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Blood pressure in relation to age and frailty
Michael R H Rockwood1, Susan E Howlett
1Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS.
Background And Purpose:
On average, systolic blood pressure (SBP) rises with age, while diastolic blood pressure (DBP) increases to age 50 and then declines. As elevated blood pressure is associated with cardiovascular disease and mortality, it also might be linked to frailty. We assessed the association between blood pressure, age, and frailty in a representative population-based cohort.
Methods:
Individuals from the second clinical examination of the Canadian Study of Health and Aging (n = 2305, all 70+ years) were separated into four groups: history of hypertension ± antihypertensive medication, and no history of hypertension ± antihypertensive medication. Frailty was quantified as deficits accumulated in a frailty index (FI).
Results:
SBP and DBP changed little in relation to age, except in untreated hypertension, where SBP declined in individuals >85 years. In contrast, SBP declined in all groups up to an FI of 0.55, and then rose sharply. DBP changed little in relation to FI. The slope of the line relating FI and age was highest in untreated individuals without a history of hypertension, indicating the highest physiological reserve.
Conclusions:
SBP declined as frailty increased in older adults, except at the highest FI levels. SBP and age had little or no relationship.
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Physiological Factors:
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.