Gutiérrez-Misis A, Sánchez-Santos M T, Banegas J R, Castell M V, González-Montalvo J I, Otero A
Health Sciences University Center San Rafael-Nebrija, Madrid, Spain.
Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
J Hum Hypertens. 2015 Sep;29(9):566-72. doi: 10.1038/jhh.2015.32. Epub 2015 Apr 16.
This study analyzed the relationship between blood pressure and all-cause mortality according to objectively measured walking speed in a Mediterranean population-based sample of older persons. We used data from the longitudinal 'Peñagrande' Cohort Study, initiated in 2008 in a sex- and age-stratified random sample of 1250 people aged ⩾65 years living in Madrid (Spain). A total of 814 individuals participated in the first study wave. The average of two standardized blood pressure readings was used. Walking speed was measured over a 3-m walk and classified as faster (⩾0.8 m s(-1)) or slower. A total of 314 individuals were slower walkers, 475 were faster walkers and 25 did not complete the walk test. Cox proportional hazards models stratified by walking speed were used to assess the association between blood pressure and all-cause death. Non-linear relationship between BP and mortality was explored by a restricted cubic spline analysis. There were 171 deaths from study entry through 31 March 2013. Systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mmHg were associated with higher mortality than blood pressure values above 140 and 90 mm Hg, respectively, but this association reached statistical significance only for systolic blood pressure and only in the slower walkers. In conclusion, systolic blood pressure levels <140 mm Hg were found associated with higher risk of total mortality among slower walkers in an old Spaniard population cohort.
本研究在一个以地中海地区为基础的老年人群样本中，根据客观测量的步行速度分析了血压与全因死亡率之间的关系。我们使用了“佩尼亚格兰德”纵向队列研究的数据，该研究于2008年启动，对居住在马德里（西班牙）的1250名年龄≥65岁的人群进行了性别和年龄分层随机抽样。共有814人参与了首次研究波次。采用两次标准化血压读数的平均值。步行速度通过3米步行测量，并分为较快（≥0.8米/秒）或较慢。共有314人步行较慢，475人步行较快，25人未完成步行测试。采用按步行速度分层的Cox比例风险模型评估血压与全因死亡之间的关联。通过受限立方样条分析探索血压与死亡率之间的非线性关系。从研究开始到2013年3月31日共有171例死亡。收缩压<140毫米汞柱和舒张压<90毫米汞柱分别比血压值高于140和90毫米汞柱时的死亡率更高，但这种关联仅在收缩压方面具有统计学意义，且仅在步行较慢者中存在。总之，在一个西班牙老年人群队列中，发现收缩压水平<140毫米汞柱与步行较慢者的全因死亡风险较高有关。
