Akagi Shinsuke, Takao Soshi, Matsuo Rumi, Matsumoto Naomi, Yorifuji Takashi
Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Laboratory of Clinical Pharmacy, Faculty of Pharmacy, Shujitsu University, Okayama, Japan.
Geriatr Gerontol Int. 2025 Jan;25(1):82-89. doi: 10.1111/ggi.15046. Epub 2024 Dec 12.
The purpose of this study is to investigate the impact of abnormal blood pressure on the risk of all-cause and cardiovascular mortality in a large cohort of older Japanese people aged ≥65 years.
This cohort study enrolled 54 760 participants from Okayama City aged ≥65 years who underwent basic health checkups from April 2006 to March 2008. Based on blood pressure, the participants were divided into six categories, from C1 (lowest) to C6 (highest). To assess the association of blood pressure with all-cause and cardiovascular mortality, we used survival analysis to estimate hazard ratios (HRs) for all-cause mortality and subdistribution HRs (SHRs) for cardiovascular mortality on C3. We then repeated the analyses based on age groups (65-74 years, 75-84 years, and ≥85 years).
The fully adjusted HRs for all-cause mortality, which included all individual potential confounders, were 1.11 (95% confidence interval [CI]: 1.04-1.19) for C5 and 1.23 (95% CI: 1.09-1.38) for C6, respectively. The fully adjusted SHRs for cardiovascular mortality were 1.11 (95% CI: 1.01-1.21) for C4, 1.19 (95% CI: 1.05-1.34) for C5, and 1.36 (95% CI: 1.09-1.70) for C6. In the age-stratification, an increased risk of hypotension was observed with older age. The HR for C1 was 1.28 (95% CI: 1.16-1.41) for ≥85 years.
Hypertension increased the risk of all-cause and cardiovascular mortality among those aged 65-74 and 75-84 years, but not among those aged ≥85 years. Geriatr Gerontol Int 2025; 25: 82-89.
本研究旨在调查血压异常对≥65岁的大量日本老年人全因死亡和心血管死亡风险的影响。
这项队列研究纳入了2006年4月至2008年3月期间在冈山市接受基本健康检查的54760名≥65岁的参与者。根据血压水平，参与者被分为六类，从C1（最低）到C6（最高）。为评估血压与全因死亡和心血管死亡的关联，我们采用生存分析来估计C3组全因死亡的风险比（HRs）和心血管死亡的亚分布风险比（SHRs）。然后我们根据年龄组（65 - 74岁、75 - 84岁和≥85岁）重复进行分析。
包含所有个体潜在混杂因素的全因死亡完全调整后HRs，C5组为1.11（95%置信区间[CI]：1.04 - 1.19），C6组为1.23（95%CI：1.09 - 1.38）。心血管死亡的完全调整后SHRs，C4组为1.11（95%CI：1.01 - 1.21），C5组为1.19（95%CI：1.05 - 1.34），C6组为1.36（95%CI：1.09 - 1.70）。在年龄分层中，随着年龄增长，低血压风险增加。≥85岁组C1的HR为1.28（95%CI：1.16 - 1.41）。
高血压增加了65 - 74岁和75 - 84岁人群的全因死亡和心血管死亡风险，但在≥85岁人群中未增加。《老年医学与老年病学国际杂志》2025年；25：82 - 89。
