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High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults

Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older a...

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Autores principales: Wu, Chen-Yi, Hu, Hsiao-Yun, Chou, Yiing-Jenq, Huang, Nicole, Chou, Yi-Chang, Li, Chung-Pin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059018/
https://www.ncbi.nlm.nih.gov/pubmed/26632749
http://dx.doi.org/10.1097/MD.0000000000002160
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author Wu, Chen-Yi
Hu, Hsiao-Yun
Chou, Yiing-Jenq
Huang, Nicole
Chou, Yi-Chang
Li, Chung-Pin
author_facet Wu, Chen-Yi
Hu, Hsiao-Yun
Chou, Yiing-Jenq
Huang, Nicole
Chou, Yi-Chang
Li, Chung-Pin
author_sort Wu, Chen-Yi
collection PubMed
description Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older adults. A total of 77,389 community-dwelling adults, aged ≥65 years, were followed between 2006 and 2010. Mortality was determined using matching cohort identifications with national death files. Cox proportional hazards regression models were used to evaluate the relationship of BP with all-cause, cardiovascular disease (CVD), and expanded-CVD mortalities. The mortality risks of the stage 2–3 hypertension group were substantial (all-cause mortality: hazard ratio [HR]: 1.23; 95% confidence interval [CI]: 1.10–1.37; CVDs mortality: HR: 1.31; 95% CI: 1.05–1.64; expanded-CVDs mortality: HR: 1.40; 95% CI: 1.15–1.71). The cardiovascular and expanded-cardiovascular mortality risks were lowest when systolic blood pressures were 120 to 129 mm Hg, and increased significantly when systolic blood pressures (SBPs) were ≥160 mm Hg or diastolic BPs were ≥90 mm Hg. A J-curve phenomenon for SBP on CVD and expanded-CVD mortality was observed. The impacts of stage 2–3 hypertension on mortality risks were significantly increased among women. The mortality risks of hypertension were not attenuated with older age. This study provides insight for identifying the optimal BP for survival in older adults, and extends the knowledge of the impacts of hypertension on mortality risks among women and the older adults.
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spelling pubmed-50590182016-11-01 High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults Wu, Chen-Yi Hu, Hsiao-Yun Chou, Yiing-Jenq Huang, Nicole Chou, Yi-Chang Li, Chung-Pin Medicine (Baltimore) 3400 Although hypertension is common among older adults, the optimal blood pressure (BP) for survival in older adults remains unclear. We attempt to use a large cohort to assess the relationship between BP and mortality and to gain insight into what level of BP is required for optimal survival in older adults. A total of 77,389 community-dwelling adults, aged ≥65 years, were followed between 2006 and 2010. Mortality was determined using matching cohort identifications with national death files. Cox proportional hazards regression models were used to evaluate the relationship of BP with all-cause, cardiovascular disease (CVD), and expanded-CVD mortalities. The mortality risks of the stage 2–3 hypertension group were substantial (all-cause mortality: hazard ratio [HR]: 1.23; 95% confidence interval [CI]: 1.10–1.37; CVDs mortality: HR: 1.31; 95% CI: 1.05–1.64; expanded-CVDs mortality: HR: 1.40; 95% CI: 1.15–1.71). The cardiovascular and expanded-cardiovascular mortality risks were lowest when systolic blood pressures were 120 to 129 mm Hg, and increased significantly when systolic blood pressures (SBPs) were ≥160 mm Hg or diastolic BPs were ≥90 mm Hg. A J-curve phenomenon for SBP on CVD and expanded-CVD mortality was observed. The impacts of stage 2–3 hypertension on mortality risks were significantly increased among women. The mortality risks of hypertension were not attenuated with older age. This study provides insight for identifying the optimal BP for survival in older adults, and extends the knowledge of the impacts of hypertension on mortality risks among women and the older adults. Wolters Kluwer Health 2015-10-30 /pmc/articles/PMC5059018/ /pubmed/26632749 http://dx.doi.org/10.1097/MD.0000000000002160 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3400
Wu, Chen-Yi
Hu, Hsiao-Yun
Chou, Yiing-Jenq
Huang, Nicole
Chou, Yi-Chang
Li, Chung-Pin
High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
title High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
title_full High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
title_fullStr High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
title_full_unstemmed High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
title_short High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults
title_sort high blood pressure and all-cause and cardiovascular disease mortalities in community-dwelling older adults
topic 3400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059018/
https://www.ncbi.nlm.nih.gov/pubmed/26632749
http://dx.doi.org/10.1097/MD.0000000000002160
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