Blood pressure and mortality in elderly people aged 85 and older: community based study
Blood pressure and mortality in elderly people aged 85 and older: community based study
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DOI：
10.1136/bmj.316.7147.1780
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发表时间：
1998-06-13
影响因子：
105.7
通讯作者：
Ligthart, GJ
中科院分区：
文献类型：
--
作者：
Boshuizen, HC;Izaks, GJ;Ligthart, GJ
目的：确定是否可以通过调整健康状况来解释85岁以上老年人的血压与全死因死亡率之间的负相关关系，以及当考虑健康状况不良的影响时，高血压是否是死亡的危险因素。设计：对85岁及以上的社区居民进行5~7年的随访。地点：荷兰莱顿。研究对象：835名1987年至1989年间记录血压的受试者。主要观察指标：全因死亡率。结果：血压与全因死亡率呈负相关。对于舒张压粗年份，所有原因死亡率从舒张压<65 mm Hg者的88%(52/59)(95%可信区间79%至95%)降至舒张压<100 mm Hg者的59%(27/46)(44%至72%)。对于收缩压粗5年，全死因死亡率从收缩压<125 mm Hg组的85%(95/112)(78%~91%)下降到收缩压<200 mm Hg组的59%(13/22)(38%~78%)。在对健康状况较差的指标进行调整后，这一下降不再显著。调整年龄和性别后，血压与心血管疾病和卒中死亡无相关性，但在调整年龄、性别和不良健康指标后，舒张压与心血管疾病和卒中死亡呈正相关。结论：85岁以上老年人血压与全因死亡呈负相关，与健康状况有关。
Objective: To determine whether the inverse relation between blood pressure and all cause mortality in elderly people over 85 years of age can be explained by adjusting for health status, and to determine whether high blood pressure is a risk factor for mortality when the effects of poor health are accounted for.Design: 5 to 7 year follow up of community residents aged 85 years and older.Setting: Leiden, the Netherlands.Subjects: 835 subjects whose blood pressure was recorded between 1987 and 1989.Main outcome measure: All cause mortality.Results: An inverse relation between blood pressure and all cause mortality was observed. For diastolic blood pressure crude year all cause mortality decreased from 88% (52/59) (95% confidence interval 79% to 95%) in those with diastolic blood pressures < 65 mm Hg to 59% (27/46) (44% to 72%) in those with diastolic pressures > 100 mm Hg. For systolic blood pressure crude 5 year all cause mortality decreased from 85% (95/112) (78% to 91%) in those with systolic pressures < 125 mm Hg to 59% (13/22) (38% to 78%) in those with systolic pressures > 200 min Hg. This decrease was no longer significant after adjustment for indicators of poor health. No relation existed between blood pressure and mortality from cardiovascular causes or stroke after adjustment for age and sex, but after adjustment for age, sex, and indicators of poor health there was a positive relation between diastolic blood pressure and mortality from both cardiovascular causes and stroke.Conclusion: The inverse relation between blood pressure and all cause mortality in elderly people over 85 is associated with health status.