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Blood pressure in the very old
R J Heikinheimo1, M V Haavisto, R H Kaarela
1Geriatric Department, Tampere City Hospital, Finland.
Insights
This study found that specific blood pressure ranges (140-169 mmHg systolic, 70-99 mmHg diastolic) are linked to lower mortality in older adults. Deviations from these levels, especially sudden drops in systolic pressure, indicate higher health risks.
Area of Science:
- Gerontology
- Cardiovascular Health
- Epidemiology
Background:
- Older adults living independently present unique health challenges.
- Blood pressure monitoring is crucial for assessing health risks in the elderly.
- Longitudinal studies are needed to understand the prognostic value of blood pressure in this demographic.
Purpose of the Study:
- To investigate the association between blood pressure levels and mortality in an elderly Finnish population.
- To identify optimal blood pressure ranges for predicting survival in individuals aged 84-88.
- To examine the impact of blood pressure changes over time on mortality and institutionalization.
Main Methods:
- A 3-year prospective cohort study involving 724 community-dwelling older adults (aged 84-88) in Tampere, Finland.
- Annual medical examinations including blood pressure measurements.
- Follow-up for mortality and institutionalization.
Main Results:
- Blood pressure level was a significant prognostic indicator for 1-year mortality.
- The lowest mortality rates were observed in individuals with systolic blood pressure (SBP) of 140-169 mmHg and diastolic blood pressure (DBP) of 70-99 mmHg.
- Blood pressures outside these ranges, particularly low SBP after a previous decline, were associated with increased all-cause, cardiac, and coronary mortality.
- Low SBP was also linked to a higher likelihood of institutionalization.
Conclusions:
- Specific blood pressure ranges are associated with reduced mortality and institutionalization risk in very elderly individuals.
- Sudden decreases in SBP, especially to low levels, are a warning sign for increased mortality.
- These findings highlight the importance of monitoring blood pressure trends in older adults for proactive healthcare.
Abstract:
Seven hundred and twenty-four people (541 female, 183 male), aged 84-88 years and living at home in the city of Tampere, Finland, accepted our invitation to be examined in the outpatient department of the local geriatric hospital. These subjects were re-examined annually, and their fate was followed for 3 years. The blood pressure level was a prognostic sign for mortality during the first year after its measurement. The lowest mortality rate was found among those subjects with systolic blood pressure between 140 and 169 mmHg and diastolic blood pressure between 70 and 99 mmHg. Blood pressures outside of these ranges were associated with increased mortality rates, particularly cardiac and coronary mortality. The mortality rate was especially high among those whose systolic blood pressure had decreased to low levels in the year before, but was lower in those whose systolic blood pressure had decreased from high to middle levels (140-169 mmHg) than in those with consistently high systolic blood pressure. Eventual institutionalization was more common in those with low systolic blood pressure.