Busby W J, Campbell A J, Robertson M C
Department of Medicine, University of Otago Medical School, Dunedin, New Zealand.
Age Ageing. 1994 Jan;23(1):69-74. doi: 10.1093/ageing/23.1.69.
Low blood pressure has been associated with increased mortality in older people, but it is unclear whether the hypotension is a risk in its own right or just a marker of disease. In this study we investigated the extent to which those in the lowest decile of systolic and diastolic pressures could be predicted by measures of cardiovascular disease and frailty. We studied 782 people 70 years and over drawn from the only group of general practices in a rural township. Hypotension was defined separately for systolic and diastolic blood pressures as a pressure less than the tenth percentile for the sample as a whole. This was a systolic pressure of < or = 122 mmHg and a diastolic pressure of < or = 68 mmHg. There was a significant relationship between low systolic blood pressure and male sex, history of myocardial infarction by questionnaire and low body mass index (BMI), and between low diastolic pressure and male sex, history of angina and myocardial infarction, use of one or more hypotensive drugs, low BMI, low corrected arm muscle area, low self-maintenance score and the use of two or more home services. There was no association with ECG abnormalities. In the multivariate analysis only 4.2% of those with low diastolic pressure and none of those with low systolic pressure could be correctly classified. Hypotension in old age is only partially explained by established cardiovascular disease and frailty.
低血压与老年人死亡率增加有关，但尚不清楚低血压本身是否为一种风险因素，还是仅仅是疾病的一个指标。在本研究中，我们调查了通过心血管疾病和身体虚弱的测量指标能够在多大程度上预测收缩压和舒张压处于最低十分位数的人群。我们研究了从一个乡村城镇唯一的一组全科医疗中抽取的782名70岁及以上的人群。收缩压和舒张压的低血压分别定义为低于整个样本第十百分位数的血压。这分别是收缩压≤122 mmHg和舒张压≤68 mmHg。收缩压降低与男性、问卷调查得出的心肌梗死病史以及低体重指数（BMI）之间存在显著关系，舒张压降低与男性、心绞痛和心肌梗死病史、使用一种或多种降压药物、低BMI、低校正手臂肌肉面积、低自我维持评分以及使用两种或更多居家服务之间存在显著关系。与心电图异常无关联。在多变量分析中，舒张压降低的人群中只有4.2%能够被正确分类，而收缩压降低的人群中无人能够被正确分类。老年低血压仅部分可由已确诊的心血管疾病和身体虚弱来解释。
