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November 23, 2021Journal of Aging and Health

Extreme SBP is linked to up to ~141% higher mortality risk in older adults.

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Why the study?

The study was conducted to assess the association of systolic blood pressure and diastolic blood pressure with mortality among older adults in Singapore.

Does the level of systolic and diastolic blood pressure affect all-cause mortality in community-dwelling older adults?

Population

4443 older adults (69.5±7.4 years; 60–97 years) in a nationally representative study in Singapore

Comparison

Different SBP and DBP categories vs reference ranges (SBP 100–119 mmHg, DBP 70–79 mmHg)

Design

Prospective observational study

Follow-up

2009 through end-December 2015

Key result

Compared to SBP 100-119 mmHg, mortality risk was significantly higher at extremes of SBP, including <100 mmHg (HR 2.41; 1.23-4.72) and ≥180 mmHg (HR 1.78; 1.12-2.81) among older adults.

Authors

QLQian LianTJTazeen H. JafarJAJohn Carson Allen

Discussion

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Overview

SBP extremes warrant caution in older adults; supports U-shaped curve but leaves optimal targets open for trials.

Study Design

Type

Observational (n=4,443)

Structured PICO

Does the level of systolic and diastolic blood pressure affect all-cause mortality in community-dwelling older adults?

P
Population
4,443 community-dwelling older adults (mean age 69.5±7.4 years; range 60–97 years) participating in a nationally representative study in Singapore.
I
Intervention
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels measured in 2009
C
Comparator
Reference SBP of 100–119 mmHg and DBP of 70–79 mmHg
O
Outcome
All-cause mortality through end-December 2015hard clinical

Main Result

Effect estimate: HR 2.41 (95% CI 1.23-4.72)

Both excessively high and low systolic and diastolic blood pressures are associated with increased all-cause mortality in community-dwelling older adults, demonstrating a U-shaped risk curve.

Cite This Study

Lian et al. (2021) conducted an observational in Community-dwelling older adults (n=4,443). Systolic and diastolic blood pressure vs. SBP 100-119 mmHg and DBP 70-79 mmHg was evaluated on All-cause mortality (HR 2.41, 95% CI 1.23-4.72). Compared to SBP 100-119 mmHg, mortality risk was significantly higher at extremes of SBP, including <100 mmHg (HR 2.41; 1.23-4.72) and ≥180 mmHg (HR 1.78; 1.12-2.81) among older adults.

synapsesocial.com/papers/6a09dac84db796859051984fhttps://doi.org/10.1177/08982643211055245
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