Key result
Normalized blood pressure (<140/90 mmHg) on antihypertensive therapy was associated with increased all-cause mortality compared to non-normalized BP.
Why the study?
It was unclear whether blood pressure values below 140/90 mmHg during antihypertensive treatment are associated with a decreased risk of all-cause mortality in community-dwelling older adults.
Does normalized blood pressure (<140/90 mmHg) during antihypertensive treatment reduce all-cause mortality in community-dwelling older adults ≥70 years?
Cohort (n=1,628)
Does normalized blood pressure (<140/90 mmHg) during antihypertensive treatment reduce all-cause mortality in community-dwelling older adults ≥70 years?
Answers are grounded in this paper and cite their sources.
Blood pressure values below 140/90 mmHg during antihypertensive treatment may be associated with an increased risk of mortality in octogenarians or elderly patients with previous cardiovascular events.
AIMS: To assess whether blood pressure (BP) values below 140/90 mmHg during antihypertensive treatment are associated with a decreased risk of all-cause mortality in community-dwelling older adults. METHODS AND RESULTS: Within the Berlin Initiative Study, we assembled a cohort of patients ≥70 years treated with antihypertensive drugs at baseline (November 2009-June 2011). End of prospective follow-up was December 2016. Cox proportional hazards models yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality associated with normalized BP [systolic BP (SBP) <140 mmHg and diastolic BP (DBP) <90 mmHg] compared with non-normalized BP (SBP ≥140 mmHg or DBP ≥90 mmHg) overall and after stratification by age or previous cardiovascular events. Among 1628 patients (mean age 81 years) on antihypertensive drugs, 636 exhibited normalized BP. During 8853 person-years of follow-up, 469 patients died. Compared with non-normalized BP, normalized BP was associated with an increased risk of all-cause mortality (incidence rates: 60.3 vs. 48.5 per 1000/year; HR 1.26; 95% CI 1.04-1.54). Increased risks were observed in patients ≥80 years (102.2 vs. 77.5 per 1000/year; HR 1.40; 95% CI 1.12-1.74) and with previous cardiovascular events (98.3 vs. 63.6 per 1000/year; HR 1.61; 95% CI 1.14-2.27) but not in patients aged 70-79 years (22.6 vs. 22.7 per 1000/year; HR 0.83; 95% CI 0.54-1.27) or without previous cardiovascular events (45.2 vs. 44.4 per 1000/year; HR 1.16, 95% CI 0.90-1.48). CONCLUSION: Blood pressure values below 140/90 mmHg during antihypertensive treatment may be associated with an increased risk of mortality in octogenarians or elderly patients with previous cardiovascular events.
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Douros et al. (2019) conducted a cohort in Older adults on antihypertensive drugs (n=1,628). Normalized blood pressure (<140/90 mmHg) vs. Non-normalized blood pressure (≥140/90 mmHg) was evaluated on All-cause mortality (HR 1.26, 95% CI 1.04-1.54). Normalized blood pressure (<140/90 mmHg) on antihypertensive therapy was associated with increased all-cause mortality compared to non-normalized BP.
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