National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China.
Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
Hypertens Res. 2024 Apr;47(4):959-969. doi: 10.1038/s41440-023-01499-1. Epub 2023 Nov 20.
Blood pressure(BP) of the longevous population with hypertension and/or frailty was under-investigated. To investigate the association between age, BP, variation of BP, and survival among the old adults with different status of hypertension and frailty, the present study included adults ≥65 years in the Chinese Longitudinal Healthy Longevity Survey (2008-2018), defined frailty using the Fried criteria, and identified hypertension by self-report or SBP/DBP ≥ 140/90 mm Hg. The association between age and BP were investigated using linear regression models. Variation of BP was defined if annual change of BP lower than quartile 1(sharp decrease) or higher than quartile 3(sharp increase). The association between age and BP variation were investigated using multinominal logistic regression models. The association between BP and survival was analyzed using Cox regression models. Among 13,447 adults (centenarian: 1965[14.6%]), age was positively associated with SBP in robust hypertensive elderly but negatively associated with it in frail hypertensive elderly. Annual change of BP was more likely to be increment among the normotensive elderly, but be decrement among the hypertensive elderly, especially among those with frailty. SBP < 120 mmHg was the risk factor of mortality among the frail oldest-old (≥85 years) while SBP ≥ 150 mmHg was that among the robust young-old (65-84 years). DBP ≥ 90 mmHg was the risk factor of mortality both in the robust young-old and the frail oldest old. In conclusion, age and frailty might be the criteria to predict the change of BP to guide the BP management of the longevous population.
血压(BP)在长寿人群中的高血压和/或虚弱状态下的研究较少。为了研究不同高血压和虚弱状态的老年人中年龄、BP、BP 变化与生存之间的关系,本研究纳入了中国长寿纵向研究(2008-2018 年)中≥65 岁的成年人,使用 Fried 标准定义虚弱,通过自我报告或 SBP/DBP≥140/90mmHg 确定高血压。使用线性回归模型研究年龄与 BP 的关系。如果 BP 的年度变化低于第 1 四分位数(急剧下降)或高于第 3 四分位数(急剧上升),则定义为 BP 变化。使用多项逻辑回归模型研究年龄与 BP 变化之间的关系。使用 Cox 回归模型分析 BP 与生存之间的关系。在 13447 名成年人(百岁老人:1965[14.6%])中,年龄与强壮的高血压老年人的 SBP 呈正相关,但与虚弱的高血压老年人的 SBP 呈负相关。在正常血压老年人中,BP 的年度变化更有可能增加,但在高血压老年人中,尤其是在虚弱的老年人中,BP 的年度变化更有可能减少。SBP<120mmHg 是虚弱最高龄老年人(≥85 岁)死亡的危险因素,而 SBP≥150mmHg 是强壮年轻老年人(65-84 岁)死亡的危险因素。DBP≥90mmHg 是强壮年轻老年人和虚弱最高龄老年人死亡的危险因素。总之,年龄和虚弱可能是预测 BP 变化的标准,以指导长寿人群的 BP 管理。