Positive life orientation and blood pressure in older adults: evidence from two Finnish generational cohorts born 20 years apart

BACKGROUND: This study investigates the association between positive life orientation (PLO) and blood pressure (BP) in two Finnish cohorts of older adults born 20 years apart. METHODS: 70-year-old residents of Turku, Finland, were surveyed in 1990 (1920-born TUVA cohort) and in 2010 (1940-born UTUVA cohort). PLO was derived from questionnaire items capturing life satisfaction, feeling needed, future plans, zest for life, and frequency of depressive feelings and loneliness. Associations between PLO and BP were examined using ANOVA with post-hoc tests and chi-squared tests for categorical outcomes, and multiple linear regression adjusted for age, gender, smoking, and BMI. Analyses included 684 TUVA and 870 UTUVA participants. RESULTS: Mean PLO score was 0.86 in TUVA and 0.88 in UTUVA (p = 0.047 for inter-cohort difference). In TUVA, systolic BP differed across PLO tertiles (153.3 ± 20.1, 158.2 ± 21.5, and 156.3 ± 21.0 mmHg; p = 0.038), as did diastolic BP (84.3 ± 10.0, 87.3 ± 10.1, and 85.4 ± 9.9 mmHg; p = 0.005). In UTUVA, no significant BP differences were observed across tertiles (p ≥ 0.13). Regression analyses showed no significant associations between PLO score and systolic or diastolic BP in either cohort (p ≥ 0.13). In UTUVA, antihypertensive medication use differed across PLO tertiles (61.4%, 55.9%, and 50.7%; p = 0.035). Other comparisons for hypertension prevalence and medication use were not significant (p ≥ 0.217) in the cohorts. CONCLUSIONS: In these two population-based cohorts, PLO had at most a minor relationship with BP, and any such association appeared attenuated in the context of widespread antihypertensive treatment in the later-born cohort.