Mildly elevated blood pressure is a marker for better health status in Polish centenarians

Abstract

The number of centenarians is projected to rise rapidly. However, knowledge of evidence-based health care in this group is still poor. Hypertension is the most common condition that leads to multiple organ complications, disability, and premature death. No guidelines for the management of high blood pressure (BP) in centenarians are available. We have performed a cross-sectional study to characterize clinical and functional state of Polish centenarians, with a special focus on BP. The study comprised 86 consecutive 100.9 ± 1.2 years old (mean ± SD) subjects (70 women and 16 men). The assessment included structured interview, physical examination, geriatric functional assessment, resting electrocardiography, and blood and urine sampling. The subjects were followed-up on the phone. Subjects who survived 180 days (83 %) as compared to non-survivors had higher systolic BP (SBP), diastolic BP (DPB), mean arterial pressure (MAP), pulse pressure (PP), higher mini-mental state examination, Barthel Index of Activities of Daily Living and Lawton Instrumental Activities of Daily Living Scale scores, higher serum albumin and calcium levels, and total iron-binding capacity, while lower serum creatinine, cystatin C, folate, and C-reactive protein levels. SBP ≥140 mm Hg, DBP ≥90 mm Hg, MAP ≥100 mm Hg, and PP ≥40 mm Hg were associated with higher 180-day survival probability. Results suggest that mildly elevated blood pressure is a marker for better health status in Polish centenarians.

Fig. 1

Individuals with SBP ≥140 mm Hg had higher 180-day survival probability (p = 0.007), similar to those with DBP ≥90 mm Hg (p = 0.046), MAP ≥100 mm Hg (p = 0.011), and PP ≥40 mm Hg (p < 0.001). a Systolic blood pressure. b Diastolic blood pressure. c Mean arterial pressure. d Pulse pressure

Fig. 2

Inverted-U-shaped relationships, according to the second-degree polynomial pattern between MMSE score and SBP, Barthel Index and SBP, MMSE score and MAP, as well as Barthel Index and MAP were revealed. a MMSE score vs. SBP. b MMSE score vs. MAP. c Barthel Index vs. SBP. d Barthel Index vs. MAP

Fig. 3

Linear correlation (first-degree polynomial approximation) was the best adjusted model to describe the relationship between MMSE score and DBP, as well as between Barthel Index and DBP, while inverted-U-shaped relationships (second-degree polynomial pattern) between MMSE score and PP as well as Barhel Index and PP were revealed. a MMSE score vs. DBP. b MMSE score vs. PP. c Barthel Index vs. DBP. d Barthel Index vs. PP