Department of Translational Medical Sciences, University of Naples Federico II, Napoli, Italy; Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France.
Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France; UMR INSERM 1295, Université Toulouse III, Toulouse, France; Department of Pharmacy, Toulouse University, Toulouse, France.
Eur J Intern Med. 2024 Jul;125:82-88. doi: 10.1016/j.ejim.2024.03.001. Epub 2024 Mar 18.
The effectiveness of the body physiological regulatory mechanisms declines in late life, and increased Blood Pressure Variability (BPV) may represent an alteration in cardiovascular homeostatic patterns. Intrinsic Capacity (IC) has been proposed by the World Health Organization as a marker of healthy aging, based on individual's functional abilities and intended at preserving successful aging. We aimed to investigate the association of visit-to-visit BPV with IC decline in a population of community-dwelling older adults.
The study population consisted of 1407 community-dwelling participants aged ≥70 years from the MAPT study evaluated during the 5-year follow-up. Systolic BPV (SBPV) and diastolic BPV (DBPV) were determined through six indicators. Cognition, psychology, locomotion and vitality constituted the four IC domains assessed. Total IC Z-score resulted from the sum of the four domains Z-scores divided by 4. The incidence of domain impairment over time was also assessed.
Higher SBPV was significantly associated with poorer IC Z-scores in all linear mixed models [1-SD increase of CV%: β(SE)=-0.010(0.001), p < 0.01]. Similar results were observed for DBPV [1-SD increase of CV%: β(SE)=-0.003(0.001), p = 0.02]. Incident IC impairment was significantly higher in participants with greater SBPV, [HR=1.16 (95 % CI, 1.01-1.33), p = 0.03], while greater DBPV did not show a higher risk of incident IC impairment.
Greater BPV is associated with IC decline over time. Our findings support BP instability as a presumable index of altered cardiovascular homeostatic mechanism, suggesting that BPV might be a clinical marker of aging and addressable risk factor for promoting healthy aging.
人体生理调节机制的有效性会随着年龄的增长而下降，血压变异性（BPV）的增加可能代表心血管稳态模式的改变。世界卫生组织（WHO）提出内在能力（IC）作为健康衰老的标志物，基于个体的功能能力，旨在保持成功的衰老。我们旨在研究在一个社区居住的老年人人群中，随访间血压变异性与 IC 下降的相关性。
该研究人群包括来自 MAPT 研究的 1407 名≥70 岁的社区居住参与者，在 5 年的随访期间进行评估。通过 6 项指标确定收缩压变异性（SBPV）和舒张压变异性（DBPV）。认知、心理、运动和活力构成了评估的四个 IC 领域。总 IC Z 评分由四个领域 Z 评分之和除以 4 得出。还评估了随时间推移各领域损伤的发生率。
所有线性混合模型中，较高的 SBPV 与 IC Z 评分较差显著相关[CV%每增加 1 个标准差：β（SE）=-0.010（0.001），p <0.01]。DBPV 也观察到类似的结果[CV%每增加 1 个标准差：β（SE）=-0.003（0.001），p = 0.02]。SBPV 较高的参与者发生 IC 损伤的比例显著更高[HR=1.16（95%CI，1.01-1.33），p = 0.03]，而 DBPV 较高则与发生 IC 损伤的风险增加无关。
较大的 BPV 与随时间推移的 IC 下降相关。我们的发现支持 BP 不稳定是心血管自主调节机制改变的推测指标，提示 BPV 可能是衰老的临床标志物，也是促进健康衰老的可干预危险因素。
