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January 27, 2016Journal of HypertensionOpen Access

The association between SBP and mortality risk differs with level of cognitive function in very old individuals

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Why the study?

Does the association of systolic blood pressure with mortality differ with respect to cognitive function in very old individuals?

Population

1115 participants aged 85, 90, and at least 95 years from the Umeå85+/GErontological Regional DAtabase…

Comparison

Systolic blood pressure levels vs SBP 126-139 mmHg

Design

Cohort

Follow-up

2 years

Key result

In very old individuals with severe cognitive impairment (MMSE 0-10), systolic blood pressure ≥165 mmHg significantly increased 2-year all-cause mortality compared to 126-139 mmHg (HR 4.54).

Authors

BWBodil WeidungHLHåkan LittbrandPNPeter Nordström

Discussion

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Overview

High SBP may raise mortality in severe cognitive impairment; hypothesis-generating and should not yet alter practice.

Study Design

Type

Cohort (n=1,115)

Multicenter

Yes

Structured PICO

Does the association of systolic blood pressure with mortality differ with respect to cognitive function in very old individuals?

P
Population
1115 participants aged 85, 90, and at least 95 years from the Umeå85+/GErontological Regional DAtabase cohort study, mean age 89.4 years.
I
Intervention
Systolic blood pressure (SBP) levels (observational exposure)
C
Comparator
SBP 126-139 mmHg
O
Outcome
All-cause mortality within 2 yearshard clinical

Main Result

Effect estimate: HR 4.54 (95% CI 1.52-13.60)

p-value: p=0.007

In very old individuals with severe cognitive impairment, both low (≤125 mmHg) and high (≥165 mmHg) systolic blood pressure are associated with increased 2-year mortality.

Limitations

  • Single measurement of MMSE score and BP did not capture variability over time
  • Lack of 24-h BP monitoring
  • BP measured in supine position, which may have yielded higher values
  • Underrepresentation of women in the study sample compared to those who declined
  • Potential misclassification of mild cognitive impairment due to MMSE sensitivity

Cite This Study

Weidung et al. (2016) conducted a cohort in Cognitive impairment and hypertension (n=1,115). Systolic blood pressure ≥165 mmHg vs. Systolic blood pressure 126-139 mmHg was evaluated on All-cause mortality within 2 years (HR 4.54, 95% CI 1.52-13.60, p=0.007). In very old individuals with severe cognitive impairment (MMSE 0-10), systolic blood pressure ≥165 mmHg significantly increased 2-year all-cause mortality compared to 126-139 mmHg (HR 4.54).

synapsesocial.com/papers/6a15ee9d66ebfaa9bad11df0https://doi.org/10.1097/hjh.0000000000000831
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