Blood pressure as a predictor of cardiovascular events in the elderly: the William Hale Research Program

Abstract

This study evaluates the association between blood pressure (BP) and the risk of developing cardiovascular disease (CVD) events in the elderly. The Morton Plant Mease Foundation has followed 4008 elderly patients 464 years of age for at least 5 years. Systolic and diastolic blood pressure (SBP and DBP) was divided into categories. Cardiovascular disease events were classified as myocardial infarction, stroke, and CVDrelated deaths reported from the National Death Index. Cox proportional hazard ratios were used to assess the relationship between BP and CVD events and controlled for weight, gender, smoker, and alcohol use. Ages o75 and X75 years were assessed separately. After 11.1 years of follow-up, elevated SBP (P ¼ o0.0001) is strongly associated with developing a future CVD event; the relationship is linear and graded and holds for ages above and below 75 years. The frequency of CVD events was lowest in the SBP o120 mm Hg group. In subjects o75 years of age, DBP elevations were not a significant risk factor for CVD events. (relative risk (RR): DBP 70 to o80 mm Hg ¼ 0.92; DBP 80 to o90 mm Hg ¼ 0.88; DBP X90 mm Hg ¼ 1.02.) With subjects X75 years of age, a DBP between 80 and 90 is associated with the lowest significant risk for CVD (RR: DBP 70 to o80 mm Hg ¼ 0.74; DBP 80 to o90 mm Hg ¼ 0.59; DBP X90 ¼ 0.71). In conclusion, these findings support the Joint National Committee on Hypertension recommendations for SBP in the elderly. Further studies are warranted to identify optimal DBP for the elderly at various ages.

Association of low fetuin-A levels with periodontitis in community-dwelling adults

“…Age, SBP, DBP, and past/current smoking status were linked to periodontitis in previous studies [16,17] and significantly differed between the no/ mild and moderate/severe periodontitis groups in the present study (Table 1). In addition, serum fetuin-A levels were significantly lower for moderate/severe periodontitis than for no/mild periodontitis (Table 1), which was also the case in a previous study [10].…”

Blood Pressure Associates with Standing Balance in Elderly Outpatients

“…Both OH and hypertension are signs of impaired blood pressure regulation [3], [4], which is associated with increased risk of cardiovascular events [5]–[7], falls [8]–[14], and mortality [15]–[18]. Another important risk factor of falls is impaired standing balance [13], [19], [20] resulting from the deterioration of underlying systems, i.e.…”

A Pilot Study on Level of Blood Vasoactive Factors in Prehypertensive and Hypertensive Patients

“…This redefinition was based mainly on the results of a number of epidemiological and clinical studies that both systolic and diastolic BPs has a strong, continuous, graded, and epidemiologically significant positive association with CVD outcomes (15). Studies have shown that compared with normal BP, prehypertension is associated with a 27% increase in all-cause mortality and 66% increase in CVD mortality (16), and is associated with CVD risk such as obesity, abnormal blood lipid profiles, subclinical atherosclerosis, elevated CRP, tumor necrosis factor-α, homocysteine, oxidized LDL, and other inflammatory markers (17).…”