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Lower systolic blood pressure is associated with greater mortality in people aged 85 and older
Lena Molander1, Hugo Lövheim, Tove Norman
1Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden. lena.molander@germed.umu.se
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 (
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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