Related Experiment Video
Updated: Sep 24, 2025
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Low Diastolic Blood Pressure and Mortality in Older Women. Results From the Women's Health Initiative Long Life Study
Bernhard Haring1,2,3, Aileen P McGinn3, Victor Kamensky3
1Department of Medicine III, Saarland University Hospital, Homburg, Germany.
Insights
Low and high diastolic blood pressure (DBP) increase mortality risk in older women. Optimal DBP targets between 68-75 mm Hg may reduce cardiovascular disease and all-cause mortality risk.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Epidemiology
Background:
- Systolic blood pressure targets often overlook diastolic blood pressure (DBP) risks.
- Low DBP is linked to increased cardiovascular disease (CVD) and mortality, particularly in older adults.
- This study investigates DBP's impact on CVD and mortality in elderly women.
Purpose of the Study:
- To examine the association between diastolic blood pressure levels and cardiovascular disease (CVD) and all-cause mortality in older women.
- To identify optimal diastolic blood pressure (DBP) targets for reducing mortality risk in elderly populations.
Main Methods:
- Analysis of 7,875 women (mean age 79) from the Women's Health Initiative Long Life Study (WHI-LLS).
- Blood pressure measured during in-person home visits (2012-2013).
- Central adjudication of CVD and all-cause mortality events, with hazard ratios (HRs) from adjusted Cox models.
Main Results:
- A 5-year follow-up revealed an 18.4% all-cause mortality rate.
- Compared to DBP of 80 mm Hg, mortality HR was 1.33 for DBP 50 mm Hg and 1.67 for DBP 100 mm Hg.
- CVD HR was 1.14 for DBP 50 mm Hg and 1.50 for DBP 100 mm Hg; the lowest mortality risk was at DBP of 72 mm Hg.
Conclusions:
- Both low and high diastolic blood pressure (DBP) pose risks in older women.
- Low DBP may indicate heightened mortality risk.
- Targeting DBP between 68-75 mm Hg may mitigate risks of higher mortality and cardiovascular disease.
Background:
Recommended systolic blood pressure targets often do not consider the relationship of low diastolic blood pressure (DBP) levels with cardiovascular disease (CVD) and all-cause mortality risk, which is especially relevant for older people with concurrent comorbidities. We examined the relationship of DBP levels to CVD and all-cause mortality in older women in the Women's Health Initiative Long Life Study (WHI-LLS).
Methods:
The study sample included 7,875 women (mean age: 79 years) who underwent a blood pressure measurement at an in-person home visit conducted in 2012-2013. CVD and all-cause mortality were centrally adjudicated. Hazard ratios (HRs) were obtained from adjusted Cox proportional hazards models.
Results:
After 5 years follow-up, all-cause mortality occurred in 18.4% of women. Compared with a DBP of 80 mm Hg, the fully adjusted HR for mortality was 1.33 (95% confidence interval [CI]: 1.04-1.71) for a DBP of 50 mm Hg and 1.67 (95% CI: 1.29-2.16) for a DBP of 100 mm Hg. The HRs for CVD were 1.14 (95% CI: 0.78-1.67) for a DBP of 50 mm Hg and HR 1.50 (95% CI: 1.03-2.17) for a DBP of 100 mm Hg. The nadir DBP associated with lowest mortality risk was 72 mm Hg overall.
Conclusions:
In older women, consideration should be given to the potential adverse effects of low and high DBP. Low DBP may serve as a risk marker. DBP target levels between 68 and 75 mm Hg may avoid higher mortality risk.
More Related Videos
Related Concept Videos
01:17Measurement of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
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.
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies