Key result
The predictive value of systolic blood pressure ≥160 mmHg for all-cause mortality decreased significantly with increasing age, from HR 1.7 in adults aged 55-64 years to HR 0.7 in those aged ≥85 years.
Why the study?
Does the predictive value of systolic blood pressure for mortality change across increasing age groups in older adults without prior cardiovascular disease?
Cohort (n=4,612)
No
Does the predictive value of systolic blood pressure for mortality change across increasing age groups in older adults without prior cardiovascular disease?
Hazard Ratio: 0.7 (95% CI 0.4–1.1)
p-value: p=<0.001 for trend
The predictive value of high systolic blood pressure for mortality decreases with advancing age, predicting higher risk between ages 55 and 75 but showing a trend toward lower risk in those aged 85 and older.
There are indications that in persons of older age, systolic blood pressure (SBP) is no longer associated with mortality. This raises the question whether the predictive value of SBP changes from younger to older age groups. Analysis in the Rotterdam Study, a population-based prospective cohort study among 4,612 participants aged ≥55 years without previous cardiovascular disease and with a median follow-up of 14.9 (interquartile range, 11.1-15.8) years. Within four age groups (55-64, 65-74, 75-84, ≥85 years), the predictive value of baseline SBP for mortality was studied. From age 55 to ≥85 years, risk of all-cause mortality associated with SBP ≥160 mmHg decreased from HR 1.7 (95%CI 1.2-2.2) to HR 0.7 (95%CI 0.4-1.1), p for trend <0.001. For participants with SBP 140-159 mmHg, the risk decreased from HR 1.2 (95%CI 0.9-1.5) to HR 0.7 (95%CI 0.5-1.1), p for trend <0.001. Analyses in the 5-year age groups showed an increased risk with higher SBPs up to age 75 years. After 75 years, a trend towards SBP no longer being associated with an increased mortality risk was seen in our study. These findings need to be considered with recently reported beneficial effects of antihypertensive treatment in this age group.
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Blom et al. (2011) conducted a cohort in No previous cardiovascular disease (n=4,612). Systolic blood pressure ≥160 mmHg vs. Systolic blood pressure <140 mmHg was evaluated on All-cause mortality (HR 0.7, 95% CI 0.4-1.1, p=<0.001 for trend). The predictive value of systolic blood pressure ≥160 mmHg for all-cause mortality decreased significantly with increasing age, from HR 1.7 in adults aged 55-64 years to HR 0.7 in those aged ≥85 years.
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