Key result
Low systolic blood pressure (≤150 mmHg) predicted increased mortality in 90-year-olds regardless of NT-proBNP levels, including a 2-fold increased risk in those with low NT-proBNP.
Why the study?
Does low systolic blood pressure predict increased mortality in 90-year-old subjects irrespective of heart failure status?
Observational (n=267)
Does low systolic blood pressure predict increased mortality in 90-year-old subjects irrespective of heart failure status?
Low systolic blood pressure (≤150 mmHg) predicts increased mortality in 90-year-olds, regardless of NT-proBNP levels or the presence of heart failure.
Answers are grounded in this paper and cite their sources.
Low SBP may flag higher mortality risk in nonagenarians even without elevated NT-proBNP; leaves open optimal BP targets and requires prospective confirmation.
AIMS: To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects without heart failure, defined by low levels of NT-proBNP, as well as in 90-year-old subjects with high levels of NT-proBNP. METHODS AND RESULTS: This study was embedded in the Leiden 85-plus Study, an observational population-based prospective study. All 90-year-old participants (n = 267) were included between 2002 and 2004 and followed up for mortality for at least 5 years. Differences in mortality risks were compared between participants with low systolic blood pressure (≤150 mmHg) and high systolic blood pressure (>150 mmHg) within strata of low NT-proBNP (<284 pg/mL for women and <306 pg/mL for men = lowest tertile) vs. high NT-proBNP (middle and highest tertile) at age 90 years. During maximal follow-up of 7.2 years, 212 participants (79%) died. Among participants with low NT-proBNP, low systolic blood pressure gave a two-fold increased risk (hazard ratio 2.0, 95% confidence interval 1.1-3.4) compared with participants with high systolic blood pressure. For participants with high NT-proBNP, low systolic blood pressure provided a 1.7 increased mortality risk (95% confidence interval 1.2-2.3) compared with high systolic blood pressure. CONCLUSION: Low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects, irrespective of the NT-proBNP level. Therefore, the absence or presence of heart failure as determined by NT-proBNP does not influence the prognostic value of low systolic blood pressure with regard to mortality in the oldest old.
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Poortvliet et al. (2012) conducted an observational in Very old age (90 years) (n=267). Low systolic blood pressure (≤150 mmHg) vs. High systolic blood pressure (>150 mmHg) was evaluated on Mortality (HR 2.0, 95% CI 1.1-3.4). Low systolic blood pressure (≤150 mmHg) predicted increased mortality in 90-year-olds regardless of NT-proBNP levels, including a 2-fold increased risk in those with low NT-proBNP.
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