Relación entre presión arterial y mortalidad a los 4 años de seguimiento en una cohorte de individuos mayores de 80 años

Farré, Teresa Badía; Formiga, Francesç; Ortega, Jesús Almeda; Feliu, Assumpta Ferrer; Rojas-Farreras, S.

doi:10.1016/j.medcli.2010.11.029

Cited by 10 publications

(7 citation statements)

References 23 publications

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“…The evidence for treating patients 80 years and older has long been debated; epidemiological studies have detected the association of higher blood pressure with increased mortality risk for this age group. 2 3 4 5 6 7 8 9 10 11 In the present study, compared with a middle value range of systolic blood pressure, a higher value (>154 mm Hg) predicted a higher risk of all cause mortality and cardiovascular mortality, which was in accordance with other investigations. 17 47 48 49 50 …”

Section: Discussionsupporting

confidence: 92%

“…Previous clinical or epidemiological studies have reported conflicting results regarding this association. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Most observational studies have found that high blood pressure predicted higher mortality risk, 3 4 5 6 7 8 9 10 11 although some observational studies reported no relation of blood pressure with mortality. 15 16 …”

Section: Discussionmentioning

confidence: 99%

“…The following limitations with previous studies need to be addressed: 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 …”

Section: Introductionmentioning

confidence: 97%

“…However, conflicting results have been reported—especially regarding systolic blood pressure and diastolic blood pressure. Most observational studies have found that changes in systolic or diastolic blood pressure predicted higher mortality risk, 3 4 5 6 7 8 9 10 11 even showing a J or U shaped association 12 13 14 ; however, some have failed to detect significant association between blood pressure and mortality. 15 16 One meta-analysis showed that higher systolic blood pressure predicted increased mortality risk in all age groups, including oldest old people.…”

Section: Introductionmentioning

confidence: 99%

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Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

Gao

Yin

et al. 2018

BMJ

136

111

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ObjectiveTo examine the associations of blood pressure with all cause mortality and cause specific mortality at three years among oldest old people in China.DesignCommunity based, longitudinal prospective study.Setting2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, conducted in 22 Chinese provinces.Participants4658 oldest old individuals (mean age 92.1 years).Main outcome measuresAll cause mortality and cause specific mortality assessed at three year follow-up.Results1997 deaths were recorded at three year follow-up. U shaped associations of mortality with systolic blood pressure, mean arterial pressure, and pulse pressure were identified; values of 143.5 mm Hg, 101 mm Hg, and 66 mm Hg conferred the minimum mortality risk, respectively. After adjustment for covariates, the U shaped association remained only for systolic blood pressure (minimum mortality risk at 129 mm Hg). Compared with a systolic blood pressure value of 129 mm Hg, risk of all cause mortality decreased for values lower than 107 mm Hg (from 1.47 (95% confidence interval 1.01 to 2.17) to 1.08 (1.01 to 1.17)), and increased for values greater than 154 mm Hg (from 1.08 (1.01 to 1.17) to 1.27 (1.02 to 1.58)). In the cause specific analysis, compared with a middle range of systolic blood pressure (107-154 mm Hg), higher values (>154 mm Hg) were associated with a higher risk of cardiovascular mortality (adjusted hazard ratio 1.51 (95% confidence interval 1.12 to 2.02)); lower values (<107 mm Hg) were associated with a higher risk of non-cardiovascular mortality (1.58 (1.26 to 1.98)). The U shaped associations remained in sensitivity and subgroup analyses.ConclusionsThis study indicates a U shaped association between systolic blood pressure and all cause mortality at three years among oldest old people in China. This association could be explained by the finding that higher systolic blood pressure predicted a higher risk of death from cardiovascular disease, and that lower systolic blood pressure predicted a higher risk of death from non-cardiovascular causes. These results emphasise the importance of revisiting blood pressure management or establishing specific guidelines for management among oldest old individuals.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

“…The following limitations with previous studies need to be addressed: 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 …”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

Gao

Yin

et al. 2018

BMJ

136

111

View full text Add to dashboard Cite

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“…Sin embargo, la posibilidad de dañ o ocasionado por un descenso demasiado intenso de la PA ha sido ignorado, cuando no silenciado. Es sabido que en la població n anciana la PA baja es un predictor de mortalidad mayor que la hipertensió n arterial 1,2 . Probablemente esto sea debido a la presencia de trastornos subyacentes, por ejemplo la insuficiencia cardiaca, que serían los causantes reales de la mayor mortalidad 3 .…”

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¿Es peligroso reducir excesivamente la presión arterial?: la curva J

Robles¹

2012

Medicina Clínica

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Health and Functional Determinants of Orthostatic Hypotension in Geriatric Ward Patients: A Retrospective Cross Sectional Cohort Study

Wojszel

Kasiukiewicz

Magnuszewski

2019

The Journal of nutrition, health and aging

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Objective: Orthostatic hypotension (OH) is a common problem in older people. Although it is indicated that OH can be a marker of frailty there are no studies that evaluate this relationship in hospitalized patients. The aim of the study was to assess the prevalence of OH in geriatric ward patients and its association with health and functional ability characteristics and patients' frailty status. Design and setting: A retrospective cross-sectional cohort study was conducted among patients aged 60 or over hospitalized in the geriatric ward. Participants: Patients' medical records were analyzed and those with Active Standing Test (AST) results were included in the study. Measurements: Orthostatic hypotension was defined by a drop in blood pressure of at least 20mmHg for systolic blood pressure and at least 10mmHg for diastolic blood pressure within 3minutes of standing up in AST. The database included sociodemographic characteristics, nutritional, functional and cognitive state, comorbidity and medical treatment. Frailty syndrome was diagnosed with Clinical Frailty Scale. Correlations with OH were counted and multivariable logistic regression models were built. Results: 416 patients were hospitalized in the study period and 353 (84.9%) were included, 78 (22.1%) men and 298 (84.4%) 75+ year-old. AST was not available in patients significantly more dependent in ADL and more frail. OH was diagnosed in 57 (16.2%) patients, significantly more frequently in men (systolic-45,5%, systolic-diastolic-40,0%). The significant independent predictors of OH were lower diastolic blood pressure at admittance, nutritional risk in MNA-SF, Parkinson disease, α1-blockers, neuroleptics and memantine, and not the frailty syndrome diagnosed with Clinical Frailty Scale. Conclusions: OH affects a significant percentage of patients in the geriatric ward, although this problem may be underestimated due to limitations in the performance of AST in very frail and functionally dependent patients.

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Relación entre presión arterial y mortalidad a los 4 años de seguimiento en una cohorte de individuos mayores de 80 años

Cited by 10 publications

References 23 publications

Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

Revisiting the association of blood pressure with mortality in oldest old people in China: community based, longitudinal prospective study

¿Es peligroso reducir excesivamente la presión arterial?: la curva J

Health and Functional Determinants of Orthostatic Hypotension in Geriatric Ward Patients: A Retrospective Cross Sectional Cohort Study

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