What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension (n=571). Intervention: History of hypertension vs. No history of hypertension. Primary outcome: All cause mortality (RR 1.19, 95% CI 0.91-1.55).

What does this research mean for the field?

A history of hypertension in 85-year-olds increases cardiovascular mortality but not all-cause mortality, while current high blood pressure is not a risk factor for mortality in this age group. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the relationship between hypertension history, current blood pressure, and mortality in individuals aged 85 and older.

January 4, 2006Journal of Hypertension

In a population-based prospective study, no association between high blood pressure and mortality after age 85 years

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Key result

A history of hypertension in 85-year-olds increased cardiovascular mortality (RR 1.60; 95% CI 1.06-2.40) but not all-cause mortality (RR 1.19; 95% CI 0.91-1.55).

Why the study?

Does a history of hypertension or current high blood pressure impact mortality in 85-year-old individuals?

Key Points

To investigate the relationship between hypertension history, current blood pressure, and mortality in individuals aged 85 and older.
Population-based cohort study in Leiden, The Netherlands with 599 participants enrolled at age 85.
Mean follow-up of 4.2 years with medical histories from practitioners and blood pressure measured twice at baseline.
Main outcome measures were all-cause and cardiovascular mortality.
39.2% had a history of hypertension; 290 participants died during follow-up, 119 from cardiovascular causes.
Increased cardiovascular mortality observed in those with hypertension (RR 1.60, CI 1.06-2.40), but equal all-cause mortality (RR 1.19, CI 0.91-1.55).
High blood pressure at age 85 was not associated with increased mortality; low baseline blood pressure (<140/70 mmHg) linked to excess mortality, especially in those with hypertension.

Study Design

Type

Cohort (n=571)

Multicenter

Structured PICO

Does a history of hypertension or current high blood pressure impact mortality in 85-year-old individuals?

Population

571 inhabitants of Leiden, The Netherlands, enrolled on their 85th birthday (birth-cohort 1912-1914) with no selection criteria related to health or demographic characteristics.

Intervention

History of hypertension and current high blood pressure at age 85

Comparator

No history of hypertension and normal/lower blood pressure

Outcome

All cause and cardiovascular mortalityhard clinical

Main Result

Effect estimate: RR 1.19 (95% CI 0.91-1.55)

In 85-year-olds, high blood pressure is not a risk factor for mortality, and blood pressure below 140/70 mmHg is associated with excess mortality, suggesting aggressive blood pressure lowering may be harmful in the oldest old.

Discussion

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Implication

May identify higher CV mortality risk in 85-year-olds with prior hypertension; leaves open optimal BP targets pending trials.

Cite This Study

Bemmel et al. (2006) conducted a cohort in Hypertension (n=571). History of hypertension vs. No history of hypertension was evaluated on All cause mortality (RR 1.19, 95% CI 0.91-1.55). A history of hypertension in 85-year-olds increased cardiovascular mortality (RR 1.60; 95% CI 1.06-2.40) but not all-cause mortality (RR 1.19; 95% CI 0.91-1.55).

synapsesocial.com/papers/6a15eea966ebfaa9bad11df5 https://doi.org/10.1097/01.hjh.0000200513.48441.8e

Topics

Hypertension management

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