Elevated systolic blood pressure (≥140 mm Hg) was associated with increased mortality in faster-walking older adults (HR 1.35; 95% CI 1.03-1.77), but not in slower walkers.
Cohort (n=2,340)
Yes
Does elevated blood pressure increase mortality risk in elderly adults, and is this association modified by walking speed?
The association between elevated blood pressure and mortality in elderly adults is modified by frailty (walking speed), suggesting that blood pressure targets may need to be individualized based on functional status.
Effect estimate: HR 1.35 (95% CI 1.03-1.77)
BACKGROUND: The association of hypertension and mortality is attenuated in elderly adults. Walking speed, as a measure of frailty, may identify which elderly adults are most at risk for the adverse effects of hypertension. We hypothesized that elevated blood pressure (BP) would be associated with a greater risk of mortality in faster-, but not slower-, walking older adults. METHODS: Participants included 2340 persons 65 years and older in the National Health and Nutrition Examination Survey, 1999-2000 and 2001-2002. Mortality data were linked to death certificates in the National Death Index. Walking speed was measured over a 20-ft (6 m) walk and classified as faster (≥ 0.8 m/s n = 1307), slower (n = 790), or incomplete (n = 243). Potential confounders included age, sex, race, survey year, lifestyle and physiologic variables, health conditions, and antihypertensive medication use. RESULTS: Among the participants, there were 589 deaths through December 31, 2006. The association between BP and mortality varied by walking speed. Among faster walkers, those with elevated systolic BP (≥ 140 mm Hg) had a greater adjusted risk of mortality compared with those without (hazard ratio HR, 1.35; 95% CI, 1.03-1.77). Among slower walkers, neither elevated systolic nor diastolic BP (≥ 90 mm Hg) was associated with mortality. In participants who did not complete the walk test, elevated BP was strongly and independently associated with a lower risk of death: HR, 0.38; 95% CI, 0.23-0.62 (systolic); and HR, 0.10; 95% CI, 0.01-0.81 (diastolic). CONCLUSIONS: Walking speed could be a simple measure to identify elderly adults who are most at risk for adverse outcomes related to high BP.
Odden et al. (Mon,) conducted a cohort in Hypertension (n=2,340). Elevated blood pressure vs. Without elevated blood pressure was evaluated on Mortality (HR 1.35, 95% CI 1.03-1.77). Elevated systolic blood pressure (≥140 mm Hg) was associated with increased mortality in faster-walking older adults (HR 1.35; 95% CI 1.03-1.77), but not in slower walkers.