Correlates of blood pressure in community-dwelling older adults. The Cardiovascular Health Study. Cardiovascular Health Study (CHS) Collaborative Research Group.

Abstract

Although elevated blood pressure is an important predictor of cardiovascular disease and stroke in the elderly, little information exists on the distribution and risk factor correlates of blood pressure in this group. As part of the Cardiovascular Health Study, a population-based cohort study of 5201 men and women aged 65 to 101 years, we investigated correlates of systolic and diastolic blood pressure. Multiple regression analyses were conducted for all participants and a subgroup of 2482 without coronary heart disease and not on antihypertensive therapy (the "healthier" subgroup). In the total group, independent predictors of diastolic blood pressure included heart rate, aortic root dimension, creatinine, hematocrit, alcohol use, and black race (positive associations) and internal carotid artery wall thickness, mitral early/late peak flow velocity, white blood cell count, cigarette smoking, and age (negative associations). Positive predictors of systolic blood pressure included mitral late peak flow velocity, left ventricular mass, common carotid artery wall thickness, serum albumin, factor VII, diabetes, alcohol use, and age; negative predictors were coronary heart disease, uric acid, height, and smoking. In the healthier subgroup, positive predictors of diastolic blood pressure included heart rate, hematocrit, serum albumin, creatinine, and body weight, whereas mitral early/ late peak flow velocity, serum potassium, smoking, and age inversely related to diastolic pressure. For the same group, common carotid artery wall thickness, left ventricular mass, serum albumin, factor VII, high-density lipoprotein cholesterol, and age were directly related to systolic blood pressure, whereas serum potassium was inversely related. Both systolic and diastolic pressures varied considerably by geographic site. Thus, in the elderly blood pressure is associated with a variety of factors as previously reported in younger populations and also with cardiovascular disease status, subclinical disease, and several blood chemistry variables not previously reported. and diastolic blood pressure (DBP) have been established as independent risk factors for increased morbidity and mortality from cardiac failure, cerebral arterial hemorrhage or occlusion, aortic aneurysms, coronary heart disease (CHD), and renal failure in both middle-aged and older adults. that of 1990, the magnitude of the problem of hypertension in the elderly is expected to increase.It is important to delineate the distribution and determinants of BP in older adults so that appropriate strategies for further research in the prevention of morbidity and mortality can be developed. Furthermore, because most current information on the association between elevated BP and other risk factors and abnormalities has been obtained in middle-aged populations, their significance in older adults needs further elaboration. For example, left ventricular hypertrophy (LVH) is a major complication of hypertension, and the probability of sudden death increases manyfold in hyper...

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease

“…237 In the Cardiovascular Health Study, the severity of carotid artery stenosis was greater in current smokers than in former smokers, and there was a significant relationship between the severity of carotid stenosis and pack-years of exposure to tobacco. 239 The RRs of finding Ͼ60% carotid stenosis were 1.5 and 3.9 among cigarette smokers with cerebral ischemia in the NOMASS and the BCID (Berlin Cerebral Ischemia Databank) studies, respectively. 258 The relationship between cholesterol and ischemic stroke is not as evident as that between cholesterol and MI, and findings from population-based studies are inconsistent.…”

Prevalence and factors affecting hypertension among old age population in rural area

“…DBP has been shown to decrease in old age whereas SBP continues to rise leading to an increasing prevalence of isolated systolic hypertension and an increasing PP. 5,6,[8][9][10]12,13 The blood pressure changes in old age can be attributed to stiffening of large, central, arteries, encompassing vessel wall changes such as increased amounts of collagen, decreased content and increased destruction of the elastic protein elastin, calcification and possibly also to alterations in vascular smooth muscle tone. 14,15 Hypertension is a threat to life at all ages and both sexes, it is one of the leading cardiovascular disorders and important risk factor for coronary artery diseases, cerebrovascular diseases and cardiac failure in elderly patient.…”

Determinants and significance of declining blood pressure in old age. A prospective birth cohort study

“…Longitudinal and cross-sectional studies have shown that systolic blood pressure increases and diastolic pressure may decrease with advancing age in Western societies [1][2][3][4][5][6] , while in primitive, isolated populations blood pressure does not change after childhood or adolescence [5] . On the other hand, some longitudinal and cross-sectional studies have indicated that on their own systolic blood pressure or diastolic blood pressure, or both systolic blood pressure and diastolic blood pressure can be low or decrease in old age [1,3,[7][8][9][10][11][12] .…”