI Recommendations for the Management of Hypertension in a General Population of Japanese Elderly: The Hisayama Study Arch Intern Med, February 10, 2003; 163(3): 361 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.-S. Rigaud and B. Forette Hypertension in Older Adults J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2001; 56(4): 217M - 225. [Abstract] [Full Text]
|
|
|
|
 |
|
 P Trenkwalder, P Hendricks, R Schoniger, J Rossberg, H Lydtin, and H.W Hense Hypertension as a risk factor for cardiovascular morbidity and mortality in an elderly German population.: The prospective STEPHY II Study Eur. Heart J., December 1, 1999; 20(23): 1752 - 1756. [Abstract] [PDF]
|
|