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Lookup NU author(s): Emerita Professor Carol Jagger, Dr Andrew KingstonORCiD, Professor Dame Louise Robinson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. OBJECTIVES: While randomized controlled trials have proven the benefits of blood pressure (BP) lowering in participating octogenarians, population-based observational studies suggest an association between low systolic blood pressure (SBP) and faster overall decline. This study investigates the effects of BP-lowering treatment, a history of cardiovascular diseases (CVD), and cognitive and physical fitness on the associations between SBP and health outcomes in the very old. METHODS: Five cohorts from the Towards Understanding Longitudinal International older People Studies (TULIPS) consortium were included in a two-step individual participant data meta-analysis (IPDMA). We pooled hazard ratios (HR) from Cox proportional-hazards models for 5-year mortality and estimates of linear mixed models for change in cognitive and functional decline. Models were stratified by BP-lowering treatment, history of CVD, Mini-Mental State Examination scores, grip strength (GS) and body mass index (BMI). RESULTS: Of all 2480 participants (59.9% females, median 85 years), median baseline SBP was 149 mmHg, 64.3% used BP-lowering drugs and 47.3% had a history of CVD. Overall, higher SBP was associated with lower all-cause mortality (pooled HR 0.91 [95% confidence interval 0.88-0.95] per 10 mmHg). Associations remained irrespective of BP-lowering treatment, history of CVD and BMI, but were absent in octogenarians with above-median MMSE and GS. In pooled cohorts, SBP was not associated with cognitive and functional decline. CONCLUSION: While in the very old with low cognitive or physical fitness a higher SBP was associated with a lower all-cause mortality, this association was not evident in fit octogenarians. SBP was not consistently associated with cognitive and functional decline.
Author(s): Bogaerts JMK, Poortvliet RKE, van der Klei VMGTH, Achterberg WP, Blom JW, Teh R, Muru-Lanning M, Kerse N, Rolleston A, Jagger C, Kingston A, Robinson L, Arai Y, Shikimoto R, Gussekloo J
Publication type: Article
Publication status: Published
Journal: Journal of Hypertension
Year: 2022
Volume: 40
Issue: 9
Pages: 1786-1794
Print publication date: 01/09/2022
Online publication date: 11/07/2022
Acceptance date: 14/05/2022
Date deposited: 01/09/2022
ISSN (print): 0263-6352
ISSN (electronic): 1473-5598
Publisher: Lippincott Williams & Wilkins
URL: https://doi.org/10.1097/HJH.0000000000003219
DOI: 10.1097/HJH.0000000000003219
PubMed id: 35822583
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