Pulse blood pressure and cardiovascular mortality in a population-based cohort of elderly Costa Ricans.
J Hum Hypertens
; 30(9): 555-62, 2016 09.
Article
in En
| MEDLINE
| ID: mdl-26674758
UNLABELLED: We studied the relationships between blood pressure (BP), pulse pressure (PP) and cardiovascular (CV) death in older adults using data from 2346 participants enrolled in the Costa Rican CRELES study, mean age 76 years (s.d. 10.2), 31% qualified as wide PP. All covariates included and analyzed were collected prospectively as part of a 4-year home-based follow-up; mortality was tracked for an additional 3 years, identifying 266 CV deaths. Longitudinal data revealed little change over time in systolic BP (SBP), a decline in diastolic BP, and widening of PP. Wide PP was associated with higher risk of CV death but only among individuals receiving antihypertensive drug therapy. Individuals with both wide PP and receiving therapy had 2.6 hazard rate of CV death relative to people with normal-PP plus not taking treatment (TRT), even adjusting for SBP. Increasing PP between visits was significantly associated to higher CV death independently of TRT status. SBP and DBP were not significantly associated to CV death when the effect of PP was controlled for. CONCLUSION: elderly hypertensive patients with wide or increasing PP, especially if receiving TRT, are the highest CV risk group, thus must be carefully assessed, monitored and treated with caution.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Blood Pressure
/
Hypertension
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America central
/
Costa rica
Language:
En
Journal:
J Hum Hypertens
Journal subject:
ANGIOLOGIA
Year:
2016
Document type:
Article
Affiliation country:
Costa Rica
Country of publication:
United kingdom