Relationship between changes in late-life blood pressure and the risk of frailty and mortality among older population...

Area of Science:

• Gerontology
• Cardiovascular Health
• Public Health

Background:

• Evidence on blood pressure (BP) changes and their effects on older individuals is inconclusive.
• The impact of frailty across the life course concerning BP changes is not well understood.

Purpose of the Study:

• To investigate the associations between different blood pressure change patterns over 3-year intervals and frailty.
• To examine the relationship between blood pressure changes and mortality risk in older adults.

Main Methods:

• Utilized data from 7335 participants (mean age 82.6 years) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008-2014.
• Calculated BP change as the difference between follow-up and baseline measurements.
• Assessed frailty using a 40-item frailty index and ascertained mortality status up to December 31, 2014.

Main Results:

• Optimal BP levels (SBP 130-150 mmHg; DBP 70-90 mmHg) were associated with the lowest risk of frailty.
• Decreasing systolic BP (SBP) and diastolic BP (DBP) were significantly correlated with increased frailty.
• Lower baseline BP (<130/70 mmHg) with an increase to optimal levels during follow-up was linked to reduced mortality (HR 0.78, 95% CI 0.63-0.98) compared to sustained low BP.
• Decreasing follow-up DBP (<70 mmHg) was associated with higher mortality (HR 1.23, 95% CI 1.07-1.42) compared to stable DBP (70-90 mmHg), even after adjusting for frailty.

Conclusions:

• Optimal blood pressure ranges are associated with a reduced risk of frailty in older adults.
• The relationship between lower blood pressure and increased mortality risk persists even when frailty is considered.
• Specific patterns of BP change, particularly decreases in DBP, may indicate higher mortality risk in this population.