Blood pressure and survival in the oldest old
Blood pressure and survival in the oldest old
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DOI：
10.1111/j.1532-5415.2007.01069.x
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发表时间：
2007-03-01
影响因子：
6.3
通讯作者：
Borzecki, Ann M.
中科院分区：
文献类型：
--
作者：
Oates, Daniel J.;Berlowitz, Dan R.;Borzecki, Ann M.
目的：目的：探讨80岁及以上高血压患者血压（BP）与全因死亡率之间的关系。设计：回顾性队列研究，随访5年。地点：10个退伍军人事务部（VA）站点。参与者：4071例80岁及以上高血压患者。从VA和社会保障档案中获得生命状态。在考克斯回归模型中收集的用于校正的变量是基线BP、药物、人口统计学、诊断和健康相关的生活质量（HRQoL）; HRQoL信息可基于退伍军人健康研究简表-36（SF-36）问卷评分在1，289名受试者中获得。与血压较低的受试者相比，血压较高的受试者（收缩压（SBP）高达139 mmHg，舒张压（DBP）高达89 mmHg）在随访期间死亡的可能性较小。基线调整后，SBP升高10分的风险比为0.82（95%置信区间（CI）=0.74-0.91），最高SBP为139 mmHg，DBP升高10分的风险比为0.85（95% CI=0.78-0.92），最高DBP为89 mmHg。生存率和血压水平之间没有显着的关联与不受控制的高血压。结论：在一个队列中的非常老，高血压的退伍军人，在受试者与控制的血压，血压水平较低的受试者有一个较低的5年生存率比那些血压较高。这表明临床医生在该年龄组中降低血压的方法应谨慎。
OBJECTIVES: To determine the relationship between blood pressure (BP) and all-cause mortality in subjects aged 80 and older with hypertension.DESIGN: Retrospective cohort study with 5 years of follow-up.SETTING: Ten Veterans AFFAIRS (VA) sites.PARTICIPANTS: Four thousand seventy-one ambulatory patients aged 80 and older with hypertension.MEASUREMENTS: The outcome measure was likelihood of survival during the follow-up period. Vital status was obtained from VA and Social Security files. Variables collected for adjustment in Cox regression models were baseline BP, medications, demographics, diagnoses, and health-related quality of life (HRQoL); HRQoL information was available on 1,289 subjects based on Veterans Health Study Short From-36 (SF-36) questionnaire scores.RESULTS: Subjects with higher BP (up to a systolic BP (SBP) of 139 mmHg and a diastolic BP (DBP) of 89 mmHg) were less likely to die during follow-up than subjects with lower BP. After baseline adjustments, the hazard ratio for a 10-point increase in SBP was 0.82 (95% confidence interval (CI)=0.74-0.91), up to a SBP of 139 mmHg, and for DBP was 0.85 (95% CI=0.78-0.92), up to a DBP of 89 mmHg. There was no significant association between survival and BP levels in subjects with uncontrolled hypertension.CONCLUSION: In a cohort of very old, hypertensive veterans, in subjects with controlled BPs, subjects with lower BP levels had a lower 5-year survival than those with higher BPs. This suggests that clinicians should use caution in their approach to BP lowering in this age group.