Predictive value of attended automated office blood pressure and resting pulse rate for mortality in community‐dwelling octogenarians: Minhang study

Abstract

Systolic blood pressure (SBP) and resting pulse rate (RPR) have been linked to mortality and cardiovascular events in younger population. Till now, no studies simultaneously investigate the non‐linear association of SBP and RPR with all‐cause and cardiovascular mortality among population aged 80 and older. Data of 2828 eligible participants were selected from electronic health records linked attended automated office blood pressure measurement system. The dose‐response relationship between the SBP, RPR, and the risk of all‐cause and cardiovascular mortality was analyzed by Cox model with restricted cubic splines. During the 3.6‐year follow‐up, 442 deaths occurred. Comparing with the optimal SBP (117‐145 mmHg), the lower (HR: 1.39, 95% CI: 1.07‐1.81) and higher SBP (HR: 1.34, 95% CI: 1.08‐1.65) were significantly associated with an increasing risk of all‐cause mortality. The higher SBP (>144 mmHg) was associated with cardiovascular mortality, with the HR (95% CI) as 1.51 (1.07‐2.12). The faster RPR showed the higher risk of all‐cause (HR: 1.36, 95% CI: 1.05‐1.76) and cardiovascular (HR: 1.51, 95% CI: 1.07‐2.13) mortality. We found both higher SBP and faster RPR were independently associated with all‐cause and cardiovascular mortality, and lower SBP was only associated with the increased risk of all‐cause mortality in oldest old community‐dwelling Chinese population. Our results demonstrate the prognostic importance of both SBP and RPR in the elderly.

An influence of elevated heart rate by automated office blood pressure measurement on cardiovascular events risk

“…Wang et al showed that Chinese octogenarians with elevated AOBM HR are associated with all-cause and cardiovascular mortalities. [25] However, the trial showed that low HR values were associated with increased risk for all-cause and cardiovascular mortalities. The lowest risk of these endpoints was observed when HR remained within 77-85 b.p.m.…”

Associations between long-term blood pressure trajectory and all-cause and CVD mortality among old people in China

“…As for single measurement, a nationwide population-based cohort study included 374,250 participants older than 75 years old in Korea found that SBP higher than 170 mmHg had a 17% (HR:1.17, 95% CI: 1.13–1.21) higher risk of mortality compared with SBP at 120–129 mmHg ( 17 ). A community-dwelling octogenarians' study in Shanghai also found that compared with SBP at 117–145 mmHg, higher SBP was associated with a 34% higher risk of all-cause mortality ( 36 ).…”