Home Blood Pressure Is Associated with Depressive Symptoms in an Elderly Population Aged 70 Years and Over: A Population-Based, Cross-Sectional Analysis

Niu, Kaijun; Hozawa, Atsushi; Awata, Shuichi; Guo, Hui; Kuriyama, Shinichi; Seki, Toru; Ohmori-Matsuda, Kaori; Nakaya, Naoki; Ebihara, Satoru; Wang, Yun; Tsuji, Ichiro; Nagatomi, Ryoichi

doi:10.1291/hypres.31.409

Cited by 34 publications

(44 citation statements)

References 37 publications

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“…Hospitalized, institutionalized, incapacitated, or demented patients were excluded from recruitment. The analysis included 144 (untreated/treated, 106/38) residents of Ohasama, Japan 21 ; 137 (75/62) inhabitants of the Tsurugaya district in Sendai, Japan 22 ; 36 (21/15) inhabitants of Didima, Greece 23 ; and 58 treated outpatients of a general hospital in Buenos Aires, Argentina. 24 All studies received ethical approval.…”

Section: Study Populationmentioning

confidence: 99%

“…Office blood pressure was the average of 2 readings obtained with a standard mercury sphygmomanometer, 23 or with an automated auscultatory 21 or oscillometric device, 22,24 using the appropriate cuff size. All home blood pressure measurements were performed in the sitting position with a validated oscillometric device, [21][22][23][24] using the appropriate cuff size.…”

Section: Collection Of the Baseline Datamentioning

confidence: 99%

“…All home blood pressure measurements were performed in the sitting position with a validated oscillometric device, [21][22][23][24] using the appropriate cuff size. The average of all available home measurements was used in the analysis.…”

Section: Collection Of the Baseline Datamentioning

confidence: 99%

“…We obtained information on each participant's medical history, use of medications, and smoking and drinking habits by means of questionnaires [21][22][23] or checking hospital files. 24 The Expanded Methods in the online only Data Supplement provide information on the collection of anthropometric and biochemical data.…”

Section: Collection Of the Baseline Datamentioning

confidence: 99%

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Defining Thresholds for Home Blood Pressure Monitoring in Octogenarians

et al. 2015

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To generate outcome-driven thresholds for home blood pressure (BP) in the elderly, we analyzed 375 octogenarians (60.3% women; 83.0 years [mean]) enrolled in the International Database on home BP in relation to cardiovascular outcome. Over 5.5 years (median), 155 participants died, 76 from cardiovascular causes, whereas 104, 55, 36, and 51 experienced a cardiovascular, cardiac, coronary, or cerebrovascular event, respectively. In 202 untreated participants, home diastolic in the lowest fifth of the distribution (≤65.1 mm Hg) compared with the multivariable-adjusted average risk was associated with increased risk of cardiovascular mortality and morbidity (hazard ratios [HRs], ≥1.96; P ≤0.022), whereas the HR for cardiovascular mortality in the top fifth (≥82.0 mm Hg) was 0.37 ( P =0.034). Among 173 participants treated for hypertension, the HR for total mortality in the lowest fifth of systolic home BP (<126.9 mm Hg) was 2.09 ( P =0.020). In further analyses of home BP as continuous variable (per 1-SD increment), higher diastolic BP predicted lower cardiovascular mortality and morbidity and cardiac and coronary risk (HR≤0.65; P ≤0.039) in untreated participants. In those treated, cardiovascular morbidity was curvilinearly associated with systolic home BP with nadir at 148.6 mm Hg and with a 1.45 HR ( P =0.046) for a 1-SD decrease below this threshold. In conclusion, in untreated octogenarians, systolic home BP ≥152.4 and diastolic BP ≤65.1 mm Hg entails increased cardiovascular risk, whereas diastolic home BP ≥82 mm Hg minimizes risk. In those treated, systolic home BP <126.9 mm Hg was associated with increased total mortality with lowest risk at 148.6 mm Hg.

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Section: Study Populationmentioning

confidence: 99%

Section: Collection Of the Baseline Datamentioning

confidence: 99%

Section: Collection Of the Baseline Datamentioning

confidence: 99%

Section: Collection Of the Baseline Datamentioning

confidence: 99%

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Defining Thresholds for Home Blood Pressure Monitoring in Octogenarians

et al. 2015

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“…24 In the 1990s the British Medical Journal published a series of articles describing the association between low BP and mood disorders in the general population. 8,9,25,26 The findings indicate that individuals with chronic hypotension have significantly increased incidence of depression, 8,[27][28][29][30][31][32][33] anxiety, 28, 29 unexplained tiredness, 8,9 and poor perception of well-being compared to matched-normotensive controls. 25 More recently we conducted focus group sessions in individuals with SCI and clinical care providers and found that both patients and clinicians were able to ascribe adverse effects of persistent asymptomatic hypotension on health related quality of life in those with SCI.…”

Section: Discussionmentioning

confidence: 86%

Orthostatic responses to anticholinesterase inhibition in spinal cord injury

et al. 2015

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Acetylcholine (Ach) is the pre-synaptic neurotransmitter of the sympathetic nervous system. Increased pre-synaptic Ach may augment post-synaptic release of norepinephrine thereby increasing systemic blood pressure (BP). The primary objective of this investigation was to determine the hemodynamic effect of pyridostigmine bromide (PYRIDO: 60 mg), an Ach inhibitor (AchI), compared to no-drug (NO-D) during head-up tilt (HUT) in individuals with spinal cord injury (SCI). Secondarily we aimed to determine the effects of PYRIDO compared to NO-D on symptoms of orthostatic intolerance (OI) and adverse event reporting (AE). Ten individuals with SCI (C4-C7) were studied on 2 occasions: visit 1) NO-D and visit 2) PYRIDO. On each visit subjects underwent a progressive HUT maneuver to 15°, 25°, 35° for 5 minutes at each angle and 45 minutes at 45°. Supine and orthostatic heart rate (HR), systolic and diastolic BP (SBP & DBP) were monitored and symptoms of OI and AE recorded. Supine hemodynamics did not differ between the trials. The significant fall in SBP during the NO-D trial was diminished with PYRIDO and five subjects had an increased DBP during HUT with PYRIDO compared to the NO-D trial. Individuals that responded to PYRIDO with an increase in orthostatic BP had significantly lower resting HR than non-responders (p<0.01), which suggests increased levels of pre-synaptic Ach. Subjective symptoms of OI and AE reporting did not differ between the two trials. These preliminary data suggest that PYRIDO is safe and may be effective at ameliorating the orthostatic fall in BP in select individuals with SCI.

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