Key result
Extreme SBP is linked to up to ~141% higher mortality risk in older adults.
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?
Observational (n=4,443)
Does the level of systolic and diastolic blood pressure affect all-cause mortality in community-dwelling older adults?
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.
Answers are grounded in this paper and cite their sources.
SBP extremes warrant caution in older adults; supports U-shaped curve but leaves optimal targets open for trials.
Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.
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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.
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