Normal values for ambulatory blood pressure are presented in a randomly selected age- and gender-stratified population. Differences between office blood pressure and ambulatory blood pressure increased with age suggesting that the previously observed higher blood pressure seen in the elderly partly might be explained by a greater impact of white coat hypertension in older people.

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OBJECTIVE: To describe differences in the 22 y mortality risk associated with body mass index (BMI), body fat or fatfree mass, in order to examine if the differential health consequences of fat and fat-free mass may be responsible for elevated mortality rates at both high and low BMI. DESIGN: Prospective cohort study, a 22 y follow-up. SETTING: General community. The study of men born in 1913, Gothenburg. SUBJECTS: 787 men aged 60 y. MAIN OUTCOME MEASURES: Number and time of total deaths from 1973 to 1995. RESULTS: The risk of dying was a linear function of percentage fat and fat-free mass, and increased from a relative risk of 1.00 in men belonging to the lowest ®fth to 1.4 (95% con®dence interval 1.11 ± 1.99) in men in the highest ®fth of percentage fat mass. For BMI the lowest risk was observed for men belonging to the middle ®fth of BMI. When the relative risk was set at 1.00 for subjects belonging to the middle ®fth of BMI the risk associated with the low BMI ®fth was 1.3 (95% con®dence interval 0.94 ± 1.68) and that with the highest ®fth was 1.5 (95% con®dence interval 1.09 ± 1.96). Analyses including both body fat and fat-free mass showed that total mortality was a linear increasing function of high fat and low fat-free mass. CONCLUSION: The apparent U-shaped association between BMI and total mortality may be the result of compound risk functions from body fat and fat-free mass.

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An association between low body mass index (BMI) and poor prognosis in patients with chronic obstructive pulmonary disease (COPD) has been found in a number of studies. The prevalence and prognostic importance of weight change in unselected subjects with COPD was examined.Subjects with COPD, defined as forced expiratory volume in one second/forced vital capacityv0.7 in the Copenhagen City Heart Study and who attended two examinations 5 yrs apart, were followed for 14 yrs for COPD-related and all-cause mortality.The proportion of subjects who lost w1 unit BMI (y3.8 kg) between the two examinations was significantly associated with level of COPD, reaching y30% in subjects with severe COPD. After adjusting for age, smoking habits, baseline BMI and lung function, weight loss was associated with higher mortality in both persons with and without COPD (rate ratio (RR) for weight loss w3 BMI units 1.71 (95% confidence interval (CI): 1.32-2.23) and 1.63 (95% CI 1.38-1.92), respectively). Weight gain was associated with increased mortality, but not significantly so in subjects with COPD. Risk of COPD-related death increased with weight loss (RR 2.14 (95% CI 1.18-3.89)), but not with weight gain (RR 0.95 (95% CI 0.43-2.08)). In subjects without COPD or with mild-to-moderate COPD, the effect of weight change was the same irrespective of initial weight. In subjects with severe COPD, there was a significant risk ratio modification (p=0.045) between effect of baseline BMI and weight change: in the normal-to-underweight (BMIv25), best survival was seen in those who gained weight, whereas for the overweight and obese (BMIo25), best survival was seen in stable weight.A high proportion of subjects with chronic obstructive pulmonary disease experienced a significant weight loss, which was associated with increased mortality. The results support further intervention studies that aim at avoiding weight loss in normal-tounderweight chronic obstructive pulmonary disease patients. In patients with chronic obstructive pulmonary disease (COPD), a number of observational studies have shown that a low body mass index (BMI) is associated with a poor prognosis independent of the degree of ventilatory impairment [1][2][3]. Consequently, nutritional support has been advocated as a useful part of the care of COPD patients with low BMI. A number of nutritional intervention studies with pulmonary function, exercise capacity or weight increase as outcome have been performed [4][5][6][7]. However, a recent meta-analysis reviewed the effect of these studies and concluded that the studies did not document a beneficial effect of nutritional support in patients with COPD [8]. So far, no controlled intervention study with mortality as outcome has tested the effect of nutritional support in these patients.A different way of addressing this question is in an epidemiological setting to study mortality rates of subjects with COPD and relate these to changes in body weight. In a previous study, the present authors have shown that low BMI was an inde...