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Does decreased diastolic blood pressure associate with increased mortality in 80-year-old Japanese?

Shuntaro Kagiyama1, Yutaka Takata, Toshihiro Ansai

  • 1Division of General Internal Medicine, Department of Health Promotion, Science of Health Improvement, Kyushu Dental College, Kitakyushu, Japan. kagishu@hotmail.com

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|December 17, 2009
PubMed

Insights

In elderly Japanese individuals aged 80 and above, lower diastolic blood pressure (DBP) is linked to increased mortality. This finding suggests that low DBP, not just high blood pressure, is a significant risk factor in the elderly.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Hypertension is a major cardiovascular disease risk factor, but its impact on mortality diminishes with age.
  • Previous research indicated systolic blood pressure (SBP) is not correlated with mortality in 80-year-old Japanese individuals.
  • The independent effect of diastolic blood pressure (DBP) on mortality in this age group requires further investigation.

Purpose of the Study:

  • To investigate the independent association between diastolic blood pressure (DBP) and all-cause mortality in elderly Japanese individuals.
  • To determine if lower DBP levels are associated with increased mortality risk in individuals aged 80 and older.

Main Methods:

  • A cohort of 639 Japanese participants, all aged 80 in 1997, were enrolled.
  • Participants were categorized into four groups based on their DBP levels (e.g., <70 mmHg, 70-80 mmHg, 80-90 mmHg, >90 mmHg).
  • Mortality data was collected over a 4-year follow-up period, and Cox multivariate regression analysis was employed.

Main Results:

  • A significantly higher mortality rate was observed in the lowest DBP group (group 1: <70 mmHg) compared to the highest DBP group (group 4: >90 mmHg) [Relative Risk (RR) 2.47, p = 0.03].
  • While not statistically significant, there was a trend towards increased relative risks of death from cardiovascular diseases, pneumonia, and cancer in the lowest DBP group.
  • The findings suggest a potential link between decreased DBP and elevated mortality risk in the elderly.

Conclusions:

  • Lower diastolic blood pressure (DBP) is associated with significantly higher all-cause mortality in 80-year-old Japanese individuals.
  • These findings highlight the importance of considering low DBP as a potential risk factor for mortality in the elderly population.
  • Further research is warranted to explore the mechanisms underlying the association between low DBP and increased mortality in older adults.

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