Si Yueqiao, Lu Binjun, Ma Lanlan, Zheng Juanjuan, Wang Wei Eric
Department of Geriatrics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400010, PR China; Department of General Practice, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, PR China.
Department of Geriatrics, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400010, PR China.
Arch Gerontol Geriatr. 2025 Jul;134:105828. doi: 10.1016/j.archger.2025.105828. Epub 2025 Mar 20.
This study aimed to investigate the impact of blood pressure levels on all-cause and cardiovascular disease (CVD) mortality in hypertensive patients over 80-year-old using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018.
A total of 8406 hypertensive patients under 80-year-old and 1082 hypertensive patients over 80-year-old were included. Kaplan-Meier curves, Cox proportional hazards regression models, and restricted cubic spline plots were employed.
In patients over 80-year-old, neither systolic blood pressure (SBP) nor diastolic blood pressure (DBP) was significantly associated with all-cause or CVD mortality (P > 0.05). However, in hypertensive patients under 80-year-old, significant differences in mortality were observed across different SBP and DBP subgroups (P < 0.05), with an optimal SBP range of 120-140 mmHg associated with reduced all-cause mortality risk. In patients over 80-year-old, male patients, high urinary albumin-to-creatinine ratio, total cholesterol, red blood cells, and elevated lymphocyte and neutrophil percentages were associated with increased all-cause mortality; SBP interaction with these risk factors slightly reduced the hazard ratio values separately.
Based on NHANES data from 2009 to 2018, tolerable SBP and DBP levels appear to have no significant impact on all-cause or CVD mortality in hypertensive patients over 80-year-old".
本研究旨在利用2009 - 2018年美国国家健康与营养检查调查（NHANES）的数据，调查血压水平对80岁以上高血压患者全因死亡率和心血管疾病（CVD）死亡率的影响。
共纳入8406例80岁以下高血压患者和1082例80岁以上高血压患者。采用Kaplan - Meier曲线、Cox比例风险回归模型和受限立方样条图。
在80岁以上患者中，收缩压（SBP）和舒张压（DBP）均与全因或CVD死亡率无显著相关性（P > 0.05）。然而，在80岁以下高血压患者中，不同SBP和DBP亚组的死亡率存在显著差异（P < 0.05），最佳SBP范围为120 - 140 mmHg与全因死亡风险降低相关。在80岁以上患者中，男性患者、高尿白蛋白肌酐比值、总胆固醇、红细胞以及淋巴细胞和中性粒细胞百分比升高与全因死亡率增加相关；SBP与这些危险因素的相互作用分别略微降低了风险比值。
基于2009年至2018年的NHANES数据，可耐受的SBP和DBP水平似乎对80岁以上高血压患者的全因或CVD死亡率没有显著影响。
