Relation between blood pressure and mortality risk in an older population: role of chronological and biological age

G Post Hospers, Y M Smulders, A B Maier, D J Deeg, M Muller

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: The relation between high blood pressure (BP) and mortality risk in older individuals (above 65 years of age) is still debated. Some data suggest that this relation is inverted in certain subgroups of (biologically) older individuals. We therefore investigated whether the association between BP and mortality is dependent on chronological age and on physical and cognitive function as indicators of biological age.

METHODS: The relationship between BP and all-cause mortality was investigated in 1466 older participants (aged 65 years and older; mean age 75.8 years) of the Longitudinal Ageing Study Amsterdam using multiple adjusted Cox proportional hazard models. Analyses were stratified for age, gait speed and mini mental state examination score.

RESULTS: A total of 1008 participants died after a median (range) follow-up of 10.6 (0.2; 15.9) years. Low diastolic blood pressure (DBP) was associated with an increased all-cause mortality risk: hazard ratio (HR) of low DBP (≤70 mmHg) compared to normal DBP (71-90 mmHg) was 1.36 [95% confidence interval (CI) 1.15; 1.61]. This relation was particularly strong in the oldest old (individuals aged >80 years) and in those who had lower levels of both physical and cognitive functioning: HRs (95% CIs) of low versus normal DBP were 1.58 (1.26; 1.98) and 1.45 (1.18; 1.77), respectively.

CONCLUSION: In a large population-based cohort of older adults, low DBP was associated with an increased all-cause mortality risk, especially in the oldest old and in biologically old individuals.

Original languageEnglish
Pages (from-to)488-497
Number of pages10
JournalJournal of Internal Medicine
Volume277
Issue number4
Early online date8 Jul 2014
DOIs
Publication statusPublished - Apr 2015

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Blood Pressure
Mortality
Population
Hypotension
Proportional Hazards Models
Cognition
Longitudinal Studies
Odds Ratio
Confidence Intervals
Hypertension

Bibliographical note

© 2014 The Association for the Publication of the Journal of Internal Medicine.

Keywords

  • Aged
  • Aged, 80 and over
  • Blood Pressure/physiology
  • Diastole/physiology
  • Female
  • Gait/physiology
  • Humans
  • Male
  • Mortality

Cite this

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title = "Relation between blood pressure and mortality risk in an older population: role of chronological and biological age",
abstract = "BACKGROUND: The relation between high blood pressure (BP) and mortality risk in older individuals (above 65 years of age) is still debated. Some data suggest that this relation is inverted in certain subgroups of (biologically) older individuals. We therefore investigated whether the association between BP and mortality is dependent on chronological age and on physical and cognitive function as indicators of biological age.METHODS: The relationship between BP and all-cause mortality was investigated in 1466 older participants (aged 65 years and older; mean age 75.8 years) of the Longitudinal Ageing Study Amsterdam using multiple adjusted Cox proportional hazard models. Analyses were stratified for age, gait speed and mini mental state examination score.RESULTS: A total of 1008 participants died after a median (range) follow-up of 10.6 (0.2; 15.9) years. Low diastolic blood pressure (DBP) was associated with an increased all-cause mortality risk: hazard ratio (HR) of low DBP (≤70 mmHg) compared to normal DBP (71-90 mmHg) was 1.36 [95{\%} confidence interval (CI) 1.15; 1.61]. This relation was particularly strong in the oldest old (individuals aged >80 years) and in those who had lower levels of both physical and cognitive functioning: HRs (95{\%} CIs) of low versus normal DBP were 1.58 (1.26; 1.98) and 1.45 (1.18; 1.77), respectively.CONCLUSION: In a large population-based cohort of older adults, low DBP was associated with an increased all-cause mortality risk, especially in the oldest old and in biologically old individuals.",
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Relation between blood pressure and mortality risk in an older population : role of chronological and biological age. / Post Hospers, G; Smulders, Y M; Maier, A B; Deeg, D J; Muller, M.

In: Journal of Internal Medicine, Vol. 277, No. 4, 04.2015, p. 488-497.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Relation between blood pressure and mortality risk in an older population

T2 - role of chronological and biological age

AU - Post Hospers, G

AU - Smulders, Y M

AU - Maier, A B

AU - Deeg, D J

AU - Muller, M

N1 - © 2014 The Association for the Publication of the Journal of Internal Medicine.

PY - 2015/4

Y1 - 2015/4

N2 - BACKGROUND: The relation between high blood pressure (BP) and mortality risk in older individuals (above 65 years of age) is still debated. Some data suggest that this relation is inverted in certain subgroups of (biologically) older individuals. We therefore investigated whether the association between BP and mortality is dependent on chronological age and on physical and cognitive function as indicators of biological age.METHODS: The relationship between BP and all-cause mortality was investigated in 1466 older participants (aged 65 years and older; mean age 75.8 years) of the Longitudinal Ageing Study Amsterdam using multiple adjusted Cox proportional hazard models. Analyses were stratified for age, gait speed and mini mental state examination score.RESULTS: A total of 1008 participants died after a median (range) follow-up of 10.6 (0.2; 15.9) years. Low diastolic blood pressure (DBP) was associated with an increased all-cause mortality risk: hazard ratio (HR) of low DBP (≤70 mmHg) compared to normal DBP (71-90 mmHg) was 1.36 [95% confidence interval (CI) 1.15; 1.61]. This relation was particularly strong in the oldest old (individuals aged >80 years) and in those who had lower levels of both physical and cognitive functioning: HRs (95% CIs) of low versus normal DBP were 1.58 (1.26; 1.98) and 1.45 (1.18; 1.77), respectively.CONCLUSION: In a large population-based cohort of older adults, low DBP was associated with an increased all-cause mortality risk, especially in the oldest old and in biologically old individuals.

AB - BACKGROUND: The relation between high blood pressure (BP) and mortality risk in older individuals (above 65 years of age) is still debated. Some data suggest that this relation is inverted in certain subgroups of (biologically) older individuals. We therefore investigated whether the association between BP and mortality is dependent on chronological age and on physical and cognitive function as indicators of biological age.METHODS: The relationship between BP and all-cause mortality was investigated in 1466 older participants (aged 65 years and older; mean age 75.8 years) of the Longitudinal Ageing Study Amsterdam using multiple adjusted Cox proportional hazard models. Analyses were stratified for age, gait speed and mini mental state examination score.RESULTS: A total of 1008 participants died after a median (range) follow-up of 10.6 (0.2; 15.9) years. Low diastolic blood pressure (DBP) was associated with an increased all-cause mortality risk: hazard ratio (HR) of low DBP (≤70 mmHg) compared to normal DBP (71-90 mmHg) was 1.36 [95% confidence interval (CI) 1.15; 1.61]. This relation was particularly strong in the oldest old (individuals aged >80 years) and in those who had lower levels of both physical and cognitive functioning: HRs (95% CIs) of low versus normal DBP were 1.58 (1.26; 1.98) and 1.45 (1.18; 1.77), respectively.CONCLUSION: In a large population-based cohort of older adults, low DBP was associated with an increased all-cause mortality risk, especially in the oldest old and in biologically old individuals.

KW - Aged

KW - Aged, 80 and over

KW - Blood Pressure/physiology

KW - Diastole/physiology

KW - Female

KW - Gait/physiology

KW - Humans

KW - Male

KW - Mortality

U2 - 10.1111/joim.12284

DO - 10.1111/joim.12284

M3 - Article

VL - 277

SP - 488

EP - 497

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 0954-6820

IS - 4

ER -