Article
 

Systolic and Diastolic Blood Pressure, Incident Cardiovascular Events and Death in Elderly Persons: The Role of Functional Limitation

Public Deposited

Downloadable Content

Download PDF
https://ir.library.oregonstate.edu/concern/articles/9g54xk596

Descriptions

Attribute NameValues
Creator
Abstract
  • BACKGROUND: Whether limitation in ability to perform activities of daily living (ADL) or gait speed can identify subgroups of elders in whom the association of systolic (SBP) and diastolic (DBP) blood pressure with cardiovascular events and death differs is not well established. METHODS: We evaluated whether ADL and gait speed modify the association of SBP or DBP with incident cardiovascular (CV) events (N= 2,358) and all-cause death (N=3,547) among participants in the 7th visit of the Cardiovascular Health Study. We used multivariable Cox regression adjusting for potential confounders. RESULTS: Mean age was 78 ± 5 years and 21% reported limitation in ≥1 ADL. There were 778 incident CV events and 1,289 deaths over approximately 9 years. Among persons without and with ADL limitation, SBP was directly associated CVD events, and the size of the HRs was similar in the two groups: HR (per 10 mmHg increase) 1.08 (95% CI 1.03, 1.13) and 1.06 (0.97, 1.17), respectively. ADL modified the association of DBP with incident CVD. Among those without ADL limitations, DBP was weakly associated with CVD, HR 1.04 (0.79, 1.37) for DBP > 80 compared to < 65. In contrast, among those with ADL limitation, DBP was inversely associated with CVD events. HR 0.65 (0.44, 0.96) for DBP 66-80 mmHg and HR 0.49 (0.25, 0.94) for DBP > 80 mmHg, compared to DBP ≤ 65 mmHg. Among persons with ADL limitation, a DBP 66-80 had the lowest risk for death, HR 0.72 (0.57, 0.91), compared with DBP ≤ 65 mmHg. Associations of BP with CVD or death did not vary by 15 feet walking speed. CONCLUSIONS: ADL can identify the subgroups of elders in whom diastolic hypotension is associated with higher CV risk and death. Functional status, rather than chronologic age, should inform design of trials to elucidate benefits and harms of lowering each BP component in elders.
  • Keywords: hypertension, activities of daily living, aged
Resource Type
DOI
Date Available
Date Issued
Citation
  • Peralta, C. A., Katz, R., Newman, A. B., Psaty, B. M., & Odden, M. C. (2014). Systolic and Diastolic Blood Pressure, Incident Cardiovascular Events, and Death in Elderly Persons The Role of Functional Limitation in the Cardiovascular Health Study. Hypertension, 64(3), 472-480. doi:10.1161/HYPERTENSIONAHA.114.03831
Journal Title
Journal Volume
  • 64
Journal Issue/Number
  • 3
Rights Statement
Funding Statement (additional comments about funding)
  • This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grant HL080295 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. Dr. Peralta is supported by is funded by the National Institutes of Diabetes and Digestive and Kidney Diseases (K23SK082793) and a Robert Wood Johnson Harold Amos Award. Dr. Odden is supported by the American Heart Association Western States Affiliate (CRP7210088) and the National Institute on Aging (K01AG039387).
Publisher
Peer Reviewed
Language
Replaces

Relationships

Parents:

This work has no parents.

Items

Thumbnail Title Date Uploaded Visibility Actions
file details OddenMichellePublicHealthHumanSciencesSystolicDiastolicBloodPressure.pdf 2017-07-27 Public Download