Document Detail

Evidence for a positive linear relation between blood pressure and mortality in elderly people.
MedLine Citation:
PMID:  7898229     Owner:  NLM     Status:  MEDLINE    
Many studies of blood pressure in the elderly have found higher death rates in groups with the lowest blood pressure than in those with intermediate values. In a large community study, we examined whether these findings are real or artifacts of short follow-up, co-morbidity, or low blood pressure in people near death. In 1982-83, we assessed drug use, medical history, disability, physical function, and blood pressure in 3657 residents of East Boston, Massachusetts, aged 65 and older. We identified all deaths (1709) up to 1992 and followed up survivors for an average of 10.5 (range 9.5-11.0) years. After adjustment for confounding variables (including frailty and disorders such as congestive heart failure and myocardial infarction) and exclusion of deaths within the first 3 years of follow-up, higher systolic pressure predicted linear increases in cardiovascular (p < 0.0001) and total (p < 0.0007) mortality. Higher diastolic pressure predicted increases in cardiovascular (p = 0.006) but not total (p = 0.48) mortality. These results differed from those for the first 3 years, during which groups with the lowest systolic and diastolic pressures had the highest death rates. In the long term, lower blood pressure in old age, as in middle age, is associated with better survival. Short-term findings may differ because of associations of co-morbidity and frailty with blood pressure near death. Overall, the findings support recommendations to treat high blood pressure in elderly people.
R J Glynn; T S Field; B Rosner; P R Hebert; J O Taylor; C H Hennekens
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Lancet     Volume:  345     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-04-27     Completed Date:  1995-04-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  825-9     Citation Subset:  AIM; IM    
Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA.
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MeSH Terms
Blood Pressure*
Boston / epidemiology
Cardiovascular Diseases / mortality
Cohort Studies
Confounding Factors (Epidemiology)
Hypertension / drug therapy,  physiopathology
Proportional Hazards Models
Grant Support
Comment In:
Lancet. 1995 Jun 3;345(8962):1433-4; author reply 1435   [PMID:  7760619 ]
Lancet. 1995 Jun 3;345(8962):1434; author reply 1435   [PMID:  7760620 ]
ACP J Club. 1995 Nov-Dec;123(3):82
Lancet. 1995 Jun 3;345(8962):1434-5   [PMID:  7760621 ]

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