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- Title
Low blood pressure predicts increased mortality in very old age even without heart failure: the Leiden 85-plus Study.
- Authors
Poortvliet, Rosalinde K.E.; Blom, Jeanet W.; Craen, Anton J.M.; Mooijaart, Simon P.; Westendorp, Rudi G.J.; Assendelft, Willem J.J.; Gussekloo, Jacobijn; Ruijter, Wouter
- Abstract
Aims To investigate whether low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects without heart failure, defined by low levels of NT-proBNP, as well as in 90-year-old subjects with high levels of NT-proBNP. Methods and results This study was embedded in the Leiden 85-plus Study, an observational population-based prospective study. All 90-year-old participants (n = 267) were included between 2002 and 2004 and followed up for mortality for at least 5 years. Differences in mortality risks were compared between participants with low systolic blood pressure (≤150 mmHg) and high systolic blood pressure (>150 mmHg) within strata of low NT-proBNP (<284 pg/mL for women and <306 pg/mL for men = lowest tertile) vs. high NT-proBNP (middle and highest tertile) at age 90 years. During maximal follow-up of 7.2 years, 212 participants (79%) died. Among participants with low NT-proBNP, low systolic blood pressure gave a two-fold increased risk (hazard ratio 2.0, 95% confidence interval 1.1–3.4) compared with participants with high systolic blood pressure. For participants with high NT-proBNP, low systolic blood pressure provided a 1.7 increased mortality risk (95% confidence interval 1.2–2.3) compared with high systolic blood pressure. Conclusion Low systolic blood pressure is predictive for increased mortality risk in 90-year-old subjects, irrespective of the NT-proBNP level. Therefore, the absence or presence of heart failure as determined by NT-proBNP does not influence the prognostic value of low systolic blood pressure with regard to mortality in the oldest old.
- Subjects
HYPOTENSION; MORTALITY; OLD age; HEART failure; SYSTOLIC blood pressure; FOLLOW-up studies (Medicine); LONGITUDINAL method
- Publication
European Journal of Heart Failure, 2013, Vol 15, Issue 5, p528
- ISSN
1388-9842
- Publication type
Article
- DOI
10.1093/eurjhf/hfs203