Epidemiology, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA.
J Gerontol A Biol Sci Med Sci. 2012 Sep;67(9):977-83. doi: 10.1093/gerona/glr245. Epub 2012 Mar 1.
In some older adults, higher blood pressure (BP) is associated with a lower risk of mortality. We hypothesized that higher BP would be associated with greater mortality in high-functioning elders and lower mortality in elders with lower functional status.
Participants were 1,562 Latino adults aged 60-101 years in the Sacramento Area Latino Study on Aging. Functional status was measured by self-reported walking speed, and BP was measured by automatic sphygmomanometer. Death information was determined from vital statistics records.
There were 442 deaths from 1998 to 2010; 53% were cardiovascular. Mean BP levels (mmHg) varied across fast, medium, and slow walkers: 136, 139, and 140 mmHg (systolic), p = .02 and 75, 76, and 77 mmHg (diastolic), p = .08, respectively. The relationship between systolic BP and mortality varied by self-reported walking speed: The adjusted hazard ratio for mortality in slow walkers was 0.96 per 10 mmHg higher systolic BP (95% confidence interval: 0.89, 1.02) and 1.29 (95% confidence interval: 1.08, 1.55) in fast walkers (p value for interaction <.001). We found a similar pattern for diastolic BP, although the interaction did not reach statistical significance; the adjusted hazard ratio per 10 mmHg higher diastolic BP was 0.89 (95% confidence interval: 0.78, 1.02) in slow walkers and 1.20 (95% confidence interval: 0.82, 1.76) in fast walkers (p value for interaction = .06).
In high-functioning older adults, elevated systolic BP is a risk factor for all-cause mortality. If confirmed in other studies, the assessment of functional status may help to identify persons who are most at-risk for adverse outcomes related to high BP.
在一些老年人中，较高的血压（BP）与死亡率降低相关。我们假设，在高功能老年人中，较高的 BP 与更高的死亡率相关，而在功能状态较低的老年人中与较低的死亡率相关。
参与者为 1562 名年龄在 60-101 岁的拉丁裔老年人，他们参加了萨克拉门托拉丁裔老龄化研究。功能状态通过自我报告的步行速度来衡量，BP 通过自动血压计来测量。死亡信息是从生命统计记录中确定的。
在 1998 年至 2010 年期间，共有 442 人死亡，其中 53%为心血管疾病。快速、中速和慢速步行者的平均 BP 水平（mmHg）分别为：136、139 和 140mmHg（收缩压），p=0.02 和 75、76 和 77mmHg（舒张压），p=0.08。收缩压与死亡率之间的关系因自我报告的步行速度而异：在慢速步行者中，每增加 10mmHg 的收缩压，死亡率的调整后的危险比为 0.96（95%置信区间：0.89，1.02），在快速步行者中为 1.29（95%置信区间：1.08，1.55）（p 值<0.001）。我们发现舒张压也存在类似的模式，尽管交互作用没有达到统计学意义；在慢速步行者中，每增加 10mmHg 的舒张压，死亡率的调整后的危险比为 0.89（95%置信区间：0.78，1.02），在快速步行者中为 1.20（95%置信区间：0.82，1.76）（p 值=0.06）。
在功能状态较高的老年人中，升高的收缩压是全因死亡率的一个危险因素。如果在其他研究中得到证实，功能状态的评估可能有助于识别与高血压相关的不良结局风险最高的人群。
