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Pulse blood pressure and cardiovascular mortality in a population-based cohort of elderly Costa Ricans.
Rosero-Bixby, L; Coto-Yglesias, F; Dow, W H.
Affiliation
  • Rosero-Bixby L; Centro Centroamericano de Población (CCP), Universidad de Costa Rica, San Pedro, Costa Rica.
  • Coto-Yglesias F; School of Public Health, the University of California, Berkeley, CA, USA.
  • Dow WH; Servicio de Geriatría, Hospital Nacional de Geriatría y Gerontología, San José, Costa Rica.
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.
Subject(s)

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

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