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. 2012 Sep;67(9):977-83.
doi: 10.1093/gerona/glr245. Epub 2012 Mar 1.

The association of blood pressure and mortality differs by self-reported walking speed in older Latinos

Michelle C Odden  1 , Kenneth E Covinsky, John M Neuhaus, Elizabeth R Mayeda, Carmen A Peralta, Mary N Haan
Affiliations

The association of blood pressure and mortality differs by self-reported walking speed in older Latinos

Michelle C Odden et al. J Gerontol A Biol Sci Med Sci. 2012 Sep.

Abstract

Background: In some older adults, higher blood pressure (BP) is associated with a lower risk of mortality. We hypothesized that higher BP would be associated with greater mortality in high-functioning elders and lower mortality in elders with lower functional status.

Methods: Participants were 1,562 Latino adults aged 60-101 years in the Sacramento Area Latino Study on Aging. Functional status was measured by self-reported walking speed, and BP was measured by automatic sphygmomanometer. Death information was determined from vital statistics records.

Results: There were 442 deaths from 1998 to 2010; 53% were cardiovascular. Mean BP levels (mmHg) varied across fast, medium, and slow walkers: 136, 139, and 140 mmHg (systolic), p = .02 and 75, 76, and 77 mmHg (diastolic), p = .08, respectively. The relationship between systolic BP and mortality varied by self-reported walking speed: The adjusted hazard ratio for mortality in slow walkers was 0.96 per 10 mmHg higher systolic BP (95% confidence interval: 0.89, 1.02) and 1.29 (95% confidence interval: 1.08, 1.55) in fast walkers (p value for interaction <.001). We found a similar pattern for diastolic BP, although the interaction did not reach statistical significance; the adjusted hazard ratio per 10 mmHg higher diastolic BP was 0.89 (95% confidence interval: 0.78, 1.02) in slow walkers and 1.20 (95% confidence interval: 0.82, 1.76) in fast walkers (p value for interaction = .06).

Conclusions: In high-functioning older adults, elevated systolic BP is a risk factor for all-cause mortality. If confirmed in other studies, the assessment of functional status may help to identify persons who are most at-risk for adverse outcomes related to high BP.

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Figures

Figure 1.
Figure 1.
Kaplan–Meier plot of all-cause mortality, stratified by self-reported walking speed. Study visits were conducted every 12–15 months.
Figure 2.
Figure 2.
The association of high systolic blood pressure (>160 mmHg) with all-cause mortality differs in older Latino adults with self-reported slow, medium, and fast walking speed. This association was assessed in a Cox proportional hazards model, adjusted for age, gender, cognitive function, creatinine, interleukin-6, and diabetes medication use. The overall p value for interaction between high systolic blood pressure and walking speed was .10.
See this image and copyright information in PMC

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