دورية أكاديمية
A U-shaped association between home systolic blood pressure and four-year mortality in community-dwelling older men.
| العنوان: | A U-shaped association between home systolic blood pressure and four-year mortality in community-dwelling older men. |
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| المؤلفون: | Okumiya K; Department of Medicine & Geriatrics, Kochi Medical School, Japan., Matsubayashi K, Wada T, Fujisawa M, Osaki Y, Doi Y, Yasuda N, Ozawa T |
| المصدر: | Journal of the American Geriatrics Society [J Am Geriatr Soc] 1999 Dec; Vol. 47 (12), pp. 1415-21. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Science Country of Publication: United States NLM ID: 7503062 Publication Model: Print Cited Medium: Print ISSN: 0002-8614 (Print) Linking ISSN: 00028614 NLM ISO Abbreviation: J Am Geriatr Soc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Malden, MA : Blackwell Science Original Publication: New York [etc.] |
| مواضيع طبية MeSH: | Blood Pressure* , Mortality*, Activities of Daily Living ; Aged ; Aged, 80 and over ; Analysis of Variance ; Blood Pressure Monitoring, Ambulatory ; Cardiovascular Diseases/mortality ; Cohort Studies ; Confounding Factors, Epidemiologic ; Humans ; Japan/epidemiology ; Male ; Proportional Hazards Models ; Prospective Studies ; Risk ; Rural Population ; Surveys and Questionnaires ; Survival Analysis ; Systole |
| مستخلص: | Background: Several studies in older people have found a U-shaped or J-shaped association of blood pressure with mortality. The increased mortality associated with the lowest levels of blood pressure in older people have been explained by concurrent illnesses and frailty, but previous studies used blood pressure measured on a single occasion. Such a casual value is different from the long-term average of blood pressure. We investigated the relation between the average level of 5-day consecutive home blood pressure and mortality in older people while adjusting for potential confounding factors including morbidity and frailty at baseline. Methods: In 1992, 1186 community residents of a rural Japanese town, Kahoku, aged 65 or older, measured their blood pressure in their homes 20 times (four times per day, 5 consecutive days). The mean value of the 20 measurements was used to examine the association between home BP and subsequent 4-year mortality. A proportional hazards model was fitted while adjusting for activities of daily living impairment, medical history, antihypertensive medication, smoking, use of alcohol, and depression. Results: A total of 134 persons died during the four-year follow-up period. There was no significant evidence that frailty is more prevalent in the lowest or highest systolic BP group than in intermediate groups. A U-shaped association between the average level of home systolic blood pressure and mortality was found in men while adjusting for potential confounding factors, including morbidity and frailty. We also showed the U-shaped curve of the association of systolic BP with all cause and noncardiovascular mortality in the whole population and the linear association of systolic BP with cardiovascular mortality. Conclusions: We showed a U-shaped association between the average level of systolic blood pressure measured at home and mortality in older men while adjusting for potential confounding factors including morbidity and frailty. Not only high home systolic BP, but also low home systolic BP, is an independent risk factor for mortality in older men. The mechanisms underlying the association between BP and mortality differ by levels of systolic BP. Cardiovascular deaths tended to be higher in the highest SBP group, and only noncardiovascular deaths were increased in the lowest SBP group. The latter finding suggests that low SBP may be not only an independent risk of mortality but also an indicator of a subclinical noncardiovascular comorbid condition. |
| التعليقات: | Comment in: J Am Geriatr Soc. 1999 Dec;47(12):1477-8. (PMID: 10591248) |
| تواريخ الأحداث: | Date Created: 19991211 Date Completed: 19991223 Latest Revision: 20230303 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1111/j.1532-5415.1999.tb01559.x |
| PMID: | 10591234 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 0002-8614 |
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| DOI: | 10.1111/j.1532-5415.1999.tb01559.x |