Sanchez-Martínez Mercedes, López-García Esther, Guallar-Castillón Pilar, Cruz Juan J, Orozco Edilberto, García-Esquinas Esther, Rodríguez-Artalejo Fernando, Banegas José R
aCollege of Sciences and Arts, Universidad Católica 'Santa Teresa de Jesús' de Ávila, AvilabDepartment of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ and CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
J Hypertens. 2016 Oct;34(10):2045-52. doi: 10.1097/HJH.0000000000001036.
Social support has been associated with greater nocturnal decline (dipping) in blood pressure (BP) in younger and middle-aged individuals. However, it is uncertain if aggregated measures of social support are related to ambulatory SBP in older adults, where high SBP is frequent and clinically challenging.
We studied 1047 community-living individuals aged at least 60 years in Spain. Twenty-four-hour ambulatory BP was determined under standardized conditions. Social support was assessed with a seven-item questionnaire on marital status, cohabitation, frequency of contact with relatives, or with friends and neighbors, emotional support, instrumental support, and outdoor companionship. A social support score was built by summing the values of the items that were significantly associated with SBP variables, such that the higher the score, the better the support.
Participants' mean age was 71.7 years (50.8% men). Being married, cohabiting, and being accompanied when out of home were the support items significantly associated with SBP variables. After adjustment for sociodemographic (age, sex, education), behavioral (BMI, alcohol, tobacco, salt consumption, physical activity, Mediterranean diet score), and clinical variables [sleep quality, mental stress, comorbidity, BP medication, and ambulatory BP levels and heart rate (HR)], one additional point in the social support score built with the abovementioned three support variables, was associated with a decrease of 0.93 mmHg in night-time SBP (P = 0.039), totaling 2.8 mmHg decrease for a score of 3 vs. 0. The three-item social support score was also inversely associated with the night/day SBP ratio (β = -0.006, P = 0.010).
In older adults, social support is independently associated with lower nocturnal SBP and greater SBP dipping. Further research is needed in prospective studies to confirm these results.
社会支持与年轻和中年个体夜间血压（BP）更大幅度的下降（血压波动）有关。然而，对于老年人而言，社会支持的综合测量指标是否与动态收缩压（SBP）相关尚不确定，因为老年人中高血压很常见且在临床上具有挑战性。
我们研究了西班牙1047名年龄至少60岁的社区居住个体。在标准化条件下测定24小时动态血压。通过一份关于婚姻状况、同居情况、与亲属或朋友及邻居的联系频率、情感支持、工具性支持和户外陪伴的七项问卷来评估社会支持。通过对与SBP变量显著相关的项目分值求和构建社会支持得分，得分越高，支持越好。
参与者的平均年龄为71.7岁（男性占50.8%）。已婚、同居以及出门时有陪伴是与SBP变量显著相关的支持项目。在对社会人口统计学（年龄、性别、教育程度）、行为（体重指数、饮酒、吸烟、盐摄入量、身体活动、地中海饮食得分）和临床变量[睡眠质量、精神压力、合并症、血压药物治疗以及动态血压水平和心率（HR）]进行调整后，由上述三个支持变量构建的社会支持得分每增加一分，夜间SBP下降0.93 mmHg（P = 0.039），得分为3分与0分相比，夜间SBP总共下降2.8 mmHg。三项社会支持得分也与夜间/日间SBP比值呈负相关（β = -0.006，P = 0.010）。
在老年人中，社会支持与较低的夜间SBP和更大的SBP波动独立相关。前瞻性研究需要进一步研究以证实这些结果。
