Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty
Objectives To investigate whether frailty modifies the association of systolic blood pressure (SBP) with cardiovascular mortality and all-cause mortality in community-dwelling older adults. Design A prospective cohort study. Setting A population-based study of nationally representative older Chinese...
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| Veröffentlicht in: | The Journal of nutrition, health & aging health & aging, 2022-10, Vol.26 (10), p.962-970 |
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| container_title | The Journal of nutrition, health & aging |
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| creator | Chen, C. L. Cai, A. P. Nie, Z. Q. Huang, Yuqing Feng, Yingqing |
| description | Objectives
To investigate whether frailty modifies the association of systolic blood pressure (SBP) with cardiovascular mortality and all-cause mortality in community-dwelling older adults.
Design
A prospective cohort study.
Setting
A population-based study of nationally representative older Chinese adults in a community setting.
Participants
This study included participants aged 65 years or older from the Chinese Longitudinal Healthy Longevity Survey 2002–2014 and followed up to 2018.
Measurements
Participants were divided into two groups according to a frailty index based on the accumulation of a 44-items deficits model. The association between SBP and mortality was analyzed using multivariable-adjusted Cox proportional hazards models.
Results
Among 18,503 participants included, the mean age was 87.2 years and the overall median follow-up time was 42.7 months. We identified 7808 (42.2%) frail participants (mean frailty index=0.33), in which 7533 (96.5%) died during the follow-up. Effect modification by frailty was detected (P for interaction=0.032). Among frail participants, a U-shaped association was found with hazard ratios of 1.16 (95% CI, 1.02–1.32) for SBP < 100 mmHg, and 1.11 (95% CI, 1.00–1.24) for SBP ≥ 150 mmHg compared with SBP 120–130 mmHg. For non-frail older adults, a tendency toward higher risk among those with SBP ≥ 130 mmHg was observed. The analyses towards cardiovascular mortality showed similar results.
Conclusion
Our results suggest the presence of effect modification by frailty indicating a possible negative effect for elevated SBP in non-frail older adults and a U-shaped relationship of SBP in frail older adults with respect to mortality even after adjusting for diastolic blood pressure. |
| doi_str_mv | 10.1007/s12603-022-1850-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2726407877</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2726407877</sourcerecordid><originalsourceid>FETCH-LOGICAL-c415t-91a206b7f5541985be3c8d89188c0544b4e5edd656bc156610b4268ee934635a3</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMoVqs_wIsEvHhZTbL5Wm9arQpKRetRwn5MdSW7qcku0n9vSquC4GlmyDNvhgehA0pOKCHqNFAmSZoQxhKqBUn4BtqhSsZGab0Ze6ayRCmiBmg3hHdCuMi03EaDVDKRCS120MvTInTO1iW-sM5V-MFDCL0HnLcVvne-y23dLXDd4pFrmr6NQ3L5CdbW7Sue2Ao8Pq9624UzPH0D_OgsYDfDY5_Xtlvsoa1ZbgPsr-sQPY-vpqOb5G5yfTs6v0tKTkWXZDRnRBZqJgSnmRYFpKWudEa1LongvOAgoKqkkEVJhZSUFJxJDZClXKYiT4foeJU79-6jh9CZpg5lvDJvwfXBMMUkJ0orFdGjP-i7630br1tSQnEpeRopuqJK70LwMDNzXze5XxhKzNK9Wbk30b1Zujc87hyuk_uigepn41t2BNgKCPGpfQX_-_X_qV-I8Yz_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2725746643</pqid></control><display><type>article</type><title>Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><source>SpringerLink Journals - AutoHoldings</source><creator>Chen, C. L. ; Cai, A. P. ; Nie, Z. Q. ; Huang, Yuqing ; Feng, Yingqing</creator><creatorcontrib>Chen, C. L. ; Cai, A. P. ; Nie, Z. Q. ; Huang, Yuqing ; Feng, Yingqing</creatorcontrib><description>Objectives
To investigate whether frailty modifies the association of systolic blood pressure (SBP) with cardiovascular mortality and all-cause mortality in community-dwelling older adults.
Design
A prospective cohort study.
Setting
A population-based study of nationally representative older Chinese adults in a community setting.
Participants
This study included participants aged 65 years or older from the Chinese Longitudinal Healthy Longevity Survey 2002–2014 and followed up to 2018.
Measurements
Participants were divided into two groups according to a frailty index based on the accumulation of a 44-items deficits model. The association between SBP and mortality was analyzed using multivariable-adjusted Cox proportional hazards models.
