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老年女性纵向身体机能和血压变化:妇女健康倡议研究结果。

Longitudinal physical performance and blood pressure changes in older women: Findings form the women's health initiative.

机构信息

Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.

Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, New York, Buffalo, New York, USA.

出版信息

Arch Gerontol Geriatr. 2022 Jan-Feb;98:104576. doi: 10.1016/j.archger.2021.104576. Epub 2021 Nov 16.

Abstract

BACKGROUND

This study evaluated the association between changes in physical performance and blood pressure (BP) (e.g., systolic [SBP], diastolic [DBP], pulse pressure) in older women.

METHODS

5627 women (mean age 69.8 ± 3.7 y) with grip strength, chair stand, gait speed performance and clinic-measured BP at baseline and at least one follow-up (years 1, 3 or 6) were included. Generalized estimating equation analysis of multivariable models with standardized point estimates described the longitudinal association between physical performance and BP changes in the overall cohort, and in models stratified by baseline cardiovascular disease (CVD), time-varying antihypertensive medication use (none, ≥1) and enrollment age (65-69 y; 70-79 y).

RESULTS

Overall, each z-score unit increment in grip strength was associated with 0.59 mmHg (95% CI 0.10, 1.08) higher SBP, and 0.39 mmHg (95% CI 0.11, 0.67) higher DBP. In stratified models, a standardized increment in grip strength was associated with higher SBP in women without CVD (0.81; 95% CI 0.23-1.39), among antihypertensive medication users (0.93; 95% CI 0.44, 1.41) and non-users (0.37; 95% CI 0.03, 0.71), and in those aged 65-69 y (0.64; 95% CI 0.04, 1.24). Similarly, a standardized increment in any of the three performance measures was associated with modestly higher DBP in antihypertensive medication users, and those aged 70-79 y. Associations between any performance measure and pulse pressure change were not significant.

CONCLUSION

These results suggest a positive, and statistically significant relationship between physical performance and BP that appears to be influenced by CVD history, antihypertensive medication use, and age.

摘要

背景

本研究评估了老年女性身体机能变化与血压(BP)(如收缩压[SBP]、舒张压[DBP]、脉压)之间的关系。

方法

本研究纳入了 5627 名女性(平均年龄 69.8±3.7 岁),她们在基线和至少一次随访(第 1、3 或 6 年)时进行了握力、椅站、步速表现和临床测量血压。使用标准化点估计的广义估计方程分析多变量模型描述了整个队列中身体机能与 BP 变化之间的纵向关联,并在基于基线心血管疾病(CVD)、随时间变化的降压药物使用(无、≥1 种)和入组年龄(65-69 岁;70-79 岁)的分层模型中进行了描述。

结果

总体而言,握力每增加一个 z 分数单位,SBP 就会升高 0.59mmHg(95%CI 0.10,1.08),DBP 升高 0.39mmHg(95%CI 0.11,0.67)。在分层模型中,握力的标准化增量与无 CVD 的女性(0.81;95%CI 0.23-1.39)、降压药物使用者(0.93;95%CI 0.44,1.41)和非使用者(0.37;95%CI 0.03,0.71)以及 65-69 岁的女性(0.64;95%CI 0.04,1.24)的 SBP 升高显著相关。同样,三种表现测量中的任何一种的标准化增量与降压药物使用者和 70-79 岁女性的 DBP 略有升高相关。任何表现测量与脉压变化之间的关联均不显著。

结论

这些结果表明,身体机能与 BP 之间存在积极且具有统计学意义的关系,这种关系似乎受到 CVD 病史、降压药物使用和年龄的影响。

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