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J Am Geriatr Soc. 2008 Oct;56(10):1853-9. doi: 10.1111/j.1532-5415.2008.01948.x. Epub 2008 Sep 22.

Lower systolic blood pressure is associated with greater mortality in people aged 85 and older.

Author information

1
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden. lena.molander@germed.umu.se

Abstract

OBJECTIVES:

To investigate the association between blood pressure and mortality in very old people.

DESIGN:

Population-based cohort study.

SETTING:

County of Västerbotten, Sweden.

PARTICIPANTS:

Half of all subjects aged 85 and all of those aged 90 and 95 and older (N=348) in one urban and five rural municipalities in the north of Sweden.

MEASUREMENTS:

Among others, supine blood pressure, Mini-Mental State Examination, Barthel Index of activities of daily living, Mini Nutritional Assessment, and body mass index. Information on diagnoses, medications, and 4-year mortality was collected. Associations between blood pressure and mortality were investigated using Cox regression analyses, controlling for a number of diagnoses and health factors.

RESULTS:

Baseline systolic blood pressure (SBP), diastolic blood pressure, and pulse pressure were all inversely associated with mortality within 4 years according to univariate analysis. SBP was the strongest predictor. In Cox regression analyses, low SBP (<or=120 mmHg) correlated with greater 4-year all-cause mortality alone and when controlling for health status. This connection persisted after exclusion of deaths within the first year. There was a tendency toward a U-shaped mortality curve for the adjusted model, with SBP of 164.2 mmHg (95% confidence interval=154.1-183.8 mmHg) being associated with the lowest mortality.

CONCLUSION:

Lower SBP seems to be associated with greater mortality in people aged 85 and older, irrespective of health status. There are indications of a U-shaped correlation between SBP and mortality, and the optimal SBP for this age group could be above 140 mmHg.

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