Journal of the American Geriatrics Society

Volume 56, Issue 10 p. 1853-1859

Lower Systolic Blood Pressure Is Associated with Greater Mortality in People Aged 85 and Older

Lena Molander Bsc,

Lena Molander Bsc

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Hugo Lövheim MD, PhD,

Hugo Lövheim MD, PhD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Tove Norman MD,

Tove Norman MD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Peter Nordström MD, PhD,

Peter Nordström MD, PhD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Yngve Gustafson MD, PhD,

Yngve Gustafson MD, PhD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Lena Molander Bsc,

Lena Molander Bsc

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Hugo Lövheim MD, PhD,

Hugo Lövheim MD, PhD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Tove Norman MD,

Tove Norman MD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Peter Nordström MD, PhD,

Peter Nordström MD, PhD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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Yngve Gustafson MD, PhD,

Yngve Gustafson MD, PhD

From the ^* Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden

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First published: 01 October 2008

https://doi.org/10.1111/j.1532-5415.2008.01948.x

Citations: 120

Address correspondence to Lena Molander, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 85 Umeå, Sweden, E-mail: [email protected]

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Abstract

OBJECTIVES: To investigate the association between blood pressure and mortality in very old people.

DESIGN: Population-based cohort study.

SETTING: County of Västerbotten, Sweden.

PARTICIPANTS: Half of all subjects aged 85 and all of those aged 90 and 95 and older (N=348) in one urban and five rural municipalities in the north of Sweden.

MEASUREMENTS: Among others, supine blood pressure, Mini-Mental State Examination, Barthel Index of activities of daily living, Mini Nutritional Assessment, and body mass index. Information on diagnoses, medications, and 4-year mortality was collected. Associations between blood pressure and mortality were investigated using Cox regression analyses, controlling for a number of diagnoses and health factors.

RESULTS: Baseline systolic blood pressure (SBP), diastolic blood pressure, and pulse pressure were all inversely associated with mortality within 4 years according to univariate analysis. SBP was the strongest predictor. In Cox regression analyses, low SBP (≤120 mmHg) correlated with greater 4-year all-cause mortality alone and when controlling for health status. This connection persisted after exclusion of deaths within the first year. There was a tendency toward a U-shaped mortality curve for the adjusted model, with SBP of 164.2 mmHg (95% confidence interval=154.1–183.8 mmHg) being associated with the lowest mortality.

CONCLUSION: Lower SBP seems to be associated with greater mortality in people aged 85 and older, irrespective of health status. There are indications of a U-shaped correlation between SBP and mortality, and the optimal SBP for this age group could be above 140 mmHg.

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Volume56, Issue10

October 2008

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Lower Systolic Blood Pressure Is Associated with Greater Mortality in People Aged 85 and Older

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Lower Systolic Blood Pressure Is Associated with Greater Mortality in People Aged 85 and Older

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