Results
Among 18,503 participants included, the mean age was 87.2 years and the overall median follow-up time was 42.7 months. We identified 7808 (42.2%) frail participants (mean frailty index=0.33), in which 7533 (96.5%) died during the follow-up. Effect modification by frailty was detected (P for interaction=0.032). Among frail participants, a U-shaped association was found with hazard ratios of 1.16 (95% CI, 1.02–1.32) for SBP < 100 mmHg, and 1.11 (95% CI, 1.00–1.24) for SBP ≥ 150 mmHg compared with SBP 120–130 mmHg. For non-frail older adults, a tendency toward higher risk among those with SBP ≥ 130 mmHg was observed. The analyses towards cardiovascular mortality showed similar results.
Conclusion
Our results suggest the presence of effect modification by frailty indicating a possible negative effect for elevated SBP in non-frail older adults and a U-shaped relationship of SBP in frail older adults with respect to mortality even after adjusting for diastolic blood pressure.</description><identifier>ISSN: 1279-7707</identifier><identifier>EISSN: 1760-4788</identifier><identifier>DOI: 10.1007/s12603-022-1850-4</identifier><identifier>PMID: 36259585</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Aged ; Aged, 80 and over ; Aging ; Blood pressure ; Blood Pressure - physiology ; Cardiovascular disease ; Cardiovascular Diseases ; Frail Elderly ; Frailty ; Geriatrics/Gerontology ; Health risks ; Humans ; Hypertension ; Independent Living ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Neurosciences ; Nutrition ; Older people ; Original Research ; Primary Care Medicine ; Prospective Studies ; Quality of Life Research</subject><ispartof>The Journal of nutrition, health & aging, 2022-10, Vol.26 (10), p.962-970</ispartof><rights>Serdi and Springer-Verlag International SAS, part of Springer Nature 2022</rights><rights>Serdi and Springer-Verlag International SAS, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-91a206b7f5541985be3c8d89188c0544b4e5edd656bc156610b4268ee934635a3</citedby><cites>FETCH-LOGICAL-c415t-91a206b7f5541985be3c8d89188c0544b4e5edd656bc156610b4268ee934635a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12603-022-1850-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12603-022-1850-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36259585$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, C. L.</creatorcontrib><creatorcontrib>Cai, A. P.</creatorcontrib><creatorcontrib>Nie, Z. Q.</creatorcontrib><creatorcontrib>Huang, Yuqing</creatorcontrib><creatorcontrib>Feng, Yingqing</creatorcontrib><title>Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty</title><title>The Journal of nutrition, health & aging</title><addtitle>J Nutr Health Aging</addtitle><addtitle>J Nutr Health Aging</addtitle><description>Objectives
To investigate whether frailty modifies the association of systolic blood pressure (SBP) with cardiovascular mortality and all-cause mortality in community-dwelling older adults.
Design
A prospective cohort study.
Setting
A population-based study of nationally representative older Chinese adults in a community setting.
Participants
This study included participants aged 65 years or older from the Chinese Longitudinal Healthy Longevity Survey 2002–2014 and followed up to 2018.
Measurements
Participants were divided into two groups according to a frailty index based on the accumulation of a 44-items deficits model. The association between SBP and mortality was analyzed using multivariable-adjusted Cox proportional hazards models.
Results
Among 18,503 participants included, the mean age was 87.2 years and the overall median follow-up time was 42.7 months. We identified 7808 (42.2%) frail participants (mean frailty index=0.33), in which 7533 (96.5%) died during the follow-up. Effect modification by frailty was detected (P for interaction=0.032). Among frail participants, a U-shaped association was found with hazard ratios of 1.16 (95% CI, 1.02–1.32) for SBP < 100 mmHg, and 1.11 (95% CI, 1.00–1.24) for SBP ≥ 150 mmHg compared with SBP 120–130 mmHg. For non-frail older adults, a tendency toward higher risk among those with SBP ≥ 130 mmHg was observed. The analyses towards cardiovascular mortality showed similar results.
Conclusion
Our results suggest the presence of effect modification by frailty indicating a possible negative effect for elevated SBP in non-frail older adults and a U-shaped relationship of SBP in frail older adults with respect to mortality even after adjusting for diastolic blood pressure.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases</subject><subject>Frail Elderly</subject><subject>Frailty</subject><subject>Geriatrics/Gerontology</subject><subject>Health risks</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Independent Living</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neurosciences</subject><subject>Nutrition</subject><subject>Older people</subject><subject>Original Research</subject><subject>Primary Care Medicine</subject><subject>Prospective Studies</subject><subject>Quality of Life Research</subject><issn>1279-7707</issn><issn>1760-4788</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kE1LAzEQhoMoVqs_wIsEvHhZTbL5Wm9arQpKRetRwn5MdSW7qcku0n9vSquC4GlmyDNvhgehA0pOKCHqNFAmSZoQxhKqBUn4BtqhSsZGab0Ze6ayRCmiBmg3hHdCuMi03EaDVDKRCS120MvTInTO1iW-sM5V-MFDCL0HnLcVvne-y23dLXDd4pFrmr6NQ3L5CdbW7Sue2Ao8Pq9624UzPH0D_OgsYDfDY5_Xtlvsoa1ZbgPsr-sQPY-vpqOb5G5yfTs6v0tKTkWXZDRnRBZqJgSnmRYFpKWudEa1LongvOAgoKqkkEVJhZSUFJxJDZClXKYiT4foeJU79-6jh9CZpg5lvDJvwfXBMMUkJ0orFdGjP-i7630br1tSQnEpeRopuqJK70LwMDNzXze5XxhKzNK9Wbk30b1Zujc87hyuk_uigepn41t2BNgKCPGpfQX_-_X_qV-I8Yz_</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Chen, C. L.</creator><creator>Cai, A. P.</creator><creator>Nie, Z. Q.</creator><creator>Huang, Yuqing</creator><creator>Feng, Yingqing</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20221001</creationdate><title>Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty</title><author>Chen, C. L. ; Cai, A. P. ; Nie, Z. Q. ; Huang, Yuqing ; Feng, Yingqing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-91a206b7f5541985be3c8d89188c0544b4e5edd656bc156610b4268ee934635a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular Diseases</topic><topic>Frail Elderly</topic><topic>Frailty</topic><topic>Geriatrics/Gerontology</topic><topic>Health risks</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Independent Living</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neurosciences</topic><topic>Nutrition</topic><topic>Older people</topic><topic>Original Research</topic><topic>Primary Care Medicine</topic><topic>Prospective Studies</topic><topic>Quality of Life Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, C. L.</creatorcontrib><creatorcontrib>Cai, A. P.</creatorcontrib><creatorcontrib>Nie, Z. Q.</creatorcontrib><creatorcontrib>Huang, Yuqing</creatorcontrib><creatorcontrib>Feng, Yingqing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of nutrition, health & aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, C. L.</au><au>Cai, A. P.</au><au>Nie, Z. Q.</au><au>Huang, Yuqing</au><au>Feng, Yingqing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty</atitle><jtitle>The Journal of nutrition, health & aging</jtitle><stitle>J Nutr Health Aging</stitle><addtitle>J Nutr Health Aging</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>26</volume><issue>10</issue><spage>962</spage><epage>970</epage><pages>962-970</pages><issn>1279-7707</issn><eissn>1760-4788</eissn><abstract>Objectives
To investigate whether frailty modifies the association of systolic blood pressure (SBP) with cardiovascular mortality and all-cause mortality in community-dwelling older adults.
Design
A prospective cohort study.
Setting
A population-based study of nationally representative older Chinese adults in a community setting.
Participants
This study included participants aged 65 years or older from the Chinese Longitudinal Healthy Longevity Survey 2002–2014 and followed up to 2018.
Measurements
Participants were divided into two groups according to a frailty index based on the accumulation of a 44-items deficits model. The association between SBP and mortality was analyzed using multivariable-adjusted Cox proportional hazards models.
Results
Among 18,503 participants included, the mean age was 87.2 years and the overall median follow-up time was 42.7 months. We identified 7808 (42.2%) frail participants (mean frailty index=0.33), in which 7533 (96.5%) died during the follow-up. Effect modification by frailty was detected (P for interaction=0.032). Among frail participants, a U-shaped association was found with hazard ratios of 1.16 (95% CI, 1.02–1.32) for SBP < 100 mmHg, and 1.11 (95% CI, 1.00–1.24) for SBP ≥ 150 mmHg compared with SBP 120–130 mmHg. For non-frail older adults, a tendency toward higher risk among those with SBP ≥ 130 mmHg was observed. The analyses towards cardiovascular mortality showed similar results.
Conclusion
Our results suggest the presence of effect modification by frailty indicating a possible negative effect for elevated SBP in non-frail older adults and a U-shaped relationship of SBP in frail older adults with respect to mortality even after adjusting for diastolic blood pressure.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>36259585</pmid><doi>10.1007/s12603-022-1850-4</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 1279-7707 1760-4788 |
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| source | MEDLINE; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Aging Blood pressure Blood Pressure - physiology Cardiovascular disease Cardiovascular Diseases Frail Elderly Frailty Geriatrics/Gerontology Health risks Humans Hypertension Independent Living Medicine Medicine & Public Health Middle Aged Mortality Neurosciences Nutrition Older people Original Research Primary Care Medicine Prospective Studies Quality of Life Research |
| title | Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty |
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