Related Experiment Videos
Blood pressure and cardiovascular morbidity and mortality rates in the elderly
W B Kannel1, R B D'Agostino, H Silbershatz
1Department of Medicine, Evans Memorial Research Foundation, Boston University School of Medicine/Framingham Heart Study, Mass., USA.
Insights
High blood pressure increases cardiovascular risk in older adults. Low blood pressure in the elderly is linked to poor cardiovascular health, not the pressure itself.
Area of Science:
- Gerontology
- Cardiology
- Epidemiology
Background:
- The relationship between blood pressure and cardiovascular outcomes in individuals over 75 is not well understood.
- An observed inverse association between blood pressure and mortality in the very old may indicate underlying cardiovascular issues.
Purpose of the Study:
- To investigate the impact of blood pressure on cardiovascular morbidity, cardiovascular mortality, and all-cause mortality in adults aged 75–94 years.
Main Methods:
- Utilized data from the Framingham Heart Study, including participants initially free of cardiovascular disease and those with pre-existing cardiovascular disease.
- Analyzed the association between systolic and diastolic blood pressures and morbidity/mortality rates across 2-year intervals over 38 years of follow-up.
Main Results:
- In individuals without prior cardiovascular disease, higher blood pressure correlated with increased cardiovascular morbidity and mortality.
- A U-shaped curve was observed for cardiovascular mortality concerning systolic blood pressure in men with existing cardiovascular disease, with increased risk below 120 mm Hg for both sexes.
Conclusions:
- Elevated blood pressure is a risk factor for cardiovascular events and mortality in older adults without pre-existing cardiovascular disease.
- The increased mortality associated with low blood pressure in the elderly is likely attributable to underlying cardiovascular disease, not hypotension itself.
Abstract:
The influence of blood pressure on the development of cardiovascular disease and mortality rate beyond 75 years of age has been uncertain. A reported inverse relation to mortality rate noted in the very old could reflect poor cardiovascular health. This report examines the impact of blood pressure on cardiovascular morbidity and mortality rates and all-cause mortality rate in those aged 75 to 94 years. For this analysis the data were the Framingham study subjects found free of cardiovascular disease and a second sample of those with cardiovascular disease present on the biennial examinations. Investigation of the relation of systolic and diastolic blood pressures to all causes and cardiovascular morbidity and mortality rates within each 2-year interval for those aged 75 to 94 years was carried out. Over the period of 38 years of follow-up there were increasing cardiovascular morbidity and mortality rates with increasing blood pressure levels for both men and women in the sample free of cardiovascular disease. In those with cardiovascular disease at the biennial examination there was a distinct U-shaped curve of cardiovascular mortality rate in relation to systolic blood pressure in men with a substantial increase in mortality rate below systolic pressures of 120 mm Hg for both men and women. Excess mortality rate reported in elderly persons with low blood pressure appears to be a result of poor cardiovascular health and not from the low pressure itself. The excess mortality rate reported for low blood pressure levels in persons older than 75 years derives from the inclusion of the substantial proportion of this age group who have cardiovascular disease.