A six-month multicomponent exercise programme did not significantly reduce pulse pressure compared with usual care in senior care facility residents (β= 0.61; 95% CI -5.0 to 3.8; P=0.79).
RCT (n=404)
1:1 cluster randomization
Yes
Does a six-month multicomponent exercise programme reduce pulse pressure in old and oldest old residents of senior care facilities compared with usual care?
A six-month multicomponent exercise program did not significantly reduce pulse pressure compared to usual care in senior care facility residents, though a reduction was seen in highly adherent participants.
Effect estimate: β= 0.61 (95% CI -5.0 to 3.8)
p-value: p=0.79
Abstract Background Elevated pulse pressure, defined as the difference between systolic and diastolic blood pressure, is a common risk factor for cardiovascular disease in older adults and contributes to physical decline. Multicomponent exercise may help to reduce it, but is not fully established in senior care facilities (SCFs). Purpose To assess pulse pressure within the bestform-trial and to investigate whether a six-month multicomponent training programme reduces pulse pressure in old and oldest old residents of SCFs compared with usual care. Methods After 1:1 cluster randomization of 21 SCFs to the intervention group (IG) or to the usual care group (UC), the residents in the IG participated in a six-month multicomponent exercise programme, while residents in the UC received lifestyle education. Pulse pressure was calculated as the difference between systolic and diastolic blood pressure measured at baseline and after the six-month intervention on both arms. For the analysis, the higher pulse pressure value of the left or right arm was used. Changes in pulse pressure from baseline to six months were analysed using a linear mixed model for group comparison, including age, weight, pre-existing hypertension, and baseline pulse pressure as further covariates and a random cluster effect. Results Out of a total of 404 participants, 289 residents (85.0±6.4 years, mean pulse pressure: 61.3±16.5 mmHg, 79.9% female) with complete data were analysed, including 148 adherent (≥70% training session attendance) participants in the IG and 141 participants in the UC. No significant difference in pulse pressure change was observed between the study groups (β= 0.61, 95% ci -5.0 to 3.8, p = 0.79). However, within the adherent IG participants a significant reduction in pulse pressure from baseline to six months was obtained (Δ = –3.1 mmHg, p = 0.021). No significant change was observed in the UC (Δ = –1.6 mmHg, p = 0.199). Conclusion Pulse pressure is high among residents of senior care facilities. Multicomponent exercise training did not lead to a significant overall reduction in pulse pressure compared with usual care. However, among participants with high training adherence, pulse pressure decreased significantly and remains easy to assess. These findings emphasise the importance of monitoring pulse pressure in SCF-residents and exploring further strategies to foster training adherence in this population.
Schaller et al. (Mon,) conducted a rct in Elevated pulse pressure (n=404). Multicomponent exercise programme vs. Usual care (lifestyle education) was evaluated on Change in pulse pressure from baseline to six months (β= 0.61, 95% CI -5.0 to 3.8, p=0.79). A six-month multicomponent exercise programme did not significantly reduce pulse pressure compared with usual care in senior care facility residents (β= 0.61; 95% CI -5.0 to 3.8; P=0.79).