Walking speed and high blood pressure mortality risk in a Spanish elderly population

Abstract

This study analyzed the relationship between blood pressure and all-cause mortality according to objectively measured walking speed in a Mediterranean population-based sample of older persons. We used data from the longitudinal 'Peñagrande' Cohort Study, initiated in 2008 in a sex- and age-stratified random sample of 1250 people aged ⩾65 years living in Madrid (Spain). A total of 814 individuals participated in the first study wave. The average of two standardized blood pressure readings was used. Walking speed was measured over a 3-m walk and classified as faster (⩾0.8 m s(-1)) or slower. A total of 314 individuals were slower walkers, 475 were faster walkers and 25 did not complete the walk test. Cox proportional hazards models stratified by walking speed were used to assess the association between blood pressure and all-cause death. Non-linear relationship between BP and mortality was explored by a restricted cubic spline analysis. There were 171 deaths from study entry through 31 March 2013. Systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mmHg were associated with higher mortality than blood pressure values above 140 and 90 mm Hg, respectively, but this association reached statistical significance only for systolic blood pressure and only in the slower walkers. In conclusion, systolic blood pressure levels <140 mm Hg were found associated with higher risk of total mortality among slower walkers in an old Spaniard population cohort.

Functional Status Modifies the Association of Blood Pressure with Death in Elders: Health and Retirement Study

“…Our findings are consistent with prior studies showing that the association of high BP with CV events and mortality was attenuated or inverted in elders with poor functional status . We extended previous research by examining the role of grip strength, an indicator of overall body strength and physical function, in the association of BP with death.…”

“…Our findings are consistent with prior studies showing that the association of high BP with CV events and mortality was attenuated or inverted in elders with poor functional status. 26,27,[33][34][35][36]38 We extended previous research by examining the role of grip strength, an indicator of overall body strength and physical function, 28 in the association of BP with death. Our findings suggest, compared to gait speed, grip strength may be a better marker of functional status in identifying subgroups of older adults in whom low BP is potentially beneficial.…”

Is treated hypertension associated with a lower one-year mortality among older residents of long-term care facilities with multimorbidity?

“…Frailty status is probably the most important factor modifying the relationship between blood pressure and outcomes of both observational studies among the community and institutionalized geriatric populations [8][9][10][21][22][23]. Longitudinal analysis of primary care electronic health record data for a large cohort of community-dwelling octogenarians in the United Kingdom found that mortality rates increased with frailty category [24].…”

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels

“…Studies on physical strength factors have demonstrated that the incidence of diabetes is highly related to reduced skeletal muscle mass 42 and that elderly individuals with diabetes have weak grip strength 43, 44 . In addition, there is an association between elderly individuals with hypertension and slow gait speed 45,46 . In Korea, elderly individuals with hypertension and diabetes have been shown to have weak grip strength 9,47 .…”