Associaitons between blood pressure and mortality among middle-aged and elderly men and women: a cohort study

The aim is to study associations between blood pressure/arterial hypertension (AH) and all-cause and cardiovascular (CVD) mortality among middle-aged and elderly Russian men and women. Methods: This study is a part of the cohort study, conducted in Moscow. Altogether, 898 males and 978 females aged 55 years and older comprised the sample. AH was determined with systolic blood pressure level (SBP) > 140 mmHg and/or diastolic blood pressure (DBP) > 90 mmHg, or on condition of antihypertensive treatment (AHT). Obesity, smoking, hypercholesterolemia, hyperglycemia and a prior stroke were assessed as risk-factors. During the follow-up period (8,05 years) 547 deaths were identified, including 330 CVD. Results: No significant gender differences in the prevalence of arterial hypertension were detected. About 80 % of females and 65 % of males took AHT. Among them, effective treatment was registered in 42 % of females and 32 % of males. Elevated blood pressure was associated with increased all-cause and CVD mortality risk only among women (HR = 1.63; 95 % CI: 1.21-2.19, HR = 1.81; 95 % CI: 1.23-2.67, respectively). No associations were found between mortality and AH and AHT. The ineffective treatment of arterial hypertension increased all-cause and CVD mortality by 1.9 and 2.5 times, respectively, but only among females. SBP > 160 mmHg and/or DBP > 100 mmHg was associated with 2.6 times (p = 0.020) greater risk of all-cause mortality. No associations were observed among the males. Conclusions: Elevated blood pressure, especially among those taking AHT, significantly increased the risk of all-cause and CVD mortality, but only among women. The results of the study warrant better blood pressure control in females aged 55 years and older with mandatory prescription of AHT.