Blood pressure and mortality risk in the elderly

Area of Science:

• Gerontology
• Epidemiology
• Cardiovascular Health

Background:

• The Established Populations for Epidemiologic Studies of the Elderly (EPESE) program collected data on blood pressure and mortality in older adults.
• Understanding blood pressure's impact on mortality in the elderly is crucial for public health interventions.

Purpose of the Study:

• To investigate the relationship between systolic and diastolic blood pressure and cause-specific mortality in elderly populations.
• To examine how baseline blood pressure levels predict mortality over a 5-year follow-up period.

Main Methods:

• Blood pressure was measured in three US communities (East Boston, New Haven, Iowa) between 1981-1983 for individuals aged 65 and older.
• Cause-specific mortality was monitored annually for 5 years.
• Statistical analysis examined the association between blood pressure strata and mortality outcomes.

Main Results:

• Initially, low systolic blood pressure (<130 mmHg) was associated with higher all-cause mortality in younger elderly (65-79 years).
• Over 5 years, increasing systolic pressure correlated with higher cardiovascular mortality, significantly in Iowa.
• Cancer mortality was highest in the low systolic pressure group across all centers.
• Low diastolic pressure (<75 mmHg) was linked to higher all-cause, cardiovascular, and cancer mortality in East Boston.
• Longer-term follow-up in East Boston showed increased cardiovascular death risk with higher systolic pressure, but no diastolic pressure relation.

Conclusions:

• Early excess mortality at lower blood pressure levels in the elderly may be influenced by baseline illness and disability.
• Systolic blood pressure shows a complex relationship with mortality, with higher levels linked to cardiovascular death over time.
• Diastolic blood pressure does not appear to have a consistent relationship with mortality risk in this elderly cohort